By Mike Miligi, Certified Medicare Insurance Planner- Michael M Insurance Services
Every fall, Bay Shore mailboxes fill up with Medicare notices, and every fall, a lot of those notices go straight
into a drawer unread. That’s a mistake with real consequences here in Suffolk County, where Bay Shore
residents have 46 Medicare Advantage plans to choose from for the 2026 plan year — including 19
Special Needs Plans — plus 10 Medicare Supplement options and 10 stand-alone Part D drug plans. These
numbers shift somewhat from year to year, but the plan count is consistently large enough that the Annual
Enrollment Period isn’t paperwork to file away. It’s your once-a-year chance to make sure your coverage still
fits your doctors, your medications, and your budget. Here’s what Bay Shore residents specifically need to
know.
What Is the Annual Enrollment Period?
The Medicare Annual Enrollment Period (AEP), also called Fall Open Enrollment, runs every year from
October 15 through December 7. Any changes you make take effect January 1. During this window, you can:
- Switch from one Medicare Advantage plan to another
- Move from Original Medicare into a Medicare Advantage plan, or go back
- Switch from one Part D prescription drug plan to another
- Enroll in Part D for the first time, or drop it
For Bay Shore, Islip, Babylon, Deer Park, Brightwaters, and the rest of the surrounding South Shore
communities, this window is when the local plan landscape actually gets worth revisiting — because it changes
every single year, whether you notice or not.
Why AEP Matters More in Bay Shore Than You'd Think
Here’s a real, local example of why “if it worked last year, it’ll work this year” doesn’t hold up: Anthem’s
Medicare Advantage plans are no longer accepted by Northwell Health facilities in this area. If you enrolled in
an Anthem plan a few years ago because your doctor was in-network, that network reality can shift under you
without you ever changing plans yourself.
This is exactly the kind of change your plan’s Annual Notice of Change (ANOC) letter — mailed every
September — is designed to flag. It’s also exactly the kind of change that’s easy to miss if you assume
nothing’s different this year.
The Local Carrier Landscape
Bay Shore and Suffolk County residents currently see Medicare Advantage plans from several major carriers,
and they are not interchangeable:
| Carrier | What Bay Shore Residents Should Know |
|---|---|
| Aetna | Generally the widest local hospital and doctor network, including out-of-state usability. The Elite plan is a popular $0-premium option. |
| Humana | Solid local network with several plan options; some copays run higher than average, though it can work well for certain Tier 3 medications. |
| Anthem | A narrower local network, and no longer accepted by Northwell facilities — worth confirming carefully before enrolling or renewing. |
| WellCare | Additional plan options in the area, worth comparing directly against your specific doctors and medications. |
| United Healthcare | Locally, largely limited to Dual Special Needs Plans (D-SNPs) for those eligible for both Medicare and Medicaid. |
Two people in the same Bay Shore neighborhood, on paper-similar plans from two different carriers, can end
up with very different access to Southside Hospital, Good Samaritan, or their specific specialists. That’s not
something premium comparisons alone will tell you.
The Medicare Calendar at a Glance
A lot of AEP confusion comes from mixing it up with other Medicare windows. Here’s the full picture:
| Window | When It Runs | What It's For |
|---|---|---|
| Initial Enrollment Period (IEP) | 7-month window around your 65th birthday | First-time Medicare enrollment |
| Annual Enrollment Period (AEP) | October 15 – December 7, every year | Full range of plan changes for anyone on Medicare |
| Medicare Advantage Open Enrollment Period (MA OEP) | January 1 – March 31, every year | One additional switch, only if you're already in a Medicare Advantage plan |
| Special Enrollment Periods (SEPs) | Triggered by specific life events | Enrollment changes outside the standard windows |
If you’re already enrolled in a Medicare Advantage plan and miss AEP, the MA OEP that follows on January 1
gives you one more shot — but it’s narrower, and it’s not a substitute for reviewing your options every fall.
Common AEP Pitfalls Bay Shore Residents Should Watch For
- Assuming your hospital is still in-network. Confirm Southside, Good Samaritan, and any specialists you
see directly against your specific plan this year, not last year’s assumption. - Comparing plans by premium alone. A $0 premium plan with a narrow network or a weak formulary for
your specific medications can cost more overall than a plan with a modest premium. - Skipping the ANOC letter. It’s mailed every September and spells out exactly what’s changing for your
plan — premium, network, drug tiers, and benefits. - Missing the December 7 deadline. There’s no grace period. Miss it, and you’re generally waiting for the
narrower MA OEP or the next AEP. - Not rechecking your prescriptions. Drug formularies and tier placement change annually, even on a plan
you’re otherwise happy with.
Your AEP Checklist for Bay Shore Residents
- Read your ANOC letter the week it arrives — don’t set it aside.
- List your current doctors and hospitals — especially if you use Southside, Good Samaritan, or a Northwell-affiliated specialist.
- Read your ANOC letter the week it arrives — don’t set it aside. List your current doctors and hospitals — especially if you use Southside, Good Samaritan, or a Northwell-affiliated specialist. Pull your medication list, including dosages, and check it against your plan’s formulary for the coming year.
- Compare more than one plan. With dozens of Medicare Advantage options in the area each year (46 for 2026), the first plan you look at is rarely the only one worth considering.
- Check the out-of-pocket maximum, not just the monthly premium, especially if you have ongoing treatment or anticipate a procedure.
- Decide before December 7 — give yourself a buffer instead of waiting for the final days of the window.
Frequently Asked Questions
How many Medicare Advantage plans are available in Bay Shore?
For the 2026 plan year, Bay Shore residents have access to 46 Medicare Advantage plans, including 19
Special Needs Plans for those who qualify for both Medicare and Medicaid or manage a qualifying chronic
condition. That exact count shifts somewhat every year as carriers add or drop plans, but it’s consistently a
large enough field that a side-by-side comparison matters far more than picking the first plan that looks
reasonable.
Will my doctors and local hospitals still be covered if I don't change plans?
Not necessarily. Provider networks can and do shift year to year — Anthem’s loss of Northwell acceptance in this area is a real recent example. The only way to know for certain is to check your specific doctors and
hospitals against your plan’s current-year network, even if you’re not planning to switch.
What's the difference between AEP and the Medicare Advantage Open Enrollment Period?
AEP (October 15 – December 7) is open to everyone on Medicare and allows a full range of changes —
switching Medicare Advantage plans, switching Part D plans, or moving between Original Medicare and
Medicare Advantage. The MA OEP (January 1 – March 31) is narrower and only available if you’re already
enrolled in a Medicare Advantage plan, allowing one additional switch.
I like my current plan — do I still need to do anything during AEP?
It’s worth at least reading your ANOC letter. Even if you end up staying with the same plan, premiums, drug
tiers, and networks can change under the hood, and it’s better to confirm that deliberately than assume it by
default.
Can I switch from a Medicare Supplement (Medigap) plan to Medicare Advantage during AEP?
Generally, yes, and it typically doesn’t require medical underwriting. Moving the other direction — from
Medicare Advantage back to Medigap — can involve underwriting in most states, so that switch is worth
planning for carefully rather than assuming it’s automatic.
Does Medicare Advantage cover dental, vision, and hearing in Bay Shore?
Does Medicare Advantage cover dental, vision, and hearing in Bay Shore?
Many local plans include some level of dental, vision, or hearing coverage as an extra benefit, but the specifics
— routine cleanings versus major work, annual allowances, in-network providers — vary significantly from plan
to plan. It’s worth confirming exactly what’s included rather than assuming all plans offer the same extras.
What if I qualify for both Medicare and Medicaid — are there local options for that?
Yes. Several carriers, including United Healthcare, offer Dual Special Needs Plans (D-SNPs) in the Bay Shore
and Suffolk County area specifically for people who qualify for both programs. These plans coordinate
Medicare and Medicaid benefits together rather than leaving you to manage both separately.
Does Good Samaritan Hospital accept Medicare Advantage plans?
It depends on the specific plan and carrier, not on Medicare Advantage as a category. Good Samaritan and
Southside are both major local hospitals, but network participation varies by carrier and can change from year
to year — the same way Anthem’s relationship with Northwell shifted. The only reliable way to know is to check
your specific plan’s current-year network directly, even if you’ve used that hospital under the same plan before.
I live in Islip, Babylon, or Brightwaters — does this apply to me too?
Yes. AEP rules and deadlines are federal and apply the same way regardless of which South Shore community
you’re in. What does vary locally is which specific plans and networks serve your exact address, since
Medicare Advantage plans are approved by county and network participation can differ slightly even between
neighboring towns. It’s worth confirming plan availability for your specific address rather than assuming it
matches a neighbor’s in a different part of Suffolk County.
Where can I get in-person Medicare help in Bay Shore during AEP?
I meet with Bay Shore-area residents by phone, video call, or in person, depending on what’s easiest for you. AEP is a short window with a hard deadline, so I’d recommend reaching out well before early December rather
than waiting for the last week, when scheduling gets tighter for everyone.
What should I bring to a Bay Shore Medicare consultation?
Your current Medicare card, a list of every medication you take with dosages, and the names of your doctors
and any hospitals you use regularly — Southside, Good Samaritan, or otherwise. If you have your current
plan’s ANOC letter, bring that too. Having all of it in one place lets us move straight to comparing real options
instead of tracking down details after the fact.
What happens if I miss the December 7 deadline?
If you’re already in a Medicare Advantage plan, you’ll have the Medicare Advantage Open Enrollment Period
(January 1 – March 31) as a narrower second chance. Otherwise, you’re generally waiting until the next AEP,
unless a qualifying life event gives you a Special Enrollment Period.
Get a Local, Side-by-Side Comparison
Reading formularies and checking hospital networks isn’t how most people want to spend a fall afternoon —
but it’s exactly what determines whether your coverage actually works when you need it. If you’re a Bay Shore,
Islip, Babylon, Deer Park, or Brightwaters resident and want a straightforward comparison built around your
actual doctors and medications, I can put one together for you at no cost. You can also see more about how I
work with local residents on my
Bay Shore Medicare Broker page.
Mike Miligi
Owner, Michael M Insurance Service
For over 10 years, Mike has helped seniors and other Medicare-eligible individuals understand their options, including
Medicare Advantage Plans (Part C), Medicare Supplement Plans (Medigap), Prescription Drug Plans (Part D), and dental
and vision programs. Mike is licensed in seven states and certified with 11 insurance carriers. As an independent
Medicare health insurance broker, he works for the client, not the insurance carriers, providing accurate, unbiased
options. Mike recertifies with CMS annually and completes continuing education to stay current on industry standards.
(631) 774-3786 | mmilinsurance@gmail.com | www.mymedicaremike.com
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