Health Insurance

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Medicare Supplements:

What is a Medicare Supplement?

Medicare Supplements, also known as Medigap policies, are sold by private insurance companies to help you cover the out-of-pocket costs left behind by Medicare.

What do Medicare Supplements Cover?
When you have a Medigap policy, Medicare pays up to its limit on your medical expenses. Then, your Medicare Supplement plan starts to help with covering costs up to the plans limit. That limit usually covers what Medicare doesn’t, however, that will depend on which policy you select.

Is there anything not covered?

Things that are not covered by Original Medicare on your Medicare Supplement:

  • Routine dental, vision, and hearing exams
  • Hearing aids
  • Eyeglasses or contacts
  • Long-term care or custodial care
  • Retail prescription drugs

Which Medigap Plans Can I Choose From?

What do Medicare Supplements cost?

Cost will vary along with plan type from county to county. The best thing to do is schedule a consultation with us so that we can review which plans are available in your area and determine the best plan and price for you.  You can also press the “Click to Call” button above to reach us today!

A Guide to Health Insurance for People with Medicare

How would I enroll?

Fill out the form and we will be in contact soon or press the “Click to Call” button above to call us today!

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Medicare Advantage:

What is a Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, is a plan provided by private insurance companies with the help from subsidies provided by the government so that the insurance company can design network based plans at a low or zero premium.

These plans are normally designed with copays and coinsurance throughout the plans as a form of cost share that the client would assume when joining one of these plans. Most plans will include additional benefits at no additional cost to you such as dental, vision, and/or hearing benefits as an example.  So let’s take a closer look at Medicare Advantage Plans.

  • It’s often less expensive to choose a Medicare Advantage plan.  
  • It’s convenient to have a single plan for everything
  • The plan covers everything traditional Medicare covers (hospital insurance and medical insurance) as well as emergency and urgent care
  • Many plans also cover dental care, eyeglasses, and wellness programs
  • Most plans also include prescription drug coverage
  • Your eligibility isn’t affected by health or financial status
  • Premiums are low
  • You’re restricted to certain doctors in your network (unless it’s an emergency)
  • Plan premiums can change from year to year
  • Difficult to switch to Medigap later on
  • Plan benefits can change from year to year
  • You’re subject to high deductibles and co-pays

Health Maintenance Organization (HMO) plans: In most HMOs, you can only go to doctors in your network (except in an urgent or emergency situation).  Preferred Provider Organization (PPO) plans: In a PPO, you pay less if you use doctors in your network. You usually pay more if you go outside of your network.

Private Fee-for-Service (PFFS) plans: PFFS plans are similar to Original Medicare in that you can generally go to any doctor as long as they accept the plan’s payment terms. The plan determines how much it will pay and how much you must pay when you get care

Special Needs Plans (SNPs): SNPs provide specialized health care for specific groups of people, like those who have both Medicare and Medicaid, live in a nursing home, or have certain chronic medical conditions. HMO Point-of-Service (HMOPOS) plans: HMO plans may allow you to get some services out-of-network for a higher copayment or coinsurance.

Cost will vary along with plan type from county to county. The best thing to do is schedule a consultation with us so that we can review which plans are available in your area and determine if the plans available would offer you additional benefits such as dental, vision, and hearing benefits. You can also press the “Click to Call” button above to reach us today!

How would I enroll?

Fill out the form and we will be in contact soon or press the “Click to Call” button above to call us today!

Prescription Drug Plans:

How Do Prescription Drug Plans Work?

Medicare drug coverage helps pay for prescription drugs you need. Even if you don’t take prescription drugs now, you should consider getting Medicare drug coverage. Medicare drug coverage is optional and is offered to everyone with Medicare. If you decide not to get it when you’re first eligible and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.

There are 2 ways to get Medicare drug coverage:
1. Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) to join a separate Medicare drug plan.

2. A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits, excluding hospice. Medicare Advantage Plans include:

  • Health Maintenance Organizations
  • Preferred Provider Organizations
  • Private Fee-for-Service Plans
  • Special Needs Plans
  • Medicare Medical Savings Account Plans

How would I enroll?

There are roughly 30 drug plans in each area to choose from.  We can help you find the lowest combination of premiums and copays based on your unique medications.   We will also help you understand star ratings, drug tiers, customer service and deductibles.  Fill out the form and we will be in contact soon or press the “Click to Call” button above to call us today!

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Health Insurance Options for People Under 65

The majority of individuals and families have health insurance through their employers. You’re likely best off with your employer’s group plan than any other option available to you. Group coverage is easier and much less expensive to get than private insurance. Plus, your employer may pay most or all of the cost for you, and you can’t be denied coverage. However, if you change jobs, get laid off, or are fired, you can lose your group health insurance. If you find yourself without employer-sponsored health insurance or Cobra, the following options may be available to you:

Prescription Plans:

Individual health insurance: Perhaps your employer doesn’t offer health insurance, or you’re self-employed, a student, or retired before age 65. If you’re relatively healthy, you should purchase an individual health insurance policy.  You can buy a policy on the marketplace or off the marketplace. 

Under 65 Health Insurance - Affordable Care Act (ACA):

The comprehensive health care reform law enacted in March 2010 sometimes known as ACA, PPACA, or “Obamacare”.

Get Covered New Jersey is the state’s official health insurance marketplace where individuals and families can easily shop for and buy coverage. It is the only place you can apply for financial help to lower the cost of your monthly insurance premiums and out-of-pocket costs. 

Get Covered New Jersey offers financial help to qualifying residents to help lower their monthly premiums and out-of-pocket expenses. In New Jersey, a family of four earning up to about $104,800 a year and an individual earning up to about $51,040 a year may qualify for financial help to lower their coverage costs.  You can learn if you might qualify for free or low-cost health insurance through NJ FamilyCare, New Jersey’s publicly funded health insurance program.

How would I enroll?

Fill out the form and we will be in contact soon or press the “Click to Call” button above to call us today!