Medicare

Proud to Offer Medicare Plans & Guidance Upstate NY & the Greater Capital Region

We understand the ins and outs of medicare so others can too. We pride ourselves on being local and understanding the unique plan dynamics and landscape of the capital region and upstate NY while others do not. Our agents take annual medicare training with each company we represent to be fully educated and knowledgable when giving assistance. Our goal is to help people get the most out of their medicare by keeping their drug costs low while being with a company they can trust and count on for medical coverage while getting the extra benefits they deserve. Since everyone’s needs are different there is no one size fits all plan which can make it difficult to figure out which option is the right fit. We’re here to do the research for you and help make this process easier and be there for a time to come.

We understand what makes each company different.
-Drug costs, deductibles, tiers, and “donut holes”
-Provider networks
-PPO, HMO, PFFS, DSNP
-Supplements vs advantage plans
-When you can change plans and enroll
-NYS EPIC, Extra Help, and the Medicare Savings Program

There are four components or “parts” to Medicare. Our qualified staff will work with you to explore all that Medicare has to offer.

Part A

Part A of Medicare covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Most people are eligible for Medicare when they turn 65. You can qualify for Part A before 65 years of age if you have a disability, End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). In order to receive all of the benefits, you must have been born in the United States or at least a citizen for five consecutive years. Part A is free to those who have paid into Medicare taxes for 40 full quarters.

Part B

Part B covers medical services and supplies. This includes doctor’s visits, outpatient care, preventative care, and more. In order to receive Part B benefits, you will need to sign up during your Initial Enrollment Period or (IEP). The premium is typically deducted from your Social Security check. If you aren’t collecting Social security yet you will have to pay your premium directly. Medicaid, and other government assistance programs may cover your Part B premium if you have a lower income.

Part C

Medicare Advantage

Part C (Medicare Advantage) is administered by private health insurance companies and includes all benefits of Parts A and B, as well as some additional benefits original Medicare doesn’t offer. You must have Parts A and B in order to join a Medicare Advantage Plan. By having a Medicare Advantage Plan your claims and Medicare coverage is through the plan instead of original Medicare. You may pay a monthly premium to the health insurance company for a Part C plan and must continue to pay your part b premium. Many Part C plans include Part D coverage. Medicare Advantage comes in the form of HMO, PPO, PFFS, SNP. And MSA.

Part D

Part D is the prescription drug benefit of Medicare. It is offered by private companies and is often included in a part c plan or can be obtained with a stand-alone part d plan. Each part d plan varies in cost and specific drugs covered. You must have Parts A and/or B to join a Part D plan.

Medicare Supplement (Medigap)

Medicare Supplements are offered by private companies at an additional premium to help fill the deductibles and coinsurance with Original Medicare. Supplements act as a secondary payor to your original Medicare benefits and cannot be paired with a Part c plan. Many people join a stand-alone Part D plan for prescription drug coverage. You must have both Parts A and B of Medicare to join a Medicare supplement.

Confused about Medicare? Call today! 518-661-6300