Health Insurance › Medicare › New York › Advantage Plans › New York County, NY

Medicare Advantage Plans in New York County, New York

Below are Medicare Advantage plans available to residents of New York county, New York. 26 carriers offer 88 plans throughout the county of New York. Residents may choose plans from carriers such as MetroPlus Health Plan, ArchCare Advantage HMO SNP and UnitedHealthcare. This data has been made available by the Centers for Medicare & Medicaid Services (CMS) and is for informational purposes only. Some data may be inaccurate or incomplete. Please note that plans can vary by city, county, and state and all plans listed may not be available in all areas. To speak to an advisor and find the Medicare Advantage plan in New York county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of New York

Carrier	Plan Title	Plan Type
MetroPlus Health Plan	MetroPlus Advantage Plan (HMO SNP) (H0423-001)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6700 out-of-pocket limit for Medicare-covered services.* $34.2 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 or $10 copay for each specialist visit for Medicare-covered benefits.*
MetroPlus Health Plan	MetroPlus Medicare Partnership in Care Plan (HMO SNP) (H0423-002)	HMO
Premium and Other Important Information In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply. $6700 out-of-pocket limit for Medicare-covered services. $23.7 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. 5% of the cost for each specialist visit for Medicare-covered benefits.
MetroPlus Health Plan	MetroPlus Select Plan (HMO SNP) (H0423-003)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
MetroPlus Health Plan	MetroPlus Platinum (HMO) (H0423-004)	HMO
Premium and Other Important Information In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply. $6700 out-of-pocket limit for Medicare-covered services. $51.3 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. 20% of the cost for each specialist visit for Medicare-covered benefits.
ArchCare Advantage HMO SNP	ArchCare - Institutional SNP - NYC (HMO SNP) (H1777-007)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each specialist doctor visit for Medicare-covered benefits.
ArchCare Advantage HMO SNP	ArchCare- Institutional Equiv SNP - NYC (HMO SNP) (H1777-009)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each specialist doctor visit for Medicare-covered benefits.
UnitedHealthcare	AARP MedicareComplete Plan 1 (HMO) (H3307-002)	HMO
Premium and Other Important Information $5 900 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	AARP MedicareComplete Mosaic (HMO) (H3307-015)	HMO
Premium and Other Important Information $3 200 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $15 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	AARP MedicareComplete Essential (HMO) (H3307-018)	HMO
Premium and Other Important Information $5 900 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	UnitedHealthcare Dual Complete LP (HMO SNP) (H3307-020)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $38.8 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Aetna Medicare	Aetna Medicare Standard Plan (HMO) (H3312-025)	HMO
Premium and Other Important Information Package: 1 - Advantage Dental: Package: 2 - Advantage Dental Plus Eye Wear: $14 monthly premium in addition to your $80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $20 monthly premium in addition to your $80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Wear $6 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $80 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Aetna Medicare	Aetna Medicare Value Plan (HMO) (H3312-043)	HMO
Premium and Other Important Information Package: 1 - Advantage Dental: Package: 2 - Advantage Dental Plus Eye Wear: $14 monthly premium in addition to your $50 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $20 monthly premium in addition to your $50 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Wear $6 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $50 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each in-area network urgent care Medicare-covered visit $40 copay for each specialist visit for Medicare-covered benefits.
Touchstone Health	Touchstone Health Medicare Power (HMO) (H3327-001)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits.
Touchstone Health	Touchstone Health Medicare Total (HMO) (H3327-002)	HMO
Premium and Other Important Information $1 700 out-of-pocket limit for Medicare-covered services. $35.4 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $10 copay for each specialist visit for Medicare-covered benefits.
Touchstone Health	Touchstone Health Medicare Core (HMO) (H3327-037)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $10 copay for each specialist visit for Medicare-covered benefits.
Touchstone Health	Touchstone Health Medicare Freedom (HMO-POS) (H3327-038)	HMO with POS Option
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $5 100 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $11 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $22 copay for each specialist visit for Medicare-covered benefits.
Fidelis Care	Fidelis Medicare Advantage without Rx (HMO-POS) (H3328-001)	HMO with POS Option
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $20 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each in-area network urgent care Medicare-covered visit $40 copay for each specialist visit for Medicare-covered benefits.
Fidelis Care	Fidelis Dual Advantage (HMO SNP) (H3328-002)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $0 or $8 copay for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Fidelis Care	Fidelis Medicare Advantage Flex (HMO-POS) (H3328-003)	HMO with POS Option
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $750 plan coverage limit every year for Non-Medicare Supplemental benefits. Contact the plan for services that apply. $39.8 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits.
Fidelis Care	Fidelis Dual Advantage Flex (HMO SNP) (H3328-013)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $400 plan coverage limit every year for Non-Medicare Supplemental benefits. Contact the plan for services that apply. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
Comprehensive Care Management Corp.	CCMC PACE Dual Eligible (PACE) (H3329-001)	National PACE
Comprehensive Care Management Corp.	CCMC - PACE - Medicare only (PACE) (H3329-002)	National PACE
EmblemHealth Medicare HMO	VIP (HMO) (H3330-021)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. $21 monthly plan premium in addition to your monthly Medicare Part B premium. $118 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
EmblemHealth Medicare HMO	Dual Eligible (HMO SNP) (H3330-029)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services.* $39.8 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
EmblemHealth Medicare HMO	VIP Essential (HMO) (H3330-032)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. $123 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $10 copay for each specialist visit for Medicare-covered benefits.
EmblemHealth Medicare HMO	VIP High Option (HMO) (H3330-033)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $154 monthly plan premium in addition to your monthly Medicare Part B premium. $180 monthly plan premium in addition to your monthly Medicare Part B premium. $271 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $0 copay for each specialist doctor visit for Medicare-covered benefits.
Liberty Health Advantage	Liberty Health Advantage Preferred Choice (HMO) (H3337-001)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit. All plan services included. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $0 copay for each specialist doctor visit for Medicare-covered benefits.
Liberty Health Advantage	Liberty Health Advantage Dual Power (HMO SNP) (H3337-003)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit. All plan services included.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 or $10 copay for each specialist visit for Medicare-covered benefits.*
Empire BlueCross BlueShield	Empire MediBlue Freedom III (PPO) (H3342-001)	Local Preferred Provider Organization
Premium and Other Important Information $2 800 out-of-pocket limit for Medicare-covered services. $103 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $50 copay for each specialist visit
Empire BlueCross BlueShield	Empire MediBlue Freedom I (PPO) (H3342-012)	Local Preferred Provider Organization
Premium and Other Important Information Package: 1 - Preventive Dental Package: Package: 2 - Comprehensive Dental and Vision Package: $12 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental $30 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear $4 500 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits. $40 copay for each primary care doctor visit $65 copay for each specialist visit
Empire BlueCross BlueShield	Empire MediBlue Freedom II (PPO) (H3342-013)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $40 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $50 copay for each specialist visit
Elderplan	Elderplan For Medicaid Beneficiaries (HMO SNP) (H3347-002)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services.* $36.4 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Elderplan	Elderplan Advantage For Nursing Home Residents (HMO SNP) (H3347-003)	HMO
Premium and Other Important Information In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply. $3 400 out-of-pocket limit for Medicare-covered services. $36.4 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits 20% of the cost for each primary care doctor visit for Medicare-covered benefits. 20% of the cost for each in-area network urgent care Medicare-covered visit 20% of the cost for each specialist visit for Medicare-covered benefits.
Elderplan	Elderplan Classic: Zero Premium (HMO) (H3347-005)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits.
Elderplan	Elderplan Plus Long Term Care (HMO SNP) (H3347-007)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Elderplan	Elderplan Medicaid Advantage (HMO SNP) (H3347-008)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Elderplan	Elderplan Extra Help (HMO) (H3347-009)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $36 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $15 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits.
Elderplan	Elderplan Independence Choice (HMO-POS) (H3347-010)	HMO with POS Option
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits.
Healthfirst Medicare Plan	Healthfirst 65 Plus Plan (HMO) (H3359-001)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Healthfirst Medicare Plan	Healthfirst Increased Benefits Plan (HMO) (H3359-019)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $39.8 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Healthfirst Medicare Plan	Healthfirst Life Improvement Plan (HMO SNP) (H3359-021)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $39.8 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* $0 copay for each specialist visit for Medicare-covered benefits.*
Healthfirst Medicare Plan	Healthfirst Coordinated Benefits Plan (HMO) (H3359-027)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Healthfirst Medicare Plan	Healthfirst Jade Benefits Plan (HMO) (H3359-032)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits.
Healthfirst Medicare Plan	Healthfirst Maximum Plan (HMO SNP) (H3359-033)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
Healthfirst Medicare Plan	Healthfirst CompleteCare (HMO SNP) (H3359-034)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
WellCare	WellCare Liberty (HMO SNP) (H3361-043)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
WellCare	WellCare Advocate Complete (HMO SNP) (H3361-105)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
WellCare	WellCare Choice (HMO-POS) (H3361-106)	HMO with POS Option
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
WellCare	WellCare Access (HMO SNP) (H3361-109)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
WellCare	WellCare Rx (HMO) (H3361-130)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $37.5 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $10 copay for each specialist visit for Medicare-covered benefits.
Empire BlueCross BlueShield	Empire MediBlue Plus (HMO) (H3370-001)	HMO
Premium and Other Important Information $2 800 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Empire BlueCross BlueShield	Empire MediBlue Essential (HMO) (H3370-019)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	AARP MedicareComplete Plan 2 (HMO) (H3379-001)	HMO
Premium and Other Important Information $4 950 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	UnitedHealthcare Nursing Home Plan (HMO SNP) (H3379-002)	HMO
Premium and Other Important Information $5 000 out-of-pocket limit for Medicare-covered services. $36.3 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. 20% of the cost for each in-area network urgent care Medicare-covered visit 0% to 20% of the cost for each specialist visit for Medicare-covered benefits.
UnitedHealthcare Community Plan	UnitedHealthcare Dual Complete (HMO SNP) (H3387-010)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
ArchCare Senior Life	ArchCare Senior Life - Dual (PACE) (H4393-001)	National PACE
ArchCare Senior Life	ArchCare Senior Life - Medicare only (PACE) (H4393-002)	National PACE
Access Medicare	Access Medicare Platinum (HMO) (H4866-002)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit. All plan services included. $39.7 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each specialist visit for Medicare-covered benefits.
Access Medicare	Access Medicare Gold (HMO) (H4866-003)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit. All plan services included. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $15 copay for each specialist visit for Medicare-covered benefits.
Access Medicare	Access Medicare Silver (HMO) (H4866-004)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit. All plan services included. $39.7 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for each specialist visit for Medicare-covered benefits.
Universal Health Care Insurance Company Inc.	Universal Hassle-Free (PPO) (H5096-001)	Local Preferred Provider Organization
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $40 copay for each specialist visit
Universal Health Care Insurance Company Inc.	Universal Hassle-Free MA Only (PPO) (H5096-002)	Local Preferred Provider Organization
Premium and Other Important Information Universal Health Care Insurance Company Inc. will reduce your monthly Medicare Part B premium by up to $ 10.00. $6 700 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $40 copay for each specialist visit
Aetna Medicare	Aetna Medicare Standard Plan (PPO) (H5521-040)	Local Preferred Provider Organization
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $1 000 annual deductible. Contact the plan for services that apply. $10 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $85 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. 40% of the cost for each primary care doctor visit 40% of the cost for each specialist visit
EmblemHealth Medicare PPO	PPO I (PPO) (H5528-001)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $5 100 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $15 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits. 25% of the cost for each primary care doctor visit 25% of the cost for each specialist visit
EmblemHealth Medicare PPO	PPO II (PPO) (H5528-002)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $5 100 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. 25% of the cost for each primary care doctor visit 25% of the cost for each specialist visit
EmblemHealth Medicare PPO	PPO III (PPO) (H5528-003)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $5 100 out-of-pocket limit for Medicare-covered services. $51 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $15 copay for each in-area network urgent care Medicare-covered visit $15 copay for each specialist visit for Medicare-covered benefits. 25% of the cost for each primary care doctor visit 25% of the cost for each specialist visit
EmblemHealth Medicare PPO	Dual Eligible (PPO SNP) (H5528-018)	Local Preferred Provider Organization
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services.* $5 100 out-of-pocket limit for Medicare-covered services.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.* $0 copay for each primary care doctor visit** $0 copay for each specialist visit**
EmblemHealth Medicare PPO	PPO High Option (PPO) (H5528-019)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $5 100 out-of-pocket limit for Medicare-covered services. $94 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $0 copay for each specialist doctor visit for Medicare-covered benefits. 35% of the cost for each primary care doctor visit 35% of the cost for each specialist visit
VNSNY CHOICE Medicare	VNSNY CHOICE Medicare Preferred (HMO SNP) (H5549-002)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $35.4 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits Authorization rules may apply. 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
VNSNY CHOICE Medicare	VNSNY CHOICE Total (HMO SNP) (H5549-003)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
VNSNY CHOICE Medicare	VNSNY CHOICE Medicare Enhanced (HMO) (H5549-004)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each specialist visit for Medicare-covered benefits.
VNSNY CHOICE Medicare	VNSNY CHOICE Medicare Maximum (HMO SNP) (H5549-006)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $31.7 monthly plan premium* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
Comprehensive Care Management Corp.	CCM Direct Complete Plan (HMO SNP) (H5989-002)	HMO
Premium and Other Important Information In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply. $6 700 out-of-pocket limit for Medicare-covered services. $39.7 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits. 20% of the cost for each specialist visit for Medicare-covered benefits.
Comprehensive Care Management Corp.	CCM Direct Total Plan (HMO SNP) (H5989-008)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit for Medicare-covered services.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits Authorization rules may apply. 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Affinity Health Plan	Affinity Medicare Ultimate (HMO SNP) (H5991-001)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit. All plan services included.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 or $10 copay for each specialist visit for Medicare-covered benefits.*
Affinity Health Plan	Affinity Medicare Solutions (HMO SNP) (H5991-002)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit. All plan services included.* $39.8 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 or $10 copay for each specialist visit for Medicare-covered benefits.*
Senior Whole Health of New York	Senior Whole Health of New York (HMO SNP) (H5992-006)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
Amerigroup Community Care	Amerivantage Specialty + Rx (HMO SNP) (H6181-007)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
Amerigroup Community Care	Amerivantage Balance + Rx (HMO) (H6181-009)	HMO
Premium and Other Important Information $1 000 annual deductible. Contact the plan for services that apply. $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $15 copay for each specialist visit for Medicare-covered benefits.
Health Plus	Health Plus Advantage (HMO) (H6264-001)	HMO
Premium and Other Important Information $5 900 out-of-pocket limit. All plan services included. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits. $15 copay for each specialist visit for Medicare-covered benefits.
Health Plus	Health Plus Elite (HMO SNP) (H6264-002)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit. All plan services included. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. Contact plan for details regarding cost sharing $0 monthly plan premium* Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
GuildNet	GuildNet Gold (HMO-POS SNP) (H6864-001)	HMO with POS Option
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services $0 annual deductible.* ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit. All plan services included. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. Contact plan for details regarding cost sharing $0 monthly plan premium* Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits.* $0 copay for the cost of each in-area network urgent care Medicare-covered visit.* $0 copay for each specialist doctor visit for Medicare-covered benefits.*
GuildNet	GuildNet Health Advantage (HMO-POS SNP) (H6864-002)	HMO with POS Option
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $3 400 out-of-pocket limit. All plan services included.* $0 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits 0% or 15% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 15% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 15% of the cost for each specialist visit for Medicare-covered benefits.*
Universal Health Care Insurance Company Inc.	Any Any Any Gold (PFFS) (H8098-001)	Private Fee for Service
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $15 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $40 copay for each specialist visit
Universal Health Care Insurance Company Inc.	Any Any Any Gold MA Only (PFFS) (H8098-003)	Private Fee for Service
Premium and Other Important Information Universal Health Care Insurance Company Inc. will reduce your monthly Medicare Part B premium by up to $ 15.00. $6 700 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $15 copay for each primary care doctor visit for Medicare-covered benefits. $40 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $40 copay for each specialist visit
EASY CHOICE HEALTH PLAN OF NEW YORK	Easy Choice Rewards (HMO) (H9285-001)	HMO
Premium and Other Important Information EASY CHOICE HEALTH PLAN OF NEW YORK will reduce your monthly Medicare Part B premium by up to $ 80.00. $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each specialist visit for Medicare-covered benefits.
EASY CHOICE HEALTH PLAN OF NEW YORK	Easy Choice Value (HMO) (H9285-002)	HMO
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $0 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each specialist visit for Medicare-covered benefits.
ActiveSaver MSA or BlueSaver MSA	ActiveSaver MSA (MSA) (H9788-004)	Medical Savings Account
Premium and Other Important Information Balance billing means that a provider may charge and bill you more than the plan's payment amount for services There is a limit on what providers may charge for Medicare-covered services $4 250 annual deductible Note that only Medicare-covered services will count toward your annual deductible. Medicare will deposit $2 500 into your bank account. You will not have a monthly plan premium. Medicare pays the monthly plan premium for the Medicare MSA Plan. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Balance billing counts towards your plan deductible. Doctor Office Visits Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met.

New York Plan Data by County

• Albany, NY Medicare Advantage Plans
• Allegany, NY Medicare Advantage Plans
• Bronx, NY Medicare Advantage Plans
• Broome, NY Medicare Advantage Plans
• Cattaraugus, NY Medicare Advantage Plans
• Cayuga, NY Medicare Advantage Plans
• Chautauqua, NY Medicare Advantage Plans
• Chemung, NY Medicare Advantage Plans
• Chenango, NY Medicare Advantage Plans
• Clinton, NY Medicare Advantage Plans
• Columbia, NY Medicare Advantage Plans
• Cortland, NY Medicare Advantage Plans
• Delaware, NY Medicare Advantage Plans
• Dutchess, NY Medicare Advantage Plans
• Erie, NY Medicare Advantage Plans
• Essex, NY Medicare Advantage Plans
• Franklin, NY Medicare Advantage Plans
• Fulton, NY Medicare Advantage Plans
• Genesee, NY Medicare Advantage Plans
• Greene, NY Medicare Advantage Plans
• Hamilton, NY Medicare Advantage Plans
• Hardin, NY Medicare Advantage Plans
• Herkimer, NY Medicare Advantage Plans
• Jefferson, NY Medicare Advantage Plans
• Kings, NY Medicare Advantage Plans
• Lewis, NY Medicare Advantage Plans
• Livingston, NY Medicare Advantage Plans
• Madison, NY Medicare Advantage Plans
• Monroe, NY Medicare Advantage Plans
• Montgomery, NY Medicare Advantage Plans
• Nassau, NY Medicare Advantage Plans
• New York, NY Medicare Advantage Plans

• Niagara, NY Medicare Advantage Plans
• Oneida, NY Medicare Advantage Plans
• Onondaga, NY Medicare Advantage Plans
• Ontario, NY Medicare Advantage Plans
• Orange, NY Medicare Advantage Plans
• Orleans, NY Medicare Advantage Plans
• Oswego, NY Medicare Advantage Plans
• Otsego, NY Medicare Advantage Plans
• Putnam, NY Medicare Advantage Plans
• Queens, NY Medicare Advantage Plans
• Rensselaer, NY Medicare Advantage Plans
• Richmond, NY Medicare Advantage Plans
• Rockland, NY Medicare Advantage Plans
• Saint Lawrence, NY Medicare Advantage Plans
• Saratoga, NY Medicare Advantage Plans
• Schenectady, NY Medicare Advantage Plans
• Schoharie, NY Medicare Advantage Plans
• Schuyler, NY Medicare Advantage Plans
• Seneca, NY Medicare Advantage Plans
• Steuben, NY Medicare Advantage Plans
• Suffolk, NY Medicare Advantage Plans
• Sullivan, NY Medicare Advantage Plans
• Tioga, NY Medicare Advantage Plans
• Tompkins, NY Medicare Advantage Plans
• Ulster, NY Medicare Advantage Plans
• Warren, NY Medicare Advantage Plans
• Washington, NY Medicare Advantage Plans
• Wayne, NY Medicare Advantage Plans
• Westchester, NY Medicare Advantage Plans
• Wyoming, NY Medicare Advantage Plans
• Yates, NY Medicare Advantage Plans

New York Plan Data by City

• Buffalo, NY Medicare Advantage Plans
• Rochester, NY Medicare Advantage Plans

• Syracuse, NY Medicare Advantage Plans
• Yonkers, NY Medicare Advantage Plans