Best Medicare Companies in Suffern, New York (2024)
Find the leading Medicare companies in Suffern, New York offering comprehensive coverage and expert advice. Compare plans, explore affordable options, and make informed decisions for your healthcare needs. Trust our reliable resources to navigate the complexities of Medicare, ensuring you receive the best possible care and financial protection.
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Daniel Walker
Licensed Insurance Agent
Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years (BBB A+). He is licensed as an agent to write property and casualty insurance, including home, life, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. He reviews content, ensuring tha...
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UPDATED: Sep 15, 2024
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UPDATED: Sep 15, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.
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UPDATED: Sep 15, 2024Fact Checked
The Rundown
- Health insurance companies like UnitedHealthcare and EmblemHealth offer Medicare Advantage plans in Suffern
- Suffern, New York, Medicare supplement plans follow the New York standards for coverage
- Suffern Medicare supplement can only be added to original Medicare
Welcome to our comprehensive guide on Medicare companies in Suffern, New York. If you’re seeking reliable coverage and expert advice for your healthcare needs, you’ve come to the right place.
In this article, we will explore the top Medicare companies in Suffern, providing you with valuable information on their coverage options, affordability, and customer satisfaction. We’ll discuss the key topics such as plan comparison, navigating the complexities of Medicare, and finding the best options to suit your unique requirements.
To make an informed decision and secure the best rates, simply enter your ZIP code below and compare rates from the top insurance providers in your area. Take control of your healthcare today and ensure you have the coverage that meets your needs.
Medicare Advantage by Company in Suffern, New York
There are Medicare Advantage companies in Suffern, NY, offering a range of options including HMO and PPO plans. There are even some plans available at no additional cost beyond your Suffern Medicare Part B premium. Take a look at the Medicare Advantage companies in Suffern, New York, to compare plans and coverage.
Read More: Best Medicare Advantage Providers
Medicare Advantage Companies in Suffern, New York
| Plan Name | Monthly Prem. (Parts C & D) | Deductible | Additional Gap Coverage | Preferred Pharmacy Copay/ Coinsurance 30-Day Supply | MOOP for Part A & B Benefits |
|---|---|---|---|---|---|
| AARP Medicare Advantage Patriot (HMO) – H3307-018-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
| AARP Medicare Advantage Plan 1 (HMO) – H3307-012-0 | $0.00 | $395 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% | $6,700 |
| AARP Medicare Advantage Plan 2 (HMO) – H3307-023-0 | $75.00 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $6,700 |
| Aetna Medicare Assure Plan (HMO D-SNP) – H3312-069-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% | n/a |
| Aetna Medicare Eagle Plan (PPO) – H5521-320-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
| Aetna Medicare Elite Plan (PPO) – H5521-120-0 | $0.00 | $250 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $7,550 |
| Aetna Medicare Elite Plan 2 (PPO) – H5521-309-0 | $39.00 | $300 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $7,550 |
| Aetna Medicare Premier Plan (PPO) – H5521-121-0 | $76.00 | $250 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $7,550 |
| Aetna Medicare Value Plan (HMO) – H3312-018-0 | $59.00 | $250 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $7,550 |
| Centers Plan for Medicaid Advantage Plus (HMO D-SNP) – H6988-004-0 | $58.70 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 | n/a |
| Centers Plan for Medicare Advantage Care (HMO) – H6988-001-0 | $0.00 | $395 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Brand: $100.00, Specialty Tier: 25% | $7,550 |
| Centers Plan for Nursing Home Care (HMO I-SNP) – H6988-003-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
| Elderplan Advantage For Nursing Home Residents (HMO I-SNP) – H3347-003-0 | $35.50 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | n/a |
| Elderplan Assist (HMO I-SNP) – H3347-015-0 | $42.30 | $445 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: 25%, Specialty Tier: 25% | n/a |
| Elderplan Plus Long Term Care (HMO D-SNP) – H3347-007-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
| EmblemHealth VIP Dual (HMO D-SNP) – H3330-042-3 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
| EmblemHealth VIP Dual Select (HMO D-SNP) – H5991-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
| EmblemHealth VIP Essential (HMO) – H3330-032-4 | $68.00 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $7,550 |
| EmblemHealth VIP Go (HMO-POS) – H3330-041-1 | $72.00 | $250 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 28% | $7,550 |
| EmblemHealth VIP Gold (HMO) – H3330-021-4 | $243.00 | $200 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $40.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% | $7,550 |
| EmblemHealth VIP Gold Plus (HMO) – H3330-038-0 | $302.00 | $200 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $40.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% | $7,550 |
| EmblemHealth VIP Part B Saver (HMO) – H3330-040-0 | $0.00 | $445 . Tier 1 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25% | $7,550 |
| EmblemHealth VIP Passport (HMO) – H5991-003-0 | $42.30 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $7,550 |
| EmblemHealth VIP Rx Saver (HMO) – H3330-039-1 | $49.00 | $395 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25% | $7,550 |
| EmblemHealth VIP Solutions (HMO D-SNP) – H5991-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15%, Tier 2: 15%, Tier 3: 15%, Tier 4: 15%, Tier 5: 15% | n/a |
| EmblemHealth VIP Value (HMO) – H3330-036-0 | $0.00 | $295 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $7,550 |
| Empire MediBlue Core Select (HMO) – H8432-036-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
| Empire MediBlue Dual Advantage Select (HMO D-SNP) – H8432-028-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
| Empire MediBlue HealthPlus (HMO) – H1732-005-0 | $25.00 | $200 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $4.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29%, Select Care Drugs: $0.00 | $5,900 |
| Empire MediBlue HealthPlus Dual Advantage (HMO D-SNP) – H1732-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
| Empire MediBlue HealthPlus Dual Connect (HMO D-SNP) – H1732-003-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
| Empire MediBlue HealthPlus Dual Plus (HMO D-SNP) – H1732-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 | n/a |
| Empire MediBlue Plus (HMO) – H8432-009-0 | $62.00 | $325 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 27% | $6,200 |
| Empire MediBlue Select (HMO) – H8432-016-0 | $26.00 | $200 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $4.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29%, Select Care Drugs: $0.00 | $6,400 |
| Fidelis Dual Advantage (HMO D-SNP) – H5599-006-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 47%, Specialty Tier: 25% | n/a |
| Fidelis Dual Advantage Flex (HMO D-SNP) – H5599-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: 24%, Non-Preferred Drug: 39%, Specialty Tier: 25% | n/a |
| Fidelis Medicare $0 Premium (HMO) – H5599-009-0 | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 33% | $7,550 |
| Fidelis Medicare Advantage Flex (HMO-POS) – H5599-007-0 | $10.90 | $445 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 25% | $7,550 |
| Hamaspik Medicare Choice (HMO D-SNP) – H0034-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
| Hamaspik Medicare Select (HMO D-SNP) – H0034-001-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% | n/a |
| Healthfirst CompleteCare (HMO D-SNP) – H3359-034-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 | n/a |
| Healthfirst Increased Benefits Plan (HMO) – H3359-019-0 | $42.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | $7,550 |
| Healthfirst Life Improvement Plan (HMO D-SNP) – H3359-021-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 | n/a |
| Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) – H3533-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% | n/a |
| Humana Honor (PPO) – H5970-016-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 |
| HumanaChoice H5970-001 (PPO) – H5970-001-0 | $16.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% | $5,500 |
| HumanaChoice H5970-015 (PPO) – H5970-015-0 | $0.00 | $250 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $9.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $6,500 |
| HumanaChoice H5970-018 (PPO) – H5970-018-0 | $0.00 | $310 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00, Generic: $16.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $7,550 |
| MVP Medicare Preferred Gold with Part D (HMO-POS) – H3305-021-0 | $140.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $35.00, Non-Preferred Drug: 27%, Specialty Tier: 33% | $5,800 |
| MVP Medicare Preferred Gold without Part D (HMO-POS) – H3305-020-0 | $62.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
| MVP Medicare Secure Plus with Part D (HMO-POS) – H3305-022-0 | $90.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $45.00, Non-Preferred Drug: 27%, Specialty Tier: 33% | $7,550 |
| MVP Medicare Secure with Part D (HMO-POS) – H3305-032-0 | $40.00 | $150 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: 26%, Specialty Tier: 30% | $7,550 |
| MVP Medicare WellSelect Plus with Part D (PPO) – H9615-009-0 | $125.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $35.00, Non-Preferred Drug: 27%, Specialty Tier: 33% | $6,500 |
| MVP Medicare WellSelect with Part D (PPO) – H9615-010-0 | $0.00 | $325 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: 25%, Specialty Tier: 27% | $7,550 |
| MVP SmartFund (MSA) – H5613-002-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
| Oscar Easy Care (HMO) – H7322-002-0 | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $45.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% | $6,700 |
| PHP Care Complete FIDA-IDD Plan (Medicare-Medicaid Plan) – H9869-001-0 | $0.00 | $0 | All Generics, All Brands | Tier 1: 0%, Tier 2: 0%, Tier 3: 0% | n/a |
| UnitedHealthcare Dual Complete (HMO D-SNP) – H3387-010-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 | n/a |
| UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) – R5342-001-0 | $16.00 | $300 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $6,700 |
| UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO) – R5342-005-0 | $46.00 | $275 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $6,700 |
| UnitedHealthcare Medicare Advantage Choice Plan 4 (Regional PPO) – R5342-006-0 | $84.00 | $150 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% | $6,700 |
| UnitedHealthcare Medicare Advantage Patriot (Regional PPO) – R5342-002-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
| UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) – H2292-002-0 | $32.60 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% | n/a |
| UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) – H3379-002-0 | $35.90 | $445 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% | n/a |
| WellCare Absolute (PPO) – H2775-111-0 | $0.00 | $150 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% | $7,550 |
| WellCare Access (HMO D-SNP) – H4868-004-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $3.00, Preferred Brand: $42.00, Non-Preferred Drug: 48%, Specialty Tier: 25% | n/a |
| WellCare Imperial (PPO D-SNP) – H2775-112-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $9.00, Preferred Brand: $45.00, Non-Preferred Drug: 49%, Specialty Tier: 25% | n/a |
| WellCare Liberty (HMO D-SNP) – H4868-002-0 | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $45.00, Non-Preferred Drug: 50%, Specialty Tier: 25% | n/a |
| WellCare Patriot (HMO) – H4868-003-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
| WellCare Today’s Options Advantage Plus 750B (PPO) – H2775-100-0 | $83.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% | $6,700 |
| WellCare Value (HMO) – H4868-019-0 | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: 48%, Specialty Tier: 33% | $6,700 |
Medicare Part D by Company in Suffern, New York
Suffern Medicare Part D companies offer plans that cover prescription medications, with deductible and copay options that vary along with the monthly cost. Whether you have original Medicare or a Suffern, New York, Medicare Advantage plan, you can buy standalone Part D coverage from a local company.
Standalone Medicare Part D Plans in Suffern, New York
| Plan | Details | Tiers |
|---|---|---|
| SilverScript SmartRx (PDP) S5601 – 178 – 0 by Aetna Medicare |
Monthly Premium: $7.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $19.00 Tier 3: $46.00 Tier 4: 49% Tier 5: 25% |
| Elixir RxPlus (PDP) S7694 – 121 – 0 by Elixir Insurance |
Monthly Premium: $15.60 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $6.00 Tier 3: $43.00 Tier 4: 45% Tier 5: 25% |
| WellCare Wellness Rx (PDP) S4802 – 172 – 0 by WellCare |
Monthly Premium: $15.60 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $5.00 Tier 3: $40.00 Tier 4: 46% Tier 5: 25% |
| Humana Walmart Value Rx Plan (PDP) S5552 – 006 – 0 by Humana |
Monthly Premium: $17.20 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $4.00 Tier 3: 16% Tier 4: 35% Tier 5: 25% |
| WellCare Value Script (PDP) S4802 – 138 – 0 by WellCare |
Monthly Premium: $17.70 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $6.00 Tier 3: $43.00 Tier 4: 47% Tier 5: 25% |
| Express Scripts Medicare – Saver (PDP) S5983 – 007 – 0 by Express Scripts Medicare |
Monthly Premium: $23.60 Annual Deductible: $285 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $2.00 Tier 2: $7.00 Tier 3: $35.00 Tier 4: 50% Tier 5: 28% |
| Cigna Secure-Essential Rx (PDP) S5617 – 282 – 0 by Cigna |
Monthly Premium: $24.00 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $2.00 Tier 3: 18% Tier 4: 40% Tier 5: 25% |
| Blue Rx Enhanced (PDP) S3375 – 003 – 0 by BlueCross BlueShield: Empire, Excellus, WNY & NEN |
Monthly Premium: $30.70 Annual Deductible: $325 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $0.00 Tier 2: $3.00 Tier 3: 20% Tier 4: 39% Tier 5: 27% |
| Express Scripts Medicare – Value (PDP) S5983 – 004 – 0 by Express Scripts Medicare |
Monthly Premium: $33.20 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $3.00 Tier 3: $20.00 Tier 4: 46% Tier 5: 25% |
| WellCare Classic (PDP) S4802 – 077 – 0 by WellCare |
Monthly Premium: $34.80 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $4.00 Tier 3: $30.00 Tier 4: 33% Tier 5: 25% |
| SilverScript Choice (PDP) S5601 – 006 – 0 by Aetna Medicare |
Monthly Premium: $35.00 Annual Deductible: $290 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $5.00 Tier 3: $35.00 Tier 4: 40% Tier 5: 27% |
| Elixir RxSecure (PDP) S7694 – 003 – 0 by Elixir Insurance |
Monthly Premium: $35.80 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $7.00 Tier 3: 15% Tier 4: 34% Tier 5: 25% |
| WellCare Medicare Rx Saver (PDP) S5810 – 037 – 0 by WellCare |
Monthly Premium: $36.80 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $2.00 Tier 3: $42.00 Tier 4: 35% Tier 5: 25% |
| Humana Basic Rx Plan (PDP) S5552 – 004 – 0 by Humana |
Monthly Premium: $37.10 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $1.00 Tier 3: 20% Tier 4: 35% Tier 5: 25% |
| Cigna Secure Rx (PDP) S5617 – 013 – 0 by Cigna |
Monthly Premium: $38.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: Yes ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $2.00 Tier 3: $25.00 Tier 4: 50% Tier 5: 25% |
| WellCare Medicare Rx Select (PDP) S5810 – 277 – 0 by WellCare |
Monthly Premium: $40.20 Annual Deductible: $300 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $3.00 Tier 3: $47.00 Tier 4: 42% Tier 5: 27% |
| AARP MedicareRx Walgreens (PDP) S5921 – 382 – 0 by UnitedHealthcare |
Monthly Premium: $40.90 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $6.00 Tier 3: $40.00 Tier 4: 40% Tier 5: 25% |
| Blue Rx Standard (PDP) S3375 – 001 – 0 by BlueCross BlueShield: Empire, Excellus, WNY & NEN |
Monthly Premium: $49.10 Annual Deductible: $440 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $2.00 Tier 3: $34.00 Tier 4: 32% Tier 5: 25% |
| EmblemHealth VIP Rx (PDP) S5966 – 003 – 0 by EmblemHealth Medicare PDP |
Monthly Premium: $49.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $2.00 Tier 2: $12.00 Tier 3: $40.00 Tier 4: 33% Tier 5: 25% |
| Cigna Secure-Extra Rx (PDP) S5617 – 248 – 0 by Cigna |
Monthly Premium: $50.00 Annual Deductible: $100 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $4.00 Tier 2: $10.00 Tier 3: $42.00 Tier 4: 50% Tier 5: 31% |
| AARP MedicareRx Saver Plus (PDP) S5921 – 379 – 0 by UnitedHealthcare |
Monthly Premium: $70.10 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $8.00 Tier 3: $31.00 Tier 4: 40% Tier 5: 25% |
| Humana Premier Rx Plan (PDP) S5552 – 005 – 0 by Humana |
Monthly Premium: $72.30 Annual Deductible: $445 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $4.00 Tier 3: $45.00 Tier 4: 39% Tier 5: 25% |
| EmblemHealth VIP Rx Plus (PDP) S5966 – 004 – 0 by EmblemHealth Medicare PDP |
Monthly Premium: $72.50 Annual Deductible: $285 Zero Premium If Full LIS Benefits: No ICL: $3,970 Additional Gap Coverage: No |
Tier 1: $0.00 Tier 2: $0.00 Tier 3: $35.00 Tier 4: $95.00 Tier 5: 28% |
| Blue Rx Plus (PDP) S3375 – 002 – 0 by BlueCross BlueShield: Empire, Excellus, WNY & NEN |
Monthly Premium: $72.70 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $3.00 Tier 3: $43.00 Tier 4: 45% Tier 5: 33% |
| SilverScript Plus (PDP) S5601 – 007 – 0 by Aetna Medicare |
Monthly Premium: $76.60 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $0.00 Tier 2: $2.00 Tier 3: $47.00 Tier 4: 48% Tier 5: 33% |
| WellCare Medicare Rx Value Plus (PDP) S5768 – 200 – 0 by WellCare |
Monthly Premium: $82.00 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $1.00 Tier 2: $4.00 Tier 3: $47.00 Tier 4: 43% Tier 5: 33% |
| Express Scripts Medicare – Choice (PDP) S5983 – 006 – 0 by Express Scripts Medicare |
Monthly Premium: $87.60 Annual Deductible: $100 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: Yes |
Tier 1: $2.00 Tier 2: $7.00 Tier 3: $42.00 Tier 4: 50% Tier 5: 31% |
| AARP MedicareRx Preferred (PDP) S5805 – 001 – 0 by UnitedHealthcare |
Monthly Premium: $94.80 Annual Deductible: $0 Zero Premium If Full LIS Benefits: No ICL: $4,130 Additional Gap Coverage: No |
Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: 40% Tier 5: 33% |
Medicare Supplement By Company in Suffern, New York
Suffern, New York, Medicare supplement plans are designed to fill in the gaps left by original Medicare. That’s why they’re also known as Medigap plans. Compare Suffern, NY, Medigap companies, and the plans they offer here.
Medicare Supplement Companies in Suffern, New York
| Company | Plans |
|---|---|
| AARP – UnitedHealthcare Insurance Company of New York (Standard) | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F, Medigap Plan G, Medigap Plan L, Medigap Plan N |
| BlueShield of Northeastern New York | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F, Medigap Plan F-high deductible, Medigap Plan G, Medigap Plan N |
| EmblemHealth Services Company | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F |
| Empire BlueCross New York | Medigap Plan A, Medigap Plan B, Medigap Plan F, Medigap Plan G, Medigap Plan N |
| Globe Life Insurance Company of New York | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan D, Medigap Plan F, Medigap Plan F-high deductible, Medigap Plan G, Medigap Plan G-high deductible, Medigap Plan L, Medigap Plan N |
| Humana (Humana Insurance Company of New York) | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F, Medigap Plan F-high deductible, Medigap Plan G, Medigap Plan G-high deductible, Medigap Plan L, Medigap Plan N |
| Mutual of Omaha Insurance Company | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan D, Medigap Plan F, Medigap Plan G |
| State Farm Mutual Automobile Insurance Company | Medigap Plan A, Medigap Plan B, Medigap Plan C, Medigap Plan F |
Medicare Supplement Coverage by Plan in Suffern, New York
Medicare supplement plans in Suffern, NY, are standardized, so you’ll get the same coverage regardless of which company you choose. Find out what the standard Medigap plans in New York cover here.
Suffern, New York Standard Medicare Plan Coverage
| Plan Name | Monthly Cost | Copays Coinsurance | Deductibles | Plan Benefits |
|---|---|---|---|---|
| Medigap Plan A | Premiums range from $169-$350 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $1,484 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: No
Part A deductible: No Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
| Medigap Plan B | Premiums range from $226-$510 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: No
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
| Medigap Plan C | Premiums range from $301-$511 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $0 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: Yes Part B excess charges: No Foreign travel emergency: Yes |
| Medigap Plan D | Premiums range from $391-$502 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: Yes |
| Medigap Plan F | Premiums range from $305-$514 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $0 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: Yes Part B excess charges: Yes Foreign travel emergency: Yes |
| Medigap Plan F-high deductible | Premiums range from $69-$91 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services after you pay $2,370 deductible | $2,370 total plan deductible. After, you pay: $0 Hospital (Part A) deductible, $0 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: Yes Part B excess charges: Yes Foreign travel emergency: Yes |
| Medigap Plan G | Premiums range from $268-$476 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: Yes Foreign travel emergency: Yes |
| Medigap Plan G-high deductible | Premiums range from $69-$91 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services after you pay $2,370 deductible | $2,370 total plan deductible. After, you pay: $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: Yes Foreign travel emergency: Yes |
| Medigap Plan K | Premiums range from $86-$207 depending on your age, sex, health status, and when you buy. | 10% Generally your cost for approved Part B services up to $6,220. Then, you’ll pay $0 for the rest of the year. | $742 (50% of Part A deductible) Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
| Medigap Plan L | Premiums range from $181-$297 depending on your age, sex, health status, and when you buy. | 5% Generally your cost for approved Part B services up to $3,110. Then, you’ll pay $0 for the rest of the year. | $371 (25% of Part A deductible) Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: No |
| Medigap Plan M | Premiums range from $524-$524 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services | $742 (50% of Part A deductible) Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: Yes |
| Medigap Plan N | Premiums range from $190-$282 depending on your age, sex, health status, and when you buy. | $0 Generally your cost for approved Part B services with some $20 and $50 copays | $0 Hospital (Part A) deductible, $203 Medical (Part B) deductible |
Skilled nursing facility: Yes
Part A deductible: Yes Part B deductible: No Part B excess charges: No Foreign travel emergency: Yes |
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Shop for Medicare Coverage in Suffern, New York
Finding the right coverage for Medicare in Suffern, New York, is a matter of looking at your choices and narrowing down the best fits for your needs and budget. Whether you want a PPO Medicare Advantage plan in Suffern, NY, or you prefer to bolster original Medicare with a Suffern Medicare supplement plan, shopping around is your best bet.
To compare Suffern, New York, Medicare rates, enter your ZIP code here for fast, free quotes.
Frequently Asked Questions
What are the eligibility requirements for Medicare in Suffern, New York?
Medicare is a federal health insurance program that provides coverage to people who are 65 years or older, people with certain disabilities, and people with end-stage renal disease. To be eligible for Medicare in Suffern, New York, you must meet one of the three criteria:
- You are 65 years or older: If you are 65 years or older, you are eligible for Medicare regardless of your income or health status.
- You have a qualifying disability: If you have a disability that qualifies you for Social Security Disability Insurance (SSDI) or Railroad Retirement Board disability benefits for 24 months, you are eligible for Medicare.
- You have end-stage renal disease: If you have end-stage renal disease (ESRD) or permanent kidney failure requiring dialysis or a kidney transplant, you are eligible for Medicare.
In addition to the above eligibility requirements, you must also be:
- a U.S. citizen or
- a legal resident of the United States for at least five years.
It’s important to note that even if you are eligible for Medicare, you may still need to pay premiums, deductibles, and co-payments for certain services. The costs associated with Medicare can vary depending on the type of plan you choose and your income level.
What are the costs associated with Medicare in Suffern, New York?
The costs associated with Medicare in Suffern, New York can vary depending on the type of plan you choose and your income level. Here are five of the main costs you can expect to pay:
- Part A premiums: Most people don’t have to pay a premium for Medicare Part A, which covers hospital stays, skilled nursing care, and some home health care services. However, if you or your spouse did not pay Medicare taxes while you were working, you may have to pay a premium for Part A.
- Part B premiums: Medicare Part B covers doctor visits, outpatient care, and some preventive services. Most people pay a standard monthly premium for Part B, which can vary based on your income. In addition to the premium, you’ll also have to pay an annual deductible and coinsurance for some services.
- Part C premiums: Medicare Advantage plans, also known as Part C, are offered by private insurance companies and can provide additional benefits beyond what’s covered by Parts A and B. The cost of these plans can vary depending on the benefits offered and the insurer.
- Part D premiums: Medicare Part D covers prescription drug costs. You’ll have to pay a monthly premium for this coverage, as well as a deductible and copayments for your medications.
- Medigap premiums: Medigap policies are supplemental insurance plans that can help cover the costs of deductibles, coinsurance, and other out-of-pocket expenses. The cost of these policies can vary based on the benefits offered and the insurer.
It’s important to note that the costs of Medicare can change each year, so it’s important to stay up-to-date on any changes to premiums, deductibles, and coinsurance rates. Additionally, if you have limited income and resources, you may be eligible for assistance in paying for some or all of your Medicare costs through programs like Medicaid or the Medicare Savings Program.
Are there any Medicare plans that cover prescription drugs in Suffern, New York?
Yes, Medicare Part D is a prescription drug plan available to Medicare beneficiaries in Suffern, New York.
- Part D plans are offered by private insurance companies.
- They provide coverage for prescription drugs not covered by Medicare Parts A and B.
- Part D plans have a formulary, a list of drugs the plan covers, that meets certain Medicare requirements.
- However, the specific drugs covered and cost-sharing can vary from plan to plan.
- Enrollees typically pay a monthly premium, annual deductible, and a portion of the cost of each prescription they fill.
- The amount paid depends on the specific plan, drugs taken, and pharmacy used.
- If enrolled in a Medicare Advantage plan (Part C) with prescription drug coverage, separate Part D plan enrollment is not possible.
- Many Medicare Advantage plans include prescription drug coverage, so it’s essential to review options carefully.
What is the process for filing a Medicare claim in Suffern, New York?
The process for filing a Medicare claim in Suffern, New York can vary depending on the type of service or item you received. Here are the general steps for filing a claim:
- Visit a provider who accepts Medicare: Make sure the provider you visit accepts Medicare assignment, which means they agree to accept the Medicare-approved amount as payment in full for the service or item you received.
- Provide your Medicare information: When you receive a service or item, provide your Medicare card to the provider. They will then submit a claim to Medicare on your behalf.
- Review the Medicare Summary Notice (MSN): After Medicare processes the claim, you will receive an MSN in the mail that shows what was billed, what Medicare paid, and what you may owe. Review the MSN carefully to make sure everything is accurate.
- Appeal the claim if necessary: If you disagree with the amount Medicare paid or any other information on the MSN, you can file an appeal. The MSN will include instructions on how to do this.
If you received a service or item from a provider who does not accept Medicare assignment, you may need to pay the full amount up front and then file a claim for reimbursement from Medicare. The process for doing this can vary depending on the type of service or item, so it’s important to check with Medicare or your plan for specific instructions.
It’s important to note that if you have a Medicare Advantage plan, the process for filing a claim may be different. Contact your plan for more information on how to file a claim.
What should I do if I have problems with my Medicare coverage in Suffern, New York?
If you have problems with your Medicare coverage in Suffern, New York, here are the five steps you can take to try to resolve the issue.
- Contact your healthcare provider: If you are having trouble getting a service or item covered by Medicare, your first step should be to contact the healthcare provider who ordered the service or prescribed the item. They may be able to help you understand why the service or item is not covered and suggest alternatives.
- Contact Medicare: If you are still having trouble getting coverage, contact Medicare directly. You can call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare website for assistance. They can help you understand your coverage options and work with you to resolve any issues.
- Contact your State Health Insurance Assistance Program (SHIP): SHIP is a national program that provides free, personalized counseling and assistance to Medicare beneficiaries. They can help you understand your coverage, file appeals, and resolve billing issues. In New York, you can contact the New York State Office for the Aging’s Health Insurance Information Counseling and Assistance Program (HIICAP) at 1-800-701-0501.
- File an appeal: If you disagree with a Medicare coverage decision, you have the right to file an appeal. The appeal process can vary depending on the type of coverage issue, so it’s important to follow the instructions provided on the Medicare Summary Notice (MSN) or by Medicare.
- Consider getting help from a Medicare advocate or attorney: If you are having persistent problems with your Medicare coverage, you may want to consider getting help from a Medicare advocate or attorney. They can help you understand your rights and work with you to resolve any issues.
It’s important to stay informed about your Medicare coverage and to act quickly if you have any problems or concerns. Don’t hesitate to ask for help if you need it, and don’t give up until you get the coverage you are entitled to.
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Daniel Walker
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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years (BBB A+). He is licensed as an agent to write property and casualty insurance, including home, life, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. He reviews content, ensuring tha...
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