New York Medicare Supplement Plan Year Round Open Enrollment.  Did you know that if you live in the state of New York you can purchase a Medicare Supplement plan with  guaranteed issue rights at any time during the year?  It is true!  Specifically, New York State state laws and regulations require that any insurance company selling Medicare Supplement (also known as “Medigap”) plans must accept a Medicare beneficiary’s application for coverage any time throughout the year.  More importantly, the insurance company cannot deny the Medicare beneficiary’s application for a Medicare Supplement policy, or make any premium rate distinctions due to health status, claims experience, medical condition(s) or whether the Medicare beneficiary is currently receiving health care services.  If you live New York, it is open enrollment all year!

Are plans offered as a result of the New York Medicare Supplement plan year round open enrollment limited?

New York Medicare Supplement plan year round enrollment includes the twelve standardized plans labeled “A” through L”. The plans are standardized by the Federal government; therefore, the New York Medicare Supplement plans’ coverage is no different from the coverage provided by a Medicare Supplement plan in any other state.  In other words, each standardized Medicare Supplement policy must provide the same basic core benefits such as covering the cost of some Medicare co-payments and deductibles. Some of the standardized Medicare Supplement plans also provide additional benefits such as at-home recovery care, foreign travel and emergency care.  Whether or not a plan provides the additional benefits depends on which of the Medicare Supplement plans labeled “A” through “L” that you purchase.

What about pre-existing conditions and the New York Medicare Supplement plan year round enrollment?

Medicare Supplement policies sold in any state can include a pre-existing condition clause which can deny coverage, or limit coverage, for certain pre-existing conditions for a certain period of time.  Specifically, any Medicare Supplement policy issued may contain up to a six month waiting period before pre-existing conditions are covered. A  pre-existing condition is defined as “a condition for which medical advice was given or treatment was recommended or received from a physician within six months before the effective date of coverage” of the Medicare Supplement policy. It is no different in New York.   However, under New York State regulation, the waiting period may be either reduced or waived entirely, depending upon your individual circumstances. Insurance companies selling Medicare Supplement plans in New York are required to reduce the waiting period by the number of days that the Medicare beneficiary was covered under some form of “creditable coverage” as long as there were no breaks in coverage of more than 63 calendar days. Coverage is considered “creditable coverage” if it is one of the following types of coverage:

  • A group health plan
  • Health insurance coverage
  • Medicaid
  • CHAMPUS AND TRICARE health care programs for the uniformed military services
  • A medical care program of the Indian Health Service or of a tribal organization
  • A State health benefits risk pool
  • Federal Employees Health Benefits Program
  • A public health plan
  • A health benefit plan issued under the Peace Corps Act
  • Medicare supplement insurance, Medicare SELECT coverage or coverage through a Medicare Advantage plan.

Credit will be given for the time that a person was previously covered under original Medicare but only if the applicant submits an application for Medicare Supplement policy prior to or during the six month period beginning with the first day of the first month in which an individual is both 65 years of age or older and is enrolled for benefits under original Medicare Part A and Part B.

New York Medicare Supplement Plan Year Round Open Enrollment provisions protect the Medicare beneficiary regardless of age or disability. The provisions also apply to Medicare beneficiaries with End Stage Renal Disease (also known as “ESRD”).

With the New York Medicare Supplement plan year round open enrollment there is no reason not to shop and compare insurance companies’ rates and always have the most affordable, most appropriate coverage.  Contact Medicare Pathways to discuss the Medicare Supplement plans available in your area and receive a quote on the most affordable insurance companies available at this time.  Let Medicare Pathways help you make the most out of your Medicare.  The Benefit Advisors are highly skilled to analyze each situation and determine if a change in plan or plan type would be appropriate for you and in your best interests.  The Medicare Pathways Benefit Advisor will assist you in enrolling in a new plan if that is the recommendation and will be the “go between” between you and the insurance company.  So if you are tired of dealing with insurance companies or are not happy with the customer service provided by certain insurance companies, allow a Medicare Pathways Benefit Advisor to become your agent and take some of the stress of dealing with insurance companies off of you.  Medicare Pathways also specializes in Medicare Advantage plans and Prescription Drug Plans (also known as “Medicare Part D“)

To speak with a Medicare Pathways Benefit Advisor you can all 1-866-466-9118, or you can simple Request a Quote and a Benefit Advisor will contact you.

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Medicare Pathways, Inc. 1-866-466-9118