Medicare Basics

Many people qualify for a Special Election Period (SEP) which allows them to change plans anytime during the year.  Call us today to see if you qualify!

What are the parts of Medicare?


Helps cover the following (including, but not limited to):

  • Inpatient hospital care
    • Semi-private room
    • Meals
    • Drugs, supplies, equipment
    • Lab and x-ray
    • Operating room/recovery services
  • Blood transfusions (hospital or skilled nursing facility
  • In and out rehabilitation services after a qualified inpatient stay
  • Some in-home skilled nursing care (restrictions apply)
  • Hospice

Part B (Medical)

Helps cover the following (including, but not limited to):

  • Doctor visits in and out of hospital
  • Preventative services
    • Flu shots
    • Mammograms
    • Annual physical
    • Many more!
  • Lab tests (Blood work)
  • MRI, CT scans, X-rays, & other diagnostic tests
  • Outpatient Physical, Occupational, & Speech/language therapy
  • Diabetes screening, education, & supplies
  • Mental Health Care
  • Durable Medical Equipment (example: wheelchair, crutches, prosthetics)
  • Ambulatory Surgical Center Services
  • Ambulance (ground or air), Emergency Room, & Urgent Care

Both parts A and B of Medicare have restrictions & limitations on covered services provided. Although these services are “covered”, you are responsible for any deductibles, co-pays, & co-insurances left behind by Medicare. This is why you should have a Medicare Supplement or Advantage plan. Call us today!

Part D (Prescription drug coverage)

  • Provided by private insurance companies overseen by Medicare
  • Helps cover cost of prescription drugs
    • Generic
    • Brand
    • Specialty
    • Vaccines & Shots
  • Can be a separate plan
    • Example:  Medicare Supplement plan and a Prescription Drug Plan
  • Can be included in a Medicare Advantage plan
    • Example:  Medicare Advantage plan that covers both medical and prescription drugs all in one plan.
  • Premiums, Co-pays, & Deductibles can be subsidized for eligible beneficiaries.
  • Prescription brands covered, co-pays, co-insurance, premiums, deductibles, and pharmacy networks are different between plans.

PART C (Medicare Advantage)

Combines Medicare Parts A & B. Most plans also include Part D and extra benefits into one plan often with no additional premium.

  • Plans often have no to low premiums
  • Most plans offer some or all of the extra benefits
    • Dental
    • Eye glasses & Hearing Aids
    • Free over the counter supplies
    • Gym membership
    • Wellness programs
    • Transportation
    • 24 hours nurse hotline
    • Food allowance
    • Part B premium reduction
  • Have network of providers
  • Coordinated Care

Your Medicare options

There are 7 coverage combinations that a Medicare beneficiary with Parts A & B can elect to be covered for their health care needs. See Below.

  • Original Medicare (Part A and/or Part B) alone

  • Original Medicare (Part A and/or Part B)
    PLUS a stand alone prescription drug plan (Part D)

  • Original Medicare (Part A and/or Part B)
    PLUS a standalone prescription drug plan (Part D)
    PLUS a Medicare Supplement (Medigap) plan

  • Original Medicare (Part A and/or Part B)
    PLUS a Medicare Supplement (Medigap) plan

  • Medicare Advantage plan (Part C) with prescription drug coverage (Part D)

  • Medicare Advantage plan (Part C) without prescription drug coverage (Part D)

  • Medicare Advantage Private Fee-for-Service plan without drug coverage (Part C) OR a Medicare Savings Account (MSA) plan
    PLUS a standalone prescription drug plan (Part D)

We help our eligible clients enroll into additional extra help programs to help subsidize their premiums, co-pays & deductibles....Find out if you qualify. Call us today!

6822 Lake Shore Rd N, Suite 1,
Verona Beach NY 13162

1- (800) 916-5703


For an in-home or phone appointment call:
1- 800-916-5703

Joshua Swinney was a huge help to me in transitioning to a Medicare policy. He cross-checked my doctors and medications to find a policy that covered all my needs and fit my budget. In addition, I learned I was qualified to have over the counter items included at no charge. This was a big benefit as well. I'm grateful for all Joshua's help.
Anne Carruthers
Anne Carruthers
22:26 02 Nov 20
Thank you for all the help with finding me a plan and keeping me updated every year on what is available for me. Great service
David Green
David Green
14:42 12 Sep 20

Contact Us Today

One of our Licensed Representatives looks forward to speaking with you. We never charge for our services and there is no obligation to enroll into a plan.