FINDING THE RIGHT PLAN

Because we are independent, our priority is you, not the insurance company. We represent many different Medicare carriers which offer a wide variety of plans and plan options.  Our goal is to introduce the most cost-effective plan based on available carriers in your area.  We work for you, on your side.  Regardless of the need, loss, or complexity. 

Romantic Senior Couple Hugging On Beach Smiling To Camera

WHAT’S YOUR SITUATION

  • Are you turning 65 soon?

  • Are you 65 or older and still employed?

  • Are you currently in a plan and need a plan review?

  • Are you a Veteran on VA benefits only?

Who is eligible for Medicare

Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. Medicare Part A and Part B are known as “Original Medicare” Parts C and D are voluntary coverages.

WHAT ARE THE PARTS OF MEDICARE

Medicare Part A (Hospital Insurance)

Helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay). Part A also pays for some home health care and hospice care.

Medicare Part B (Medical Insurance)

Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services

Medicare Part C (Medicare Advantage)

Part C includes all the benefits and services a member would receive under original Medicare Parts A and B. Usually the plan includes Medicare Prescription Drug Coverage (Part D). Some plans may even include dental and vision coverage, wellness programs, and personal care management. Medicare Advantage is offered by Medicare-approved private insurance companies and may include extra benefits and services.

Prescription Drug Plan (Medicare Part D)

Medicare Part D, Prescription Drug Plan Coverage, can be purchased as a stand-alone plan or in conjunction with a Medicare Advantage plan (known as MA-PD). Prescription drug plans can help keep out-of-pocket costs lower. Prescription Drug Plan coverage is offered by Medicare-approved private insurance companies.

Medicare Supplement (Medigap)

Medicare Supplement Plans are designed to protect against the out-of-pocket costs that Medicare Parts A and B do not cover, such as deductibles and coinsurance. Medicare Supplement Plans do not include prescription drug coverage. Prescription drug coverage must be covered under another plan.

When is Medicare open enrollment?

Medicare open enrollment, also known as Medicare’s annual election period (AEP) – runs from October 15 through December 7 each year.

During the Medicare open enrollment period, you can:

  • Switch from Original Medicare to Medicare Advantage (as long as you’re enrolled in both Medicare Part A and Part B, and you live in the Medicare Advantage plan’s service area)
  • Switch from Medicare Advantage to Original Medicare (plus a Medicare Part D plan, and possibly a Medigap plan)
  • Switch from one Medicare Advantage plan to another
  • Switch from one Medicare Part D prescription drug plan to another
  • Enroll in a Medicare Part D plan if you didn’t enroll when you were first eligible for Medicare. If you haven’t maintained other creditable coverage, a late-enrollment penalty may apply

During the Medicare Advantage open enrollment period (January 1 – March 31)

Americans who are already enrolled in Medicare Advantage can:

  • Switch to Original Medicare (and enroll in a Part D plan; access to Medigap might require medical underwriting, depending on the circumstances)
  • Switch to a different Medicare Advantage plan
  • Only one plan change is allowed during this window (unlike the fall enrollment period, when a person can change their mind multiple times)

Special Enrollment Periods (SEP)

You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.

  • You change where you live
  • You lose your current coverage
  • You have a chance to get other coverage 
  • Your eligible for both Medicare and Medicaid

Already have coverage through the VA?

A Medicare Advantage plan may add flexibility to your VA coverage.

Get started with Medicare

Getting Medicare is a major milestone. Here’s where you can get the information you need, no matter where you are in your Medicare journey.

5 important facts:

  1. Some people get Medicare automatically, and some have to sign up. You may have to sign up if you’re 65 (or almost 65) and not getting Social Security.
  2. There are certain times of the year when you can sign up or change how you get your coverage.
  3. If you sign up for Medicare Part B when you’re first eligible, you can avoid a penalty.
  4. You can choose how you get your Medicare coverage.
  5. You may be able to get help with your Medicare costs.

Things to do now:

Already enrolled in Medicare? Use this checklist [PDF, 142 KB] to make the most of your new coverage. Or, choose any path below to find out more about Medicare, and when and how to sign up:

Medicare Advantage(Part C)

Combined Medicare

Coverage

This coverage is a private plan that combines Parts A and B, and may include prescription drug benefits.

Medicare Supplement(Medigap)

A Variety of Coverage Options

This coverage, purchased in addition to Parts A and B, may help pay deductibles and copays

Medicare Advantage(Part C)

Coverage Exclusively for Prescription Drugs

This coverage may be added on top of Parts A and B, as well as a Medicare Supplement Insurance plan.

New York State residents can get support with becoming eligible for Medicaid.  We can help you understand the tools and services available to help you qualify for Medicaid.  We can discuss your income limits and how to spend down any monies over those limits.

Pooled Income Trust - How does it work?

What is a pooled-income trust, and how does it apply to a Medicaid home-care and/or Community Medicaid recipient in New York State?

Managed Long-Term Care Plan Members

Managed Long-Term Care (MLTC) helps people who are chronically ill or have disabilities and who need health and long-term care services, such as home care or adult day care, stay in their homes and communities as long as possible. The MLTC plan arranges and pays for a large selection of health and social services, and provides choice and flexibility in obtaining needed services from one place.

KEY TAKEAWAYS
  • Long-term care insurance usually covers all or part of assisted living facilities and in-home care for people 65 or older or with a chronic condition that needs constant care.
  • It is private insurance available to anyone who can afford to pay for it.
  • Long-term care insurance offers more flexibility and options than Medicaid

 

Let us help you understand MLTC and how to qualify for it.  We can walk you through the process and introduce MLTC agencies who will work with you to help qualify for Medicaid, and Long Term Managed Home Care 

There are two ways to apply for Medicaid:

Children’s Health Insurance Program (CHIP)

If your income is too high for Medicaid, your child may still qualify for the Children’s Health Insurance Program (CHIP). It covers medical and dental care for uninsured children and teens up to age 19.

How To Apply Online For Just Medicare

If you are within three months of turning age 65 or older and not ready to start your monthly Social Security benefits yet, you can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses’ benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.

 

To find out what documents and information you need to apply, go to the Checklist For The Online Medicare, Retirement, and Spouses Application

Once you apply and receive your Medicare card, please call us to discuss getting on a Medicare Advantage plan. We will evaluate plans in your area and match you with the best plan based on your medical, prescription drug needs and primary care physician. We will also explore other benefits if qualified to participate.  We will simplify this process for you and get you the entitled benefits you deserve.

Not sure what you need? Let us help you eliminate the guess work to make sure your life’s work is protected from the unexpected.

  • We can review your current plan or policies to insure they still meet your goals.
  • Let us provide a no cost insurance policy and/or plan review to make sure your life’s work is protected from the unexpected.
  • We can review any life changing events like weddings, death, college, divorce, new family additions, promotions, or home purchase.