585-563-7979
We are licensed in the following states:
New York, Pennsylvania, Maryland, Florida, Ohio, Colorado, North Carolina, South Carolina, Alabama, Michigan, Tennesee, Nevada, Virginia, Washington, Oklahoma, Massachusetts and Missouri.
Medicare
From Us to You: promise is to help you navigate through the many moving parts of Medicare, assist you in making the best decision regarding your Medicare insurance, and to work for you and treat you like family.
As Independent Medicare Brokers, We provide a FREE consultation for those over 65 years old, turning 65, and for those other individuals that are eligible for Original Medicare. We represent over 25 different Medicare insurance plans through 10 different insurance companies, giving you many options to meet both your health and financial needs.
It is our pleasure to work with you and for you to help you stay healthy and get the medical care you need.
- Robin Leone and Brian Maust
Medicare Plans
Original Medicare Part A
What's covered?
In general, Part A covers:
- Hospital care
- Skilled nursing facility care
- Nursing home care (as long as custodial care isn't the only care you need)
- Hospice
- Home health services
Original Medicare Part B
What's covered?
Part B covers 2 types of services
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment. Part B covers things like:
- Clinical research
- Ambulance services
- Durable medical equipment (DME)
- Mental health
- Inpatient
- Outpatient
- Partial hospitalization
- Getting a second opinion before surgery
- Limited outpatient prescription drugs
What Original Medicare A & B Doesn't Cover
Medicare doesn't cover everything. If you need certain services Medicare doesn't cover, you'll have to pay for them yourself unless you have other insurance or you're in a Medicare health plan that covers them. Even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments. Some of the items and services that Medicare doesn't cover include:
- Long-term care (also called custodial care)
- Most dental care
- Eye examinations related to prescribing glasses
- Dentures
- Cosmetic surgery
- Acupuncture
- Hearing aids and exams for fitting them
- Routine foot care
Many of these options may not be covered with Original Medicare, but could be covered under Medicare Advantage Plans or Medicare Supplement Plans.
I can walk you through your options in detail.
Resources
Questions and Answers
https://www.health.ny.gov/forms/doh-5080.pdf
The Elderly Pharmaceutical Insurance Coverage (EPIC) program is a New York State program for seniors administered by the Department of Health. It helps more than 337,000 income-eligible seniors aged 65 and older to supplement their out-of-pocket Medicare Part D drug plan costs. Seniors can apply for EPIC at any time of the year and must be enrolled or eligible to be enrolled in a Medicare Part D drug plane to receive EPIC benefits and maintain coverage.
EPIC provides secondary coverage for Medicare Part D and EPIC covered drugs purchased after any Medicare Part D deductible is met. EPIC also covers approved Part D excluded drugs once a member is enrolled in Part D.
https://secure.ssa.gov/i1020/start
Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $5,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia.
www.goodrx.com
Goodrx coupons will help you pay less than the cash price for your prescription. They're free to use and are accepted at virtually every U.S. pharmacy.
It's similar to using a coupon at a grocery store. Simply print the coupon and bring it with you to the pharmacy when you pick up your prescription. The pharmacist will enter the numbers on the coupon into their system to find the discount.
Strong and Highland Hospital Charity Care: https://www.urmc.rochester.edu/medialibraries/urmcmedia/strong-memorial/charity-care/documents/charity-care-brochure.pdf
Rochester Regional Health Charity Care: https://www.rochesterregional.org/billing-and-insurance/financial-assistance
Charity Care: As the name suggests, charity care is just that; charity. Charity Care, also commonly referred to as uncompensated health care, is health care provided for free, or at a reduced cost, to people with limited income who would otherwise be unable to pay for their treatment.
Charity Care is a state-mandated and partially state-funded program that allows uninsured or underinsured people to receive inpatient and outpatient care at a reduced cost. Only people who meet certain income and asset criteria are eligible to receive charity care.
https://www.health.ny.gov/health_care/medicaid/
Medicaid is a program for New Yorkers who can't afford to pay for medical care. Medicaid pays for a number of services, but some may not be covered for you because of your age, financial circumstances, family situation, transfer of resource requirements, or living arrangements. Some services have small co-payments. These services may be provided using your Medicaid card or through your managed care plan if you are enrolled in managed care.
https://www.health.ny.gov/forms/doh-4328.pdf
The Medicare Savings Program (MSP) is a Medicaid-administered program that can assist people with limited income in paying for their Medicare premiums. Depending on your income, the MSP may also pay for other cost-sharing expenses. When you enroll in an MSP, you will also automatically get EXTRA HELP, the federal program that helps pay most of your Medicare prescription drug (Part D) plan costs. There is no resource test for the MSP programs. This means many Medicare beneficiaries who may not qualify for Medicaid because of excess resources can qualify for an MSP.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.
Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
This is a solicitation for insurance.
Contact Us
1225 Jefferson Rd. Suite A03
Rochester, NY 14623
Office: 585-563-7979
Cell: 585-362-9104 (Brian)
Cell: 716-572-5696 (Robin)
By submitting this information, you are aware a licensed sales agent may call or email you to discuss Original Medicare, Medicare Advantage, Prescription Drug Plans or, Medicare Supplement Insurance Plans. We are not requesting any medical, pharmacy history or dosage information. Please do not send any personal information. (example: Social Security Number or Date of Birth)
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All consultations are free of charge.