If you’re a senior living in Rochester, you might wonder about Medicare in Rochester, New York. Rochester is home to 261,549 beneficiaries, 117,010 of which fall under MA plans, yielding a 67.68% participation rate. The average age of beneficiaries is 69, only three less than the national average, split into 53.06% female and 46.94% male participants.
Medicare plans in Rochester, NY
This article will cover the types of New York Medicare plans available to you or your loved one, including the average costs and what kind of coverage you can expect. We’ve based the below quotes on a female aged 65.
While this provides a good reference point, you can expect the quotes to change slightly based on your demographics.
Medicare Advantage plans
Compared to previous years, the average Medicare beneficiary has access to more Medicare Advantage plans in 2022, an 8% increase over 2021, amounting to 39 total. Of those, 31 include New York Medicare Advantage Prescription Drug (MAPD) coverage.
Medicare in Rochester, New York, has around 84,539 FFS beneficiaries and 117,010 MA beneficiaries. We’ll cover some of the more popular and cost-effective plans below.
Wellcare offers a $0 premium, appealing to almost anyone seeking coverage. Enjoy a $7,550 maximum out-of-pocket (MOOP) limit. This program is a local PPO plan with a four-star rating, making it one of the more sought-after plans on the market.
offers the same $0 premium, and the MOOP comes to $6,700. This program is a regional PPO plan with a four-star rating.
Excellus Health sits a little above the others at a five-star rating, and this is an HMO-POS plan type with a $0 premium. Beneficiaries can expect a $4,500 MOOP.
The average cost of Medicare Advantage plans in Rochester, New York
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATING |
| Wellcare | $0 | $7,550 | LOCAL PPO | 4 |
| Aetna | $0 | $7,550 | LOCAL PPO | 4 |
| $0 | $6,700 | REGIONAL PPO | 4 | |
| Excellus Health | $0 | $4,500 | HMO-POS | 5 |
| Wellcare | $0 | $6,700 | LOCAL PPO | 4 |
Medicare Supplement plans
While you might expect specific Medicare plans in Rochester, New York Medigap plans are standardized nationwide, separated into different letters.
This means benefits will remain the same regardless of your state. The only difference lies in monthly premiums. Plan G, for example, offers premiums as low as $184.70 and as high as $463.75.
The average cost of Medicare Supplement plans in Rochester, New York
| LETTER PLAN | LOWEST PREMIUM | HIGHEST PREMIUM |
| PLAN A | $152.57 | $285.56 |
| PLAN B | $204.82 | $382.69 |
| PLAN C | $272.95 | $396.95 |
| PLAN D | $183.80 | $376.42 |
| PLAN F | $300.67 | $578.22 |
| PLAN HDF | $52.53 | $62.22 |
| PLAN G | $184.70 | $463.75 |
| PLAN HDG | $52.53 | $61.93 |
| PLAN K | $77.62 | $141.75 |
| PLAN L | $172.00 | $222.73 |
| PLAN M | $308.38 | $393.08 |
| PLAN N | $192.01 | $303.50 |
Medicare Part D prescription drug plans
Some patients opt to forgo traditional Medicare plans in Rochester, New York, in favor of Part D plans. These standalone plans cover prescription medications in New York. Medigap plans don’t cover prescriptions, and only some Medicare Advantage plans do.
One of the more sought-after plans is Aetna, boasting a $7.20 premium. With Aetna, you will pay a $480 deductible. Overall, this plan earns a three-star rating, making it a fine choice for anyone looking for a solid plan.
With a slightly higher premium at $12.90, Wellcare is another popular choice. Expect a similar $480 deductible. This plan clocks in at three stars, making it one of the mainstays of Part D plans.
For something with a slightly higher premium, consider . You will pay $34.20 with a $310 deductible. This plan has a four-star rating, making it more desirable than similar plans.
The average cost of Medicare Part D plans in Rochester, New York
| PLAN | PREMIUM | DEDUCTIBLE | STAR RATING |
| Aetna | $7.20 | $480 | 3 |
| Wellcare | $12.90 | $480 | 3 |
| Humana | $25.00 | $480 | 3 |
| $34.20 | $310 | 4 | |
| Cigna | $40.80 | $480 | 3 |
Special Needs plans
Medicare in Rochester, New York, offers Special Needs Plans. SNPs comprise a subset of Medicare Advantage plans for people with chronic disabilities or special needs and come in three categories: dual, chronic, and institutional.
If you need a stellar dual plan, consider Wellcare HMO or local PPO plans. Each program sports a $0 premium, making it easy and cost-effective. Likewise, the MOOP for each amounts to $3,450.
Elderplan is an excellent option for those seeking an institutional plan. This HMO plan has a $42.40 deductible to account for high-quality services. The MOOP comes in at $7,550.
Another great option is Aetna, with a $0 premium. This HMO plan offers dual eligibility and has a MOOP of $7,550.
The average cost of Medicare Special Needs plans in Rochester, New York
| PLAN | PREMIUM | MOOP | PLAN TYPE | ELIGIBILITY |
| Wellcare | $0 | $3,450 | HMO | Dual |
| $0 | $7,550 | HMO | Dual | |
| Aetna | $0 | $7,550 | HMO | Dual |
| Elderplan | $42.40 | $7,550 | HMO | Institutional |
| Wellcare | $0 | $3,450 | LOCAL PPO | Dual |
How to sign up for Medicare plans in Rochester
Medigap covers all your Medicare needs in Rochester, New York. We work with every carrier free of charge for you and compare all the best plans to find one that works for you. Give us a call or complete our rate form to get rates now.
