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Medigap New York | New York Supplementary Health Insurance

Medigap Info for Residents of New York who are being terminated by Medicare Managed Health Care Plans

If you have received a notice this fall from Medicare Managed Care Plans that will no longer be providing coverage in your area after Dec. 31st 2016 then you will need to make a decision to enroll in another Medicare Managed Healthcare Plan if available in your county  or if you will return to the Original Medicare Plan.

If you are going to return to the “Original Medicare Plan” then you are more likely to be considering purchasing a Medigap policy to help cover cost that are not covered by Medicare like co-insurance or deductibles.

Your Medigap coverage application must be accepted at any time throughout the year; and if you are enrolled in both Part A and Part B of Original Medicare, you are guaranteed the right to purchase any of the standardized Medigap policies “A” through “N”.

Insurers cannot deny you a Medigap policy or make any premium rate distinctions because of your current health status or claims experience, medical condition or whether you are receiving health care services.

Medigap policies may contain up to a six-month waiting period before pre-existing conditions are covered. Medigap insurers are required to reduce the waiting period by the number of days that you were covered under certain types of health insurance, including Medicare Managed Care Plan coverage, if you enroll within 63 calendar days of losing coverage.

Disenrollment from a Medicare Managed Care Plan due to any of the reasons described below, you may obtain a Medigap policy without a waiting period for pre-existing conditions even if you were enrolled in the Medicare Managed Care Plan for less than six months. The issuer of a Medigap policy may not impose a pre-existing condition limitation under the policy if you seek to enroll under a Medigap policy within the time limits described below.

  • IF YOUR – Medicare Managed Care Plan has notified you that it is terminating its Medicare participation or terminating Medicare services in the area in which you reside and you decide to stay enrolled in the Plan until the contract ends, your coverage under the Plan will end on December 31, 2016. You will automatically be enrolled in the Original Medicare Plan on January 1, 2017. You must apply for a Medigap policy no later than 63 calendar days after your coverage ends under the Plan. This means that you must apply for a Medigap policy no later than March 4, 2017. However, remember that the Medigap policy will not actually begin covering claims until its stated effective date. Therefore, by waiting until March 4, 2017 to apply, you may incur a gap in coverage.
  • IF YOUR – Medicare Managed Care Plan has notified you that it is terminating its Medicare participation or no longer going to provide Medicare services in the area in which you reside and you decide to leave your Medicare Managed Care Plan before December 31, 2016 and return to the Original Medicare Plan, you must apply for a Medigap policy no later than 63 days after the effective date of disenrollment from the Medicare Managed Care Plan.

If your Medicare Managed Care Plan coverage terminates under either of the situations described above, the Managed Care Plan must provide you with written notification of your right to purchase any Medigap policy on an open enrollment basis without a waiting period for pre-existing conditions. You should not wait until your Managed Care Plan coverage has terminated before applying for a Medigap policy. In order to prevent a gap in coverage, you should apply for a Medigap policy while you are still enrolled in your Managed Care Plan and request that the Medigap coverage begin the same day as your Original Medicare Plan coverage. If you fail to enroll in a Medigap policy within the time limits described above, you may still purchase any of the standardized Medigap plans, however, you may have to satisfy a pre-existing condition waiting period if more than 63 days has passed since enrollment in your Medicare Managed Care Plan has terminated.

Remember, to purchase a Medigap policy, you must contact a private insurance company that sells Medigap policies and request an application. Neither your existing Medicare Managed Care Plan nor the Original Medicare Plan can do this for you. A list of the insurance companies that sell Medigap policies in New York State and the current premium rates appear below. Also appearing below is a list of the Medicare Managed Care Plans that are available in New York State. Note that such Medicare Managed Care Plans may not be available in all counties throughout the state.

Insurers in New York State Offering Medicare Supplement Insurance

Insurance Carriers With Approved Standardized Medicare Supplement Benefit Plans. 

Medicare Supplement Insurance Carrier

Pre-Ex Wait

Benefit Plans Offered

A B C D F F+ G K L M N
Aetna Life Insurance Company
(Individual)
6 months X X X
American Progressive Life & Health Insurance Company of New York
(Individual)
6 months X X X X X X
Bankers Conseco Life Insurance Company
(Individual)
6 months X X X X X X X X X
CDPHP Universal Benefits, Inc. (CDPHP)
(Individual)
6 months X X X X
Excellus Health Plan, Inc.
(doing business as Excellus BlueCross BlueShield)
(Individual & Group)
6 months X X X X X
Excellus Health Plan, Inc.
(doing business as Univera Healthcare)
(Individual & Group)
6 months X X X X X
First United American Life Insurance Company
(Individual & Group)
2 months X X X X X X X X X X
Group Health Incorporated (GHI)
(Individual)
6 months X X X X
Hartford Life Insurance Company
(Group)
6 months X X X X X X
HealthNow New York Inc.
(doing business as BlueShield of Northeastern New York)
(Individual)
6 months X X X X X
HealthNow New York Inc.
(doing business as BlueCross BlueShield of Western New York)
(Individual)
6 months X X X X X
Humana Insurance Company of New York
(Individual)
3 months X X X X X X X X
Mutual of Omaha Insurance Company
(Individual)
6 months X X X X X X X
Transamerica Financial Life Insurance Company
(Group)
6 months X X X X X X X X X X
UnitedHealthCare Insurance Company of New York
(American Association of Retired Persons)
(Group Association)
6 months X X X X X X X
A B C D F F+ G K L M N
Benefit Plans Offered

 

 

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