Medicare Coverage for You

Medicare is a federal health-insurance program for people age 65 or older, under 65 with certain disabilities, and any age with certain conditions such as End-Stage Renal Disease (ESRD). 
How Do I Decide the Medicare Coverage I Need?
Comprised of Parts A, B, C and D, Medicare can seem like an alphabet soup of confusion; but it doesn’t need to be that way. Carmelo and the team at New Jersey Medicare are experts in demystifying the federal health insurance program and matching its products to your needs. We will educate you, so you will be both protected and confident with your Medicare selection.
Download our Medicare
Overview Booklet
Read on to view other insurance policies you should consider.

Medicare Supplemental Insurance (Medigap)

With continually rising health care costs, purchasing a Medicare supplement insurance policy (or Medigap) is an important decision that can be beneficial but requires careful consideration. A monthly premium is not the only factor to keep in mind, as some companies are notorious for rate hikes, and you may find yourself in an uncomfortable position later on down the road. By enlisting the help of a knowledgeable Medicare supplement insurance broker like ours, you can ensure that you don't end up paying too much.

What is Medigap?

Medicare supplemental insurance, also known as Medigap, is a type of health insurance that is designed to cover certain expenses that aren't covered by the Original Medicare Plan. In New York State, Medigaps are sold through private insurance companies, such as UnitedHealthcare (UHC). In addition to enhancing your financial security by limiting your out-of-pocket expenses, the NYS Medicare supplement plans allow you to keep your doctor and hospital and to choose your own specialists and other health care providers. This is not possible with Medicare Advantage, which forces you to use doctors that are in a particular network.

Medigaps are designated by the letters A through N. Plan A is the core package, while Plans B, C, D, F, G, M, and N each differ according to their benefits but include all of the benefits of Plan A. Plans K and L offer catastrophic coverage only, and Plans E, H, I, and J are no longer available to new enrollees.

The Medigap Services We Provide

Our service package includes first comparing Medicare Advantage (Part C) and Medigap (Medicare Supplement) and then checking to see if your doctors participate with the plan that you're considering. It's important to note that you cannot have Medicare Advantage and Medigap at the same time, so comparing the two in detail is a crucial step in the process.

You could spend a Sunday afternoon wading through the charts at the New York State Department of Financial Services website and do your own Medigap plans comparison, but we have access to privileged information that we have compiled over many years of Medigap and Medicare Advantage health insurance data from various sources. We'll share this information with you either in-person or over the phone. Best of all, this is a resource that will be valuable for years to come. As healthcare continues to reform, we will be there to discuss the changes and how they impact you.

In addition to discussing the differences between Medigap and Medicare Advantage, we will check your prescriptions to confirm that they're included in the formulary list of the plan in question. Then, we look at the monthly cost and present you with a doctor and Rx report. If that's agreeable to you, we complete the enrollment forms for your signature and submit your application to the insurance company. We follow up in a few days for your approval and ID #.

After that, we're available to discuss anything with you, whether it's three weeks or three years after you enroll with us! We do not just enroll you in a plan and say, "Good luck." We're available for you for the next 30 years. For instance, you may want to call us if you have a doctor that you must see and that doctor does not participate with the plan your currently enrolled in. Our job will be to help you find a plan that this doctor participates with and help you switch plans through a special enrollment period (SEP).

Another reason why you might call us is if you have an Rx that is very expensive. We can check if it is cheaper on any other Part D health plan's Rx formulary list, or perhaps see if you qualify for state programs like Elderly Pharmaceutical Insurance Coverage (EPIC) or federal programs. We'll help you understand the program's benefits and guidelines, if you qualify, help you enroll and save you hundreds of dollars on your prescriptions every month.

For answers to all the frequently asked questions about Medigap, download our Medicare Overview booklet

Medicare Advantage (Part C)

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You will get your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare. In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you’re in a Medicare Advantage Plan. Medicare Advantage Plans aren’t supplemental coverage.

What Does a Medicare Advantage Plan Cover?

Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.

For more on Medicare Advantage Part C, download our Medicare Overview booklet

Prescription Drug Coverage & Medicare Part D

Medicare offers prescription drug coverage to everyone with Medicare. Even if you don’t take a lot of prescriptions now, it’s important for you to consider joining a Medicare drug plan.

If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, you will likely pay a late enrollment penalty. To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and specific drugs covered. Download the Medicare Overview below to learn more.

There are two ways to get Medicare prescription drug coverage:

1. Medicare Prescription Drug Plans: These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.

2. Medicare Advantage Plans: This may be an HMO or PPO or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

In either case, you must live in the service area of the Medicare drug plan you want to join.

For answers more on Medicare Prescription Drug Plans, download our Medicare Overview booklet

Final Expense Insurance

Final expense insurance gives your loved ones the resources to pay for your funeral and burial service. It is an affordable way to provide for these costs, so that family and friends can celebrate your life without financial obligations.

There are various Final Expense or Burial insurance policies you can apply for and may qualify for depending on your medical history. We offer these 2 types of Senior Life Insurance:

  1. Simplified Issue Plan: This requires that you complete a basic medical questionnaire and meet specific qualifications.
  2. Guaranteed Issue Plan: This requires no questionnaire or medical exam and guarantees acceptance of your application is a good alternative.

While a traditional life insurance policy can provide funeral and burial coverage, final expense insurance policies have a lower face value than standard life insurance plans. You can purchase a final expense insurance policy with a coverage limit of several thousand dollars, enough to pay for a basic funeral service, casket, burial, and cemetery plot. Term or whole life coverage generally begins at $10,000, an amount that may exceed your needs. Final expense insurance gives you just the right amount of coverage to arrange the funeral that you want.

Schedule a Meeting with Carmelo

Don’t put off finding the coverage you need. Take the next step now.

(718) 554-3425
3971 Victory Blvd,
Staten Island NY 10314

Medicare New Jersey