Best Medicare Companies in Utica, New York (2025)
Unlock the perfect Medicare coverage in Utica, New York. Empower yourself with expert guidance to explore an extensive range of comprehensive options. From understanding plans to navigating enrollment, our experienced team is here to help you make an informed decision that aligns with your specific needs and budget.
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Table of Contents
Michael Vereecke
Commercial Lines Coverage Specialist
Michael Vereecke is the president of Customers First Insurance Group. He has been a licensed insurance agent for over 13 years. He also carries a Commercial Lines Coverage Specialist (CLCS) Designation, providing him the expertise to spot holes in businesses’ coverage. Since 2009, he has worked with many insurance providers, giving him unique insight into the insurance market, differences in ...
Written by
Michael Vereecke
Michael Vereecke
Kristen Gryglik
Licensed Insurance Agent
Kristen is a licensed insurance agent working in the greater Boston area. She has over 20 years of experience counseling individuals and businesses on which insurance policies best fit their needs and budgets. She knows everyone has their own unique needs and circumstances, and she is passionate about counseling others on which policy is right for them. Licensed in Massachusetts, New Hampshire,...
Reviewed by
Kristen Gryglik
Kristen Gryglik
Updated January 2025
The Rundown
- There are offering Medicare plans in Utica, New York
- Utica, New York, Medicare supplement plans follow the New York standards for coverage
- Health insurance companies like WellCare and WellCare offer Medicare Advantage plans in Utica
Welcome to our comprehensive guide on Medicare companies in Utica, New York. If you’re looking for reliable and affordable Medicare coverage options, you’ve come to the right place.
In this article, we will delve into the key topics surrounding Medicare in Utica, New York, including understanding different plans, eligibility requirements, enrollment periods, and the top insurance providers in the area. Whether you’re new to Medicare or looking to switch plans, we’ve got you covered with valuable information and expert insights.
Don’t miss out on finding the best coverage for your healthcare needs. Enter your ZIP code now to compare rates from the top insurance providers. And take a step towards securing your peace of mind today.
Medicare Advantage by Company in Utica, New York
There are Medicare Advantage companies in Utica, NY, offering a range of options including HMO and PPO plans. There are even some plans available at no additional cost beyond your Utica Medicare Part B premium. Take a look at the Medicare Advantage companies in Utica, New York, to compare plans and coverage.
Medicare Advantage Companies in Utica, 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 (HMO) – H3379-039-0 | $0.00 | $195 . 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: 29% | $6,700 |
| Aetna Medicare Assure Plan (HMO D-SNP) – H3312-070-0 | $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 Credit Plan (PPO) – H5521-313-0 | $0.00 | $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 Eagle Plan (PPO) – H5521-323-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
| Aetna Medicare Premier Plan (PPO) – H5521-077-0 | $0.00 | $200 . Tier 1 and 2 exempt | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% | $7,550 |
| Aetna Medicare Value Plan (HMO) – H3312-048-0 | $0.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $2.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% | $7,550 |
| CDPHP $0 Medicare Rx (HMO) – H3388-014-0 | $0.00 | $300 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $17.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% | $7,500 |
| CDPHP Basic RX (HMO) – H3388-013-0 | $31.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $15.00, Preferred Brand: $45.00, Non-Preferred Drug: $97.00, Specialty Tier: 33% | $6,700 |
| CDPHP Choice (HMO) – H3388-001-0 | $39.90 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 |
| CDPHP Choice Rx (HMO) – H3388-002-0 | $130.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $11.00, Preferred Brand: $40.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% | $5,000 |
| CDPHP Flex (PPO) – H5042-012-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
| CDPHP Flex Rx (PPO) – H5042-011-0 | $41.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $14.00, Preferred Brand: $44.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% | $5,500 |
| CDPHP Value Rx (HMO) – H3388-004-0 | $60.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $13.00, Preferred Brand: $42.00, Non-Preferred Drug: $93.00, Specialty Tier: 33% | $5,800 |
| CDPHP Vital Rx (PPO) – H5042-009-0 | $0.00 | $350 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00, Generic: $17.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% | $7,500 |
| 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) – H5599-004-0 | $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) – H5599-002-0 | $7.40 | $445 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: 24%, Non-Preferred Drug: 41%, Specialty Tier: 25% | $7,550 |
| Fidelis Medicare Advantage without Rx (HMO-POS) – H5599-005-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
| Humana Gold Plus H3533-001 (HMO) – H3533-001-0 | $0.00 | $350 . 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: 26% | $7,200 |
| Humana Gold Plus H3533-013 (HMO) – H3533-013-0 | $25.00 | $275 . Tier 1, 2 and 3 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% | $6,700 |
| 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 H5970-015 (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 |
| HumanaChoice H5970-019 (PPO) – H5970-019-0 | $23.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $99.00, Specialty Tier: 33% | $5,500 |
| MVP Medicare Patriot Plan with Part D (PPO) – H9615-014-0 | $36.00 | $250 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $40.00, Non-Preferred Drug: 27%, 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) – H9615-007-0 | $116.00 | $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) – H9615-008-0 | $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 |
| Medicare BlueBasic (PPO) – H3335-043-0 | $45.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 |
| Medicare BlueClassic (PPO) – H3335-038-0 | $38.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% | $7,200 |
| Medicare BlueEnhanced (PPO) – H3335-015-0 | $138.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% | $5,000 |
| Medicare BlueEssential (PPO) – H3335-053-0 | $0.00 | $150 . Tier 1 and 2 exempt | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 30% | $7,550 |
| Medicare BlueSecure (PPO) – H3335-014-0 | $101.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 33% | $6,700 |
| 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 (HMO-POS I-SNP) – H3379-022-0 | $36.00 | $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 1 (PPO I-SNP) – H2292-001-0 | $34.10 | $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 Summit (PPO) – H2775-113-0 | $5.10 | $445 . Tier 1 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% | $6,700 |
| WellCare Today’s Options Advantage Plus 150A (PPO) – H2775-105-0 | $121.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $35.00, Non-Preferred Drug: $75.00, Specialty Tier: 33% | $3,400 |
| WellCare Today’s Options Advantage Plus 550B (PPO) – H2775-106-0 | $0.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% | $6,700 |
| WellCare Today’s Options Premier 200 (PFFS) – H2816-037-0 | $71.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
| WellCare Today’s Options Premier 300 (PFFS) – H2816-038-0 | $0.00 | No Rx Coverage | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
| WellCare Today’s Options Premier Plus 250A (PFFS) – H2816-013-0 | $156.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $35.00, Non-Preferred Drug: $75.00, Specialty Tier: 33% | n/a |
| WellCare Today’s Options Premier Plus 650B (PFFS) – H2816-019-0 | $55.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% | n/a |
| 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 Utica, New York
Utica 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 an Utica, New York, Medicare Advantage plan, you can buy standalone Part D coverage from a local company.
Standalone Medicare Part D Plans in Utica, 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 Utica, New York
Utica, 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 Utica, NY, Medigap companies, and the plans they offer here.
Medicare Supplement Companies in Utica, 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 Utica, New York
Medicare supplement plans in Utica, 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.
Utica, 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 Utica, New York
Finding the right coverage for Medicare in Utica, 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 Utica, NY, or you prefer to bolster original Medicare with an Utica Medicare supplement plan, shopping around is your best bet.
To compare Utica, New York, Medicare rates, enter your ZIP code here for fast, free quotes.
Frequently Asked Questions
Can Medicare beneficiaries in Utica, New York, choose any Medicare company, or are they limited to a certain network of providers?
Medicare beneficiaries in Utica, New York, have the ability to choose from a variety of Medicare companies and plans, but they may be limited to a certain network of healthcare providers depending on the type of plan they choose.
There are two main types of Medicare plans:
- Original Medicare: beneficiaries can go to any doctor or hospital that accepts Medicare. However, they may still have to pay deductibles, coinsurance, and copays for their services.
- Medicare Advantage plans: beneficiaries are typically required to use providers within the plan’s network in order to receive the most coverage at the lowest cost. These plans may also offer additional benefits, such as prescription drug coverage, dental, vision, or hearing benefits, which are not covered by Original Medicare.
When choosing a Medicare Advantage plan, it’s important to review the plan’s provider network and make sure that the healthcare providers you want to use are in the network. Some Medicare Advantage plans may also offer out-of-network coverage, but beneficiaries will typically pay more for services received outside of the network.
What factors should I consider when selecting a Medicare company in Utica, New York?
When selecting a Medicare company in Utica, New York, there are several factors that you should consider in order to find the plan that best fits your needs. Here are the seven important factors to consider:
- Type of plan: You should consider whether you want to enroll in Original Medicare, a Medicare Advantage plan, or a Medicare Supplement (Medigap) plan. Each type of plan has its own benefits and drawbacks, so it’s important to research each option and determine which one best meets your healthcare needs.
- Premiums: You should compare the monthly premiums of different Medicare plans to determine which one is the most affordable for you. Keep in mind that some plans may have lower monthly premiums but higher out-of-pocket costs, while others may have higher monthly premiums but lower out-of-pocket costs.
- Deductibles and copays: You should review each plan’s deductibles and copays to determine how much you will need to pay out of pocket for healthcare services. Some plans may have lower deductibles and copays, but higher premiums, while others may have higher deductibles and copays, but lower premiums.
- Provider network: You should review each plan’s provider network to determine whether your preferred healthcare providers are covered. If you have a specific doctor or hospital that you prefer to use, you should make sure that they are in the plan’s network before enrolling.
- Prescription drug coverage: If you take prescription medications, you should consider whether the plan offers prescription drug coverage. Some Medicare Advantage plans may offer more comprehensive prescription drug coverage than Original Medicare, while Medigap plans do not typically offer prescription drug coverage.
- Extra benefits: Some Medicare Advantage plans may offer extra benefits such as dental, vision, or hearing coverage, which are not covered by Original Medicare. If you have specific healthcare needs, you should consider whether these extra benefits would be beneficial for you.
- Quality of care: You should review each plan’s quality of care ratings and customer satisfaction ratings to determine whether the plan has a good reputation for providing high-quality healthcare services.
Overall, selecting a Medicare company in Utica, New York requires careful consideration of several factors to determine which plan will provide the most comprehensive and affordable healthcare coverage for your individual needs.
Are there any special Medicare plans available in Utica, New York, such as those for individuals with chronic conditions or low-income beneficiaries?
Yes, there are special Medicare plans available in Utica, New York, for individuals with chronic conditions or low-income beneficiaries. Here’s the four types of the Special Medicare plans:
- Chronic Condition Special Needs Plans (C-SNPs): C-SNPs are Medicare Advantage plans designed for individuals with certain chronic conditions, such as diabetes, heart disease, or cancer. These plans offer specialized care management and coordination services to help individuals manage their chronic conditions and improve their health outcomes.
- Dual Eligible Special Needs Plans (D-SNPs): D-SNPs are Medicare Advantage plans designed for individuals who are eligible for both Medicare and Medicaid. These plans offer coordinated healthcare services and may offer additional benefits, such as dental, vision, or hearing coverage, to help meet the unique healthcare needs of dual eligible beneficiaries.
- Medicare Savings Programs (MSPs): MSPs are programs that help low-income Medicare beneficiaries pay for their Medicare premiums and out-of-pocket costs. There are four different types of MSPs, each with different eligibility requirements and benefits. These programs can provide significant cost savings for low-income beneficiaries.
- Extra Help (Low-Income Subsidy) for Prescription Drug Coverage: Extra Help is a program that helps low-income Medicare beneficiaries pay for their prescription drug coverage. This program provides significant cost savings on prescription drugs and can be a valuable resource for individuals who struggle to afford their medications.
In addition to these special Medicare plans, there may also be other state or local programs available to help individuals with chronic conditions or low-income beneficiaries access healthcare services. It’s important to research all available options and determine which programs may be the most beneficial for your individual healthcare needs and financial situation.
Are there any penalties for dropping coverage with a Medicare company in Utica, New York, such as late enrollment penalties or other fees?
It depends on the type of Medicare coverage you have and when you drop the coverage.
If you have Original Medicare (Part A and/or Part B) and you drop coverage:
- There is generally no penalty for doing so.
- However, if you drop Part B and then decide to enroll in Part B again at a later date, you may be subject to a late enrollment penalty.
- The penalty is 10% of the Part B premium for every 12-month period you were eligible for Part B but did not enroll
- the penalty is added to your monthly premium for as long as you have Part B.
If you have a Medicare Advantage plan or a Medicare Part D prescription drug plan:
- there may be penalties or fees associated with dropping coverage
- Medicare Advantage plans generally have an Annual Enrollment Period (AEP) from October 15th to December 7th each year
- During which beneficiaries can switch plans or drop coverage
- If you drop your Medicare Advantage plan outside of the AEP, you may not be able to enroll in another Medicare Advantage plan until the next AEP
- You may be subject to a late enrollment penalty if you choose to enroll in another plan at that time.
If you drop your Medicare Part D prescription drug plan:
- you may be subject to a late enrollment penalty if you go without prescription drug coverage for a period of time
- The penalty is 1% of the national base beneficiary premium for every month you were eligible for Part D but did not enroll
- The penalty is added to your monthly premium for as long as you have Part D
It’s important to carefully consider your healthcare needs and the costs associated with each Medicare plan before dropping coverage. If you are unsure about the consequences of dropping coverage, you should contact your Medicare company or a licensed insurance agent for guidance.
How can I find out more information about the Medicare companies available in Utica, New York, such as their ratings, customer reviews, and accreditation status?
There are four resources available to help you find information about Medicare companies in Utica, New York:
- Medicare.gov: The official Medicare website provides a wealth of information about Medicare companies, including their star ratings, customer reviews, and accreditation status. You can use the Medicare Plan Finder tool to search for Medicare Advantage plans, Medicare Prescription Drug plans, and Medigap plans in your area, and compare their features and costs.
- National Committee for Quality Assurance (NCQA): The NCQA is an independent, non-profit organization that accredits and rates healthcare plans based on their quality of care and customer satisfaction. You can visit the NCQA website to search for accredited Medicare Advantage plans in Utica, New York, and see how they rank compared to other plans in the area.
- State Health Insurance Assistance Program (SHIP): The SHIP is a federally funded program that provides free, unbiased counseling and assistance to Medicare beneficiaries. The program can help you navigate your Medicare options, compare plans, and find information about Medicare companies in Utica, New York. You can visit the SHIP website or call 1-800-MEDICARE to find a local SHIP office.
- Insurance company websites: You can visit the websites of individual insurance companies that offer Medicare plans in Utica, New York, to learn more about their plans, benefits, and customer satisfaction ratings. Many insurance companies also offer customer reviews and ratings on their websites.
It’s important to do your research and compare multiple Medicare plans before choosing one that meets your healthcare needs and budget. By using the resources above, you can make an informed decision and choose a Medicare plan that’s right for you.
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