Medicare in New York: 2026 Guide
New York Medicare at a Glance
New York mandates community-rated Medigap and bans Part B excess charges — but has the highest Medigap premiums nationally.
| Metric | Value (2026) |
|---|---|
| Medicare enrollees | 3.60 million |
| Medicare Advantage penetration | 46% |
| Typical Plan G (65 yo nonsmoker) | $240/month |
| Nursing homes (Medicare-certified) | 615 |
| 5-star nursing homes | 30% |
| Median SNF semi-private room | $13,100/month |
| Median assisted living | $5,500/month |
Your Medicare Choices in New York
Every Medicare-eligible resident chooses between two paths:
- Original Medicare + Medigap + Part D — any-doctor access, stable benefits, higher premium.
- Medicare Advantage (Part C) — bundled benefits, often $0 premium, but networks and prior auth.
About 46% of New York's Medicare enrollees choose Advantage. Your best path depends on your doctors, travel patterns, health, and budget.
Medigap in New York
Medigap is federally standardized across all states except Massachusetts, Minnesota, and Wisconsin — so Plan G in New York is the same coverage as Plan G anywhere else in the country. What differs is premium and carrier availability.
- Typical 65-year-old nonsmoker Plan G: $240/month
- Plan N averages 20–30% less
- Your one-time Medigap Open Enrollment is the 6 months beginning when you're 65+ AND enrolled in Part B
Nursing Home Quality in New York
New York has 615 Medicare-certified nursing homes; 30% carry a 5-star Overall CMS rating. Before choosing a facility, check its Medicare Care Compare listing, read the most recent state inspection report, and visit in person on both a weekday meal and a weekend shift. Oversight agency: New York State Department of Health.
- SHIP (free Medicare counseling): 1-800-701-0501
- State long-term care ombudsman: 1-855-582-6769
Related Resources
- Nursing homes in New York
- Assisted living in New York
- Medicare Supplement (Medigap) guide
- Medicare Advantage vs Medigap
- Medicare cost calculator
Disclaimer: Figures are approximate 2026 benchmarks. Not affiliated with the U.S. government or the federal Medicare program. Consult a licensed agent or SHIP counselor before making decisions.