Don’t Be Medi-Careless!™
Our team of dedicated , knowledgeable and caring professionals is here to guide you though the process.
Who is Eligible for Medicare?
Medicare is a federally run program that offers health insurance to its recipients who are eligible with their healthcare expenses. There are 4 parts to Medicare. Parts A, B, C and D.
You are eligible for Medicare if:
- You are 65 and older
- Under 65 with certain disabilities
- OR Have end stage renal disease.
Please submit your information to speak with a licensed agent.
Your entire life someone has told you which insurance you would be in.
Now that you are in Medicare there are about 30 options.
Which one would you want to choose to sign up for? Choosing and determining your eligibility for Medicare insurance can be quite confusing.
Our experienced agents will be there to guide you from your initial signing up for Medicare and will be there year after year to answer your questions and ensure that you are in the correct plan for your needs.
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Know Your Medicare Basics
Medicare Part A
Hospital Coverage, Skilled Nursing, Hospice Care and Limited Home Health Care. There is no premium for Part A if you or your spouse has worked 40 quarters and you are eligible for part A.
Medicare Part B
Medical Insurance and covers Physician Services, Outpatient Care, Tests and Supplies. Part B has a monthly premium and is decided by your yearly income.
Medicare Part C
Also called Advantage Plans, Part C is an alternative to original Medicare and includes Parts A and B. New York Medicare Advantage Plans are offered by private insurance companies that have been approved by Medicare.
Medicare Part D
If you are enrolled in Part A, B or C, you are eligible to join a plan that offers prescription drug coverage. If you do not sign up for a drug plan when you are eligible and do not have credible coverage, you will receive a penalty which is 1% of the national premium for every day that you have not joined a drug plan when you are eligible to.
Medicare Advantage Plans are an alternative to original Medicare. It includes Part A (Hospital), Part B (Doctor Tests and other services) in Medicare and some plans include Part D.
Also called Part C, Advantage Plans give you extra benefits that are not included in original Medicare such as Vision, Dental and Hearing Service Plans. Some of them also include Silver Sneaker which is a gym membership to certain covered gyms.
In these Advantage Plans you have to follow their guidelines, network, co-pays and include max out of pocket. Some types of plans are HMO- Must stay in network, PPO- Can go out of pocket if doctor accepts assignment. Most areas have 15 to 30 options in a particular area.
Contact one of our agents and we will offer analysis to see if doctors are in network or are participating in the plan and that your current medications are in the formulary to see if this is the best option for you.
Also known as Prescription Drug Plans, these are private insurance companies that have been approved by Medicare. If you currently have Medicare, you can add a Part D Drug Plan.
At Senior Health Plan Specialists, we will assist you when choosing the correct drug plan for your current medications. We offer a no cost analysis as to which company has your current medications in their formularies and offer the lowest cost per year. We will also assist you to see if you qualify for LIS (Low Income Subsidy) or EPIC to help with premiums for your drug plans and cost of medications if you qualify.
Medicare Supplement (Medigap Insurance) is sold by private insurance companies and can help fill the “gaps” in original Medicare. They pay some of the healthcare costs that original Medicare does not cover (co-pays and deductibles that you are responsible to pay.)
It is your responsibility as a consumer to see who has the lowest premiums as supplemental plan cover the same services from each company. Their rates are by claims submitted so the premiums vary.
Senior Health Plan Specialists agents will assist by providing quotes from top rate companies. We will also guide you as to which supplemental plan would best serve you and be most cost effective.
We represent several companies and the most reputable carriers that offer Medicare Advantage, Medicare Supplements and Part D Drug Plans, which ensures you receive the best coverage and plans that Medicare has to offer.
All quotes and services from Senior Health Plan Specialists never have a fee for our services. We are compensated by the insurance carriers.