By Mike Miligi | Michael M Insurance Services Brightwaters, NY
10 years of Medicare experience | Licensed in 12 states | 18 insurance carriers appointed
Last updated: July 2026
If you’re turning 65 — or you’ve been on Medicare for
years and you’re due for your annual checkup on your
coverage — you’ve probably heard the standard advice:
“Medicare Advantage plans are cheaper, and Medicare
Supplements give you freedom to see any doctor.”
That advice used to be simple. In Bay Shore and the
surrounding towns of western Suffolk County, it isn’t
anymore.
Two things are happening at the same time in 2026.
Medicare Advantage networks — the very thing that makes
those plans affordable — are shrinking, with major local
hospital systems losing contracts with major carriers. And
Medicare Supplement premiums, the plans that guarantee
you access anywhere, have been climbing by double digits
over the last several years.
That leaves you squeezed in the middle: the “cheap and
flexible” plan may no longer include your hospital, and the
“always covered” plan is getting more expensive every
year. This article walks through exactly what’s changed,
which plans still cover the hospitals you rely on, and how
to think through the Advantage-vs-Supplement decision
with real information instead of guesswork.
Why This Matters So Much in Bay Shore and Western Suffolk County
If you live in Bay Shore, Brightwaters, West Islip, Islip,East Islip, or a nearby town within about 10 miles, your
care is almost certainly centered on one (or both) of two
hospital systems:
- Southside Hospital (Bay Shore) — part of
Northwell Health - Good Samaritan University Hospital (West
Islip) — part of Catholic Health
Between these two systems, most residents in this area get their primary care, cardiology, surgery, and emergency care. For patients with more complex or specialized needs,
some plans also extend to regional and specialty center
like Stony Brook University Hospital, Memorial Sloan
Kettering, and Hospital for Special Surgery — though
access to those varies significantly by plan, which we’ll get
into below.
When a carrier and a hospital system can’t agree on a
contract, it isn’t an abstract business dispute. It’s the
difference between your cardiologist being covered next
month or not.
The 2026 Network Changes Affecting Bay Shore Residents
❌ Southside Hospital (Northwell) — Two Carrier Out
Northwell Health, which operates Southside Hospital, h
had two significant Medicare Advantage terminations in
2026:
HealthSpring (formerly Cigna Medicare) ended its
entire Northwell network relationship effective January
1, 2026 . This includes Southside Hospital, every
Northwell-affiliated physician, and all Northwell ancillary
services.
WellCare did not renew its Northwell contract, which
expired June 30, 2026 . As of July 1, 2026 , Southside
Hospital and all Northwell facilities are out-of-network for
WellCare Medicare Advantage members. A
continuity-of-care window allows established WellCare
patients to continue Northwell treatment through August
29, 2026 , but only with Wellcare’s authorization for each
service — it is not automatic.
If you’re on either plan and you’ve seen a Southside
Hospital or Northwell provider this year, verify with your
carrier whether those claims were processed in-network.
❌Good Samaritan Hospital (Catholic Health) — Healthfirst Out
Catholic Health’s contract with Healthfirst ended on
March 15, 2026 . The two organizations entered a
two-month member cooling-off period, after which the
relationship formally ended on May 15, 2026 .If you’re a Healthfirst Medicare Advantage member who
relies on Good Samaritan Hospital or its affiliated
physicians, that care is now out-of-network unless you’ve
qualified for a continuity-of-care exception through
Healthfirst directly.
Quick Reference: Local Hospital Network Status by Carrier (July 2026)
| Plan | Southside Hospital (Northwell) |
Good Samaritan Hospital (Catholic Health) |
Notes |
|---|---|---|---|
| Aetna | ☑ Generally in-network — verify | ☑ Generally in-network — verify | No confirmed disputes reported |
| Anthem BCBS | ☑ Generally in-network — verify | ☑ Generally in-network — verify | No confirmed disputes reported |
| United Health care | ☑ Generally in-network — verify | ☑ Generally in-network — verify | Always confirm individual physician participation |
| Humana | ☑ Generally in-network — verify | ☑ Generally in-network — verify | No confirmed disputes reported |
| Emblem Health | ☑ Generally in-network — verify | ☑ Generally in-network — verify | No confirmed disputes reported |
| Health first | ✖ Out of network since May 15, 2026 | ☑ Generally in-network | Cooling-off period ended; confirmed termination |
| WellCare | ✖ Out of network since July 1, 2026 | ☑ Generally in-network — verify | Continuity window through Aug 29, 2026, with authorization |
| Health Spring | ✖ Out of network since Jan 1, 2026 | ☑ Generally in-network — verify | Full Northwell termination |
| Medigap plan | ☑ Always covered | ☑ Always covered | No network restrictions |
Network status as of July2026. Contracts are subject to change. Always verify your
specific physician’s participation directly with your carrier before scheduling
non-emergency care.
Plan Star Ratings and Why They Matter
Anthem Medicare Advantage 3 (HMO-POS) — 5
Stars
Anthem’s HMO-POS plan holds the only 5-star overall
CMS rating available to Suffolk County enrollees for 2026
— the highest possible score. It pairs that top rating with a
strong Northwell and Catholic Health doctor and hospital
network. The tradeoff, as noted earlier in this article, is the
HMO-POS structure: less flexibility than a PPO, so if you
split your care across multiple health systems, verify that
all of your providers are covered under this specific plan.
Aetna Medicare Elite (PPO) — 4.5 Stars
Aetna’s Elite PPO combines a strong 4.5-star rating with
the largest doctor and hospital network of any Medicare
Advantage plan in the tri-state area. For residents who see
specialists across different hospital systems — say, a
cardiologist at one and an orthopedist at another —
Aetna’s PPO structure and network breadth is hard to
beat. As always, confirm your specific physicians are
in-network, since individual provider participation can
differ from the overall network relationship.
Humana Direct Choice Giveback (PPO) — 3 Stars
Humana’s standout feature is its Part B giveback — this
plan reduces your monthly Part B Premium by up to
42,which is real monthly savings, but it comes with trade offs: a
3−Star Rating,a comparatively weaker doctorand hospital
network in this area,and higher−than−typical copays for
common services. An MRI could be as High as $780 compared
to $300 with some of the other plans discussed here. This
plan can make sense if the premium giveback matters
more to you than broad network access or lower per-visit
costs — but go in with your eyes open about that tradeoff.
Star ratings and plan details reflect 2026 CMS data as published in
each carrier’s Summary of Benefits. Ratings are re-evaluated
annually — always confirm the current year’s rating and your
specific providers’ network status before enrolling.
Anthem Medicare Advantage 3 (HMO-POS) — 5 Stars
Anthem’s HMO-POS plan holds the only 5-star overall
CMS rating available to Suffolk County enrollees for 2026
— the highest possible score. It pairs that top rating with a
strong Northwell and Catholic Health doctor and hospital
network. The tradeoff, as noted earlier in this article, is the
HMO-POS structure: less flexibility than a PPO, so if you
split your care across multiple health systems, verify that
all of your providers are covered under this specific plan.
Aetna Medicare Elite (PPO) — 4.5 Stars
Aetna’s Elite PPO combines a strong 4.5-star rating with
the largest doctor and hospital network of any Medicare
Advantage plan in the tri-state area. For residents who see
specialists across different hospital systems — say, a
cardiologist at one and an orthopedist at another —
Aetna’s PPO structure and network breadth is hard to
beat. As always, confirm your specific physicians are
in-network, since individual provider participation can
differ from the overall network relationship.
Humana Direct Choice Giveback (PPO) — 3 Stars
Humana’s standout feature is its Part B giveback — this
plan reduces your monthly Part B Premium by up to
42,which is real monthly savings, but it comes with trade offs: a3−Star Rating,a comparatively weaker doctorand hospital
network in this area,and higher−than−typical copays for
common services. An MRI could be as High as $780 compared
to $300 with some of the other plans discussed here. This
plan can make sense if the premium giveback matters
more to you than broad network access or lower per-visit
costs — but go in with your eyes open about that tradeoff.
Star ratings and plan details reflect 2026 CMS data as published in
each carrier’s Summary of Benefits. Ratings are re-evaluated
annually — always confirm the current year’s rating and your
specific providers’ network status before enrolling.
The Real Decision: Medicare Advantage vs. Medicare Supplement
This is the question underneath everything above, and it
doesn’t have a single right answer — it depends on your
Health, your Doctor Needs, and Monthly Premium
considerations.
| Plan Type | Medicare Advantage |
Medicare Supplement (Medigap) |
|---|---|---|
| Premium | Often $0–low monthly premium | Monthly premium required, and has been rising. |
| Network | Limited to carrier’s contracted providers — subject to change | Any doctor or hospital that accepts Medicare, nationwide |
| Cost predictability | Copays/coinsurance vary by service | Highly predictable — most costs covered after deductible |
| Risk if a hospital drops your plan | You may lose access to your hospital or doctor midyear | Not applicable — no network to lose |
| Extra benefits | Often includes dental, vision, hearing | Typically requires separate standalone plans |
| Part D | Usually included in plan | Purchased separately |
In my 10+ years writing Medicare business in New York,
I’ve watched Medicare Supplement premiums —
particularly Plan G and Plan N — climb by double digits
over the last several renewal cycles. This is driven in large
part by New York’s guarantee-issue and community-rating
rules, which limit insurers’ ability to price based on
individual health status, spreading costs differently than in
most other states.
That rising cost is real. But so is the risk on the other side:
if you’re on a Medicare Advantage plan and your hospital
system loses its contract — as just happened with two
carriers and two hospitals in your own area — you may be
forced to either pay out-of-network costs or switch doctors
mid-treatment.
Neither option is automatically “better.” It depends on
how much you value premium savings versus certainty of
access.
What To Do Right Now — Depending on Your Situation
If you’re on WellCare and use Southside Hospital:
- Call WellCare before your next appointment and confirm authorization
- Ask specifically whether your doctor is in-network effective July 1, 2026
- Call my office — you may qualify for a SpecialEnrollment
If you’re on HealthSpring and use Southside Hospital: Period
- Review your 2026 Explanation of Benefits for out-of-network charges
- Contact HealthSpring about any claims processed since January 1
- Call my office to review your options
If you’re on Healthfirst and use Good Samaritan Hospital:
- Confirm with Healthfirst whether you qualify for a continuity-of-care exception
- Call my office to review Special Enrollment Period eligibility
If you’re weighing Medicare Advantage against a Medicare Supplement for the first time:
- Before comparing premiums, let’s talk about your Doctors and any Hospital needs.
- I’ll check live network status for every plan available in your ZIP code
- We’ll review the cost benefits of paying a monthly premium vs no premium and copays.
If you’re already on a Medicare Supplement:
- You’re protected from everything above — your access to Southside, Good Samaritan, or any Medicare-accepting provider isn’t affected by carrier network disputes
- Still worth an annual review of your premium and Part D plan to make sure you’re getting the best value
Frequently Asked Questions
Does WellCare cover Southside Hospital in 2026?
No. WellCare’s contract with Northwell Health, whichoperates Southside Hospital,
expired June 30, 2026. As of July 1, Southside is out-of-network for WellCare Medicare
Advantage members, with a continuity-of-care window through August 29, 2026,
requiring authorization.
Does HealthSpring cover Southside Hospital in 2026?
No. HealthSpring terminated its entire Northwell Health network relationship effective
January 1, 2026.
Does Healthfirst cover Good Samaritan Hospital?
No. Catholic Health’s contract with Healthfirst ended March 15, 2026, with the
relationship fully terminating after a two-month cooling-off period on May 15, 2026.
Would a Medicare Supplement protect me from losing access to my hospital?
Yes. Medigap works alongside Original Medicare, and both Southside Hospital and
Good Samaritan Hospital accept Original Medicare. No carrier-hospital contract dispute
affects Medigap access.
Can I switch Medicare plans mid-year if my carrier dropped my hospital?
Possibly — losing access to your hospital or provider network due to a contract
termination may qualify you for a Special Enrollment Period. Call my office to review
your specific situation.
I'm Here to Help
I’ve been helping Bay Shore-area residents navigate Medicare for over 10 years. I am a
Medicare Beneficiary myself so I understand firsthand the choices available in our area.
If you’re unsure whether your plan still covers your hospital, or you’re trying to decide
between a Medicare Advantage plan and a Medicare Supplement, call me. I’ll look at
your specific circumstances, your plan, and help you with your options.
That conversation is always free.
Related Topics-
Information Sources
Mike Miligi
Michael M Insurance Services
Brightwaters, NY
631-774-3786
mmilinsurance@gmail.com
www.mymedicaremike.com
Serving Babylon, Bay Shore, Brightwaters, West Islip, Islip, East Islip, and
surrounding western Suffolk County towns
Disclaimer: Michael M Insurance Services is not connected with or endorsed by the
United States government or the federal Medicare program. Networkparticipation
status reflects information available as of July 2026 and is subject to change. Contract
negotiations between carriers and health systems are ongoing — always verify current
network status directly with your carrier before scheduling non-emergency care. We do
not offer every plan available in your area. Contact Medicare.gov or 1-800-MEDICARE
for information on all of your options.
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