If you live in Albany and have Medicare, the annual enrollment period from October 15 to December 7 is your yearly chance to review your coverage and make a change. You can join, switch, or drop a Medicare Advantage or drug plan, and the plan must get your request by December 7 for coverage that starts January 1. This guide is for people in Albany, Schenectady, Troy, Colonie, Guilderland, Bethlehem, Delmar, Latham, Cohoes, Rensselaer, Clifton Park, and Saratoga Springs.
This article is educational. Instant Health Help is a licensed health insurance agency, and our agent, Lobsang Rivas, is licensed in New York and certified as a broker with NY State of Health. We are not Medicare, CMS, NY State of Health, the New York State Office for the Aging, or an insurance company, and we do not quote prices or name plans here. Check official dates on Medicare.gov.
The short answer
You have three good places to start in the Capital Region, and you can use more than one:
- Medicare. Medicare.gov Plan Finder and 1-800-MEDICARE (1-800-633-4227) show the plans sold in your ZIP code.
- HIICAP, New York’s State Health Insurance Assistance Program. The New York State Office for the Aging runs HIICAP through local offices for the aging. Call 1-800-701-0501 and you are routed to a counselor for your county. See the HIICAP page.
- A licensed agent. An agent can compare options with you and help you enroll. Medicare.gov suggests checking the rules agents must follow.
Where do you sign up for Medicare? Medicare.gov says you sign up for Part A and Part B through Social Security, online or at a local Social Security office. Once you have Part A and Part B, the three options above can help you choose a plan.
Key Medicare dates
- Annual enrollment: October 15 to December 7. Changes start January 1.
- Medicare Advantage open enrollment: January 1 to March 31, only if you are already in a Medicare Advantage plan. You can switch to another Advantage plan or go back to Original Medicare.
- Turning 65: your initial enrollment period lasts seven months, starting three months before the month you turn 65.
Have retiree coverage? Check first
The Capital Region has a lot of retirees from state and local government, schools, hospitals, and private employers. Medicare.gov says that if you have other health insurance or drug coverage, you should talk to your benefits administrator before you join a plan or make any change. Some retiree plans have their own rules about Medicare, so ask before you switch.
EPIC: New York’s drug cost help for seniors
The New York State Department of Health runs the Elderly Pharmaceutical Insurance Coverage (EPIC) program. It helps income-eligible New Yorkers age 65 and older with out-of-pocket Medicare Part D drug costs. You can apply at any time of the year, and you must be enrolled in, or eligible for, a Part D drug plan to get EPIC benefits. When you compare drug plans, tell us or your HIICAP counselor if you have EPIC. See the EPIC page. If your income is limited, Medicare.gov also points to Extra Help, which you apply for through Social Security, and Medicare Savings Programs, which you apply for through the state.
Why your address decides your choices
Medicare.gov says that to join a Medicare health or drug plan, you must live in the plan’s service area. So choices in Albany County may differ from Schenectady, Rensselaer, or Saratoga County. Rensselaer County borders Massachusetts and Vermont. If you live across the line in either state, our agent is not licensed there, so use Medicare.gov or that state’s SHIP counselors, which you can find through SHIP’s national locator.
Just moved to be near family? Medicare.gov says that if you move to a new address outside your plan’s service area, your chance to switch starts when you move and lasts for 2 full months after. If you tell your plan before you move, it can start the month before. See Medicare’s Special Enrollment Periods page.
What to review this fall
Your Annual Notice of Change. Read what is changing for next year before you decide to stay.
Your doctors and hospitals. Whether you go to a hospital near downtown Albany, in Troy, or in Schenectady, confirm directly with the office and the plan.
Your prescriptions and pharmacy. Enter every drug you take in Plan Finder, along with the pharmacy you actually use.
If you spend winters elsewhere. If you live in another state for part of the year, Medicare.gov suggests checking whether the plan will cover you there.
Someone in your house under 65?
If a spouse or adult child needs their own coverage, New Yorkers apply through NY State of Health, not HealthCare.gov. Open enrollment for Qualified Health Plans starts November 1, and Medicaid, Child Health Plus, and the Essential Plan are open all year for people who qualify. Our agent is certified as a broker with NY State of Health, so we can go through the application with you, compare plans with your doctors and prescriptions in mind, and help you enroll, at no extra cost to you for our help. We are not NY State of Health, and NY State of Health decides what you qualify for. See our New York open enrollment guide for the full dates, or NY State of Health.
How we help
We help New Yorkers with Medicare by phone and online, in English or Spanish. Learn more on our New York health insurance help page. We look at your doctors, prescriptions, ZIP code, and any retiree or EPIC coverage you have, explain the options in plain English, and leave the decision to you. If you are helping a parent, you are welcome on the call too.
Want a second set of eyes before December 7?
Have your Medicare card, your drug list, and your doctors’ names ready, and we can walk through it together.
Call (321) 315-0054 | agent@inshh.com
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 489 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, is available 24 hours a day, 7 days a week, except some federal holidays. Instant Health Help is not connected with or endorsed by the U.S. government or the federal Medicare program.
Featured photo: New York State Capitol building, full by Shaunfrombrooklyn, CC BY-SA 4.0, cropped with text added.
