Medicare in New York
The Medicare program is diverse, and it’s designed to offer policyholders benefits that are customizable to their personal health care needs. With the help of your dedicated Stahlka Agency agent, you’ll be able to get the Medicare portfolio that is best for your present and future wellness needs.
You can purchase your Medicare benefits online now by filling out a quote form, or by calling 716-634-7070 for more information.
Common Medicare Questions
How Does Medicare Work?
The United States government started the Medicare program in 1965 to provide payroll tax-funded health insurance to senior citizens and others who have significant health needs and who often don’t have access to private insurance.
Like all health insurance, Medicare will help beneficiaries pay to see a doctor for both routine and urgent care, surgical intervention, and other needs. Depending on your medical needs, you might need different types and amounts of cost assistance, and Medicare allows you the flexibility to choose benefits that are customized to your advantage.
What are the Different Parts of Medicare?
Medicare’s primary benefits—Original Medicare—consist of two types of coverage:
Medicare Part B (Medical Insurance): For your everyday health care needs, you will need Part B coverage. This part of Original Medicare pays for regular checkups, lab services, X-rays, vaccinations and other outpatient costs.
These benefits remain consistent for all Medicare beneficiaries, and are supported primarily by the federal government and payroll taxes.
However, because everyone’s health care needs are different, private insurers offer enhanced, Medicare-approved benefits that are designed to fill gaps in coverage left by Original Medicare.
Medicare Part C (Medicare Advantage): Advantage plans must offer all the benefits of Part A & Part B coverage (with limited exceptions). However, they take your coverage a step further by offering expanded benefits like prescription drug coverage, dental insurance and vision care.
Medicare Part D (Medicare Prescription Drug Benefits): Original Medicare participants who do not have Medicare Advantage can buy Part D coverage to get their prescription drug insurance. Part D plans offer various drug formularies, premiums and pharmacy networks.
Medicare Supplementals (Medigap Plans): Medicare supplements are private plans designed to cover outstanding costs not insured by Original Medicare, such as copayments, deductibles, coinsurance and the costs of out-of-network care.
Who is Eligible for Medicare?
Most people become eligible for Medicare around their 65th birthday. However, some people qualify earlier if they have end-stage renal disease (ESRD) or other qualifying disabilities). Speak to one of our agents to learn more about your individual qualifications.
How do I Enroll in Medicare?
If you are turning 65 and newly eligible for Original Medicare, then you can enroll in Original Medicare by visiting Medicare.gov during your Initial Enrollment Period (IEP).
Your IEP is a seven-month period that:
Begins the first day of the month three months before the month of your birthday. If your birthday is in November, then your IEP begins August 1.
Ends the last day of the month three months after your IEP. If your birthday is in December, then then your IEP ends the following March 31.
You must first enroll in Original Medicare (both Part A & Part B) before you can enroll in a Medicare insurance plan. Many people enroll in private benefits during their IEP.
If you do not enroll at this time, then you can enroll during the Medicare Insurance Annual Enrollment Period (AEP), which occurs annually from Oct. 15 – Dec. 7.
During the AEP, you can:
Change from Original Medicare to a Medicare Advantage Plan.
Change from a Medicare Advantage Plan back to Original Medicare.
Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
Switch from a Medicare Advantage Plan that does not offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that does not offer drug coverage.
Join a Medicare drug plan.
Switch from one Medicare drug plan to another Medicare drug plan.
Drop your Medicare drug coverage completely.
For help with all your Medicare needs, contact your Stahlka Agency agent at 716-634-7070 today! We know all the ins and outs of the Medicare system, and we’re here to help you get perfect benefits that will enable you to get the care you deserve.