Brighton Beach: D-SNPs, IB-Dual, and the “default enrollment” letter

Brighton Beach has one of the highest concentrations of older adults in the city, living in the prewar apartment buildings along Brighton Beach Avenue and in the larger buildings near the boardwalk and Ocean Parkway. Most arrived from the former Soviet Union, and a very large share have both Medicare and Medicaid. Some are only now reaching Medicare age after years in a Medicaid managed care plan and have just received a “default enrollment” letter.

This page is for them and for the adult children and home attendants who read their mail. It explains, without recommending any plan, what the letter asks, what happens if nobody acts, what happens if you opt out, and how to get a free counselor in Russian or English.

Brighton Beach is in Kings County; the address says New York, but the county on every Medicare and Medicaid form is Kings. Medicaid is administered citywide by the NYC Human Resources Administration (HRA). ZIP 11235 covers Brighton Beach and continues into Sheepshead Bay (approximate; verify with USPS). All New York City integrated dual plans on the state’s 2026 IB-Dual chart list Kings County.

The neighborhood’s public hospital is NYC Health + Hospitals / Coney Island on Ocean Parkway, a short bus ride west, and the medical offices along Brighton Beach Avenue and Coney Island Avenue are where most residents are seen. Whether your doctor, that hospital, and the pharmacy under the train are in a specific D-SNP’s Medicare network is the first question for a counselor.

The B and Q at Brighton Beach and the buses along Brighton Beach Avenue put two in-person HIICAP sites within a short trip.

Brighton Beach Avenue is lined with storefront offices that “help with Medicare.” Before handing the letter to one of them, know what it is: a notice from your own Medicaid plan, sent at least 60 days before Medicare starts, saying you will be placed in that plan’s D-SNP unless you opt out by the date it gives. A storefront may be paid by the plans it enrolls people in; HIICAP is not affiliated with any plan.

Opting out means calling or writing the plan, and New York Medicaid Choice can connect you. For most people it also ends the Medicaid managed care plan, and Medicaid continues as fee-for-service. Staying means IB-Dual if you need no more than 120 days of community long-term services, or a MAP plan if you need more. Many Brighton Beach households are in the second group, so ask which version of the notice you received.