Medicare – Senior Benefits

What is Medicare?

Medicare is a federal health-insurance program for people age 65 or older, under 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant.

How Do I Decide Which Parts 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.
The insurance professionals at NYC Business Group are experts in demystifying the federal health-insurance program and matching its products to our clients’ needs. We will educate you, so you will be both protected and confident with your Medicare selection.

What Does Each Medicare Part Cover?

The different parts of Medicare help cover specific services if you meet certain conditions. In brief:

• Medicare Part A (Hospital Insurance) helps cover inpatient care.
• Medicare Part B (Medical Insurance) helps cover doctor services and outpatient care. Part B generally pays 80 percent of the Medicare-approved amount for covered services.
• Medicare Part C (Medicare Advantage Plans) provides a way to get Medicare benefits through private companies approved by and under contract with Medicare. Advantage plans include Part A and Part B, and usually other benefits Medicare doesn’t cover. Most plans also provide prescription drug coverage.
• Medicare Part D (Prescription Drug Coverage) is operated by private companies approved by Medicare. This coverage may be under a Medicare Advantage Plan or separate Medicare Prescription Drug Plan.

Medicare Supplement Plans

Medicare Supplement and Medigap plans are labeled as Plans A through N, and include two high-deductible options. Medicare Supplemental plans start at $99 in New York City and do not include Part D Prescriptions, which would need to be purchased separately at an additional cost. Supplemental Plans allow you to visit any Medicare-approved doctors, specialists and hospitals with no network restrictions and no referrals required.

Medicare Advantage Plans

Medicare Advantage plans called (Part C) offer Low Premiums, Low co-pays and a CAP on out-of-pocket expenses. The premium for most Medicare Advantage plans in New York is $0 or $25 and they include benefits not included with Medicare Supplemental plans such as Gym memberships, Dental, Vision and Hearing benefits. There are various Medicare Advantage Plans offered in New York including the HMO which offers only in-network benefits and the PPO which offers in and out-of-network benefits.

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