"Medicare doesn't have to be a battle. Let's discuss your custom plan together, or read the book to learn how to avoid hidden costs and surprise bills."
"Steve has help me get the best health Insurance for my needs, when I lived in AZ., and now in CA. He has always been prompt to return calls, emails with answers that are straight forward. You are never wondering with his answer. I feel I can trust him and make sound decisions. Thank You, Steve."
Verified Customer
JP
Jorge Palomares
3 Reviews
5 months ago
★★★★★
"Steve and his team have been fantastic to work with! I'm new to the Medicare experience and from the first day I spoke with Steve, his years of experience and knowledge in the field where very valuable and impactful to me. Thank you, Steve!"
Verified Customer
CL
Cody Lang
3 Reviews
4 months ago
★★★★★
"Steve is a truly stand up guy! He made us feel comfortable from the get go about a subject that can be quite confusing and downright nerve wracking. He was able to walk us through all of our health insurance options and has been readily available for any questions we've had along the way. Steve is extremely knowledgeable and highly professional. We are very grateful for him, and would highly recommend him!"
Verified Customer
BM
Beraha Morrison
4 Reviews
4 months ago
★★★★★
"Steve been help us for three years and I dont think we could manage on our own if we do it we cant find a words how to thank him what he do to assist to all of us that we dont know about medicare keep up the great work"
Verified Customer
AC
Alan Cook
1 Review
1 month ago
★★★★★
"We have kept in close contact with Steve over the last couple of years.. He has reached out a number of times (not pestering) when he thought we could save money on our insurance premiums. He is a perfect gentleman, very knowledgeable, and helpful."
Verified Customer
PM
Pamela Mitchell
5 Reviews • 4 Photos
3 months ago
★★★★★
"Steve Pomerantz is very experienced and cares about his clients! He updates you whenever there are any changes and is available for any problems you might have with your insurance claims. I highly recommend Steve for Medicare and insurance needs."
Verified Customer
BP
Brenda Priddy
2 Reviews
1 month ago
★★★★★
"Steve and his staff are always available, and are always willing to assist. Better yet, they make things happen. I'm extremely satisfied with all the services his agency has provided over the last few years, and I highly recommend them."
Verified Customer
CC
Cathy Ciganek
4 Reviews
2 months ago
★★★★★
"Steve made signing up for Medicare so easy for me. He gave me a list of steps to follow and when completed went over my options to select the best policy for my needs. He is fantastic and incredibly helpful!"
Verified Customer
MP
Michael Paquin
Local Guide • 33 Reviews
3 months ago
★★★★★
"Steve Pomerantz is extremely knowledgeable and helpful in navigating the Medicare insurance world and all the options available. He personalizes his approach to match his clients' needs. I feel very secure and confident in our decisions."
Clear, straightforward answers about Medicare, Marketplace coverage, and planning your insurance options.
Medicare is a federal health insurance program primarily for people 65 and older as well as certain younger individuals with disabilities or End-Stage Renal Disease (ESRD). Medicare is divided into four parts: A, B, C, and D. Part A (Hospital Insurance) helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Part B helps cover doctor visits, outpatient care, preventive services, durable medical equipment, lab tests, and some home health services. Part C is Medicare Advantage, while Part D is the prescription drug benefit. Part D is available as a standalone plan to supplement Original Medicare (Part A and Part B) or is often included in Medicare Advantage plans. Part D is provided exclusively through private insurers who contract with Medicare.
Medicare Advantage is an alternative to Original Medicare offered by private insurance companies approved by Medicare. Plans must cover all Medicare Part A and Part B services and often include additional benefits such as dental, vision, and prescription drug coverage. The private insurer then becomes responsible for covering your Medicare benefits. Medicare Advantage is not a supplement to Medicare. It replaces Original Medicare for your healthcare delivery though you remain enrolled in Medicare and must continue paying your Part B premium (and Part A premium if applicable). The federal government pays the insurer a fixed amount each month to cover your care.
The most common path to Medicare eligibility is age. You are eligible to enroll in Medicare when you turn 65. However, you must also be a U.S. citizen or be a lawful permanent resident who has lived in the United States for at least five continuous years. In addition to residency requirements, you or your spouse generally must have worked and paid Medicare taxes for a minimum of 10 years (40 quarters) to qualify for premium-free Part A.
If you are under 65, you can still qualify for Medicare if you have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months.
The Medicare Initial Enrollment Period (IEP) is the seven-month window around your 65th birthday when you first become eligible for Medicare — three months before, the month of, and three months after your birthday month.
The AEP is October 15 to December 7 each year. During this time, you can switch from Original Medicare to a Medicare Advantage plan; switch from Medicare Advantage back to Original Medicare; switch from one Advantage plan to another; enroll in a standalone Part D plan; or switch/drop a Part D plan. Changes made take effect January 1 of the following year.
Medigap (Medicare Supplemental Insurance) is private health insurance that helps pay some of the healthcare costs that Original Medicare doesn’t cover such as copayments, coinsurance, and deductibles. Medigap policies are sold by private insurance companies.
The Medigap/Medicare Supplement Open Enrollment Period is the best time to buy a Medigap policy. It is a six-month window during which insurance companies must sell you any Medigap policy they offer — at the best available rate — regardless of your health status. They cannot deny you coverage or charge you more due to pre-existing conditions. It begins the month you turn 65 and are enrolled in Medicare Part B. Outside this window, insurers in most states can use medical underwriting, meaning they can deny your application, charge you higher premiums based on health conditions, or exclude coverage for pre-existing conditions. If you miss the Medigap Open Enrollment Period, you may still be able to get Medigap coverage but insurers can underwrite your application. Some states have more protective laws that allow year-round guaranteed issue.
The Marketplace is also called the “Health Insurance Marketplace” or the “Exchange”. It is an online shopping platform created by the Affordable Care Act (ACA; also known colloquially as Obamacare) where individuals, families, and small businesses can compare and purchase health insurance plans.
In a word, no. A broker is a licensed insurance professional who helps people shop for and enroll in insurance plans. A broker works with multiple insurance companies and can present plan options from several carriers. Meanwhile, a captive agent works for only one insurance company and can only sell that company’s plan. Brokers are paid commissions by insurance companies, not by the plan purchaser.
HMO stands for Health Maintenance Organization. In an HMO you must receive care from doctors and hospitals within the plan’s network except in emergencies. You will typically need a Primary Care Provider (PCP) who coordinates your care and provides referrals to specialists. HMO plans often have lower premiums and out-of-pocket costs than other plan types but offer less flexibility in choosing providers. On the other hand, PPO (Preferred Provider Organization) plans give you more flexibility to see doctors outside the plan’s network but at a higher cost. You can see specialists without a referral and can receive care from non-network providers though you will pay more for out-of-network services. PPO plans typically have higher premiums than HMOs.
A PCP is a doctor, nurse practitioner, or physician assistant who provides and coordinates your overall care.
A network includes the facilities, providers, and suppliers your health insurer has contracted with to provide healthcare services.
Not to worry. A deductible is the amount you must pay for covered healthcare services before insurance begins to pay. Coinsurance is your share of costs for a covered healthcare service calculated as a percentage (for example, 20%) of the approved amount. You pay this amount after you've paid your deductible. Your copay is a fixed dollar amount you pay for a covered healthcare service, usually paid at the time of service, while cost-sharing is the portion of healthcare costs you pay out of your own pocket while insurance pays the rest.
A pre-existing condition is a health problem you had before starting a new health coverage plan.
Observation services are outpatient hospital services used when doctors need time (usually 24–48 hours) to decide whether you should be admitted or can safely go home. You might be in a hospital bed, get tests, and receive treatment — but still be classified as an outpatient.
Hospice care is for individuals with a terminal illness who have a life expectancy of six months or less, as certified by their doctor. Care focuses on comfort rather than curative treatment.
Step therapy is a coverage requirement by some insurance plans that requires you to try one or more lower-cost drugs before they will cover a more expensive prescribed medication.
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