Personalized Medicare Guidance

Empower your Medicare journey with expert
and personalized advice from MedigapRx.

Our team of advisors is dedicated to de-mystifying the world of
Medicare so you can enroll with confidence. Let our team help you find
the right Medicare providers to meet your needs, or help you navigate
through what your current Medicare plan entails.

A professional woman helps an elderly man

Call (954) 737-7877 Book an appointment

Who We Help:

Anyone who is Medicare eligible and in need of Medicare guidance

Individuals who receive Medicaid and are Medicare eligible

Individuals who are turning 65

Medicare recipients who are unhappy with their current coverage

Clients on employer coverage interested in Medicare options

Individuals who are collecting Social Security Disability

Our Process

FREE INITIAL CONSULTATION

Step 1

Review your current health insurance situation

In our office, at your house or over the phone
Understand your eligible enrollment periods
Review of Employer and Retiree Health Plans
Compare Retiree options to Medicare to help make informed deicison if taking a Medicare plan is the right move

Educate you on medicare options

Explain difference between Medicare Supplement & Medicare Advantage Plans
Explanation and overview of different Medicare Part D Phase (Deductible, Initial, Coverage Gap, Catastrophic Phase)
Explain Original Medicare A&B
Provide plan options that include your favorite doctors and local pharmacies
Include any additional benefits like eyecare, dental, hearing and fitness memberships

Break down of all medicare costs and fees

Overview of all Original Medicare costs
Provide a break down of monthly and yearly costs including premiums, copays and coinsurance
Analysis of your unique IRMAA situation
Review & compare Supplemental plan coverage and cost options
Review & compare Advantage plan coverage and cost options
Review Part D coverage and costs and copays
Ensure you do not incur any penalties

STEP-BY-STEP ENROLLMENT

Step 2

Help enrolling in Medicare Parts A & B, including all necessary paperwork
Send all plan information directly to your home, highlighting important information for you to review
Send a digital enrollment option via email
Submit plans directly to insurance companies on your behalf
Confirm enrollment with insurance carriers and notify you when plans are approved
Help enrolling in Medicare Supplement, Medicare Advantage and Part D Plans

ON-GOING SUPPORT

Step 3

24/7 access to our client service department via phone
You never need to call an insurance company directly or wait on hold with an 1-800 number
Personal reviews every year during open enrollment, to ensure your current plan is the best and most cost effective
Update you on plan changes throughout the year
Inform you on industry news that could impact your coverage
Order replacement Medicare cards and materials as needed
Review medical bills or claims
Advise on Medicare appeals
Provide annual rate shopping

Medicare plans

Inpatient care in hospitals
Hospice care
Skilled nursing facility care
Home health services and nursing home care may also be covered (if deemed medically necessary)

Who can get Medicare Part A?

If you are a U.S. citizen or a permanent, legal resident of the United States, and you are (or are turning) 65 years old, you are eligible for Medicare Part A. Additionally, people under the age of 65 with certain disabilities, and people with End-Stage Renal Disease are entitled to receive Medicare Part A.

When and how can I sign up for Medicare Part A?

Most people will get Medicare Part A automatically during their Initial Enrollment Period (IEP). If you are automatically enrolled, you will receive your red, white, and blue Medicare card in the mail 3 months before your 65th birthday (or the 25th month of your disability). Some people will need to sign up for Medicare Part A if you are not collecting Social Security or Railroad Retirement Board benefits.

What does Medicare Part A cost?

Medicare Part A is free, provided that you or your spouse has paid Medicare taxes while employed. If you or your spouse are not entitled to “premium-free” Part A, you still may be able to purchase it.

Doctor services
Ambulance services
Nursing services
Chemotherapy
Durable medical equipment
Preventive services to prevent illness
Prescription drugs under limited conditions (doctor’s office or hospital outpatient setting)

Who is eligible for Medicare Part B?

Any U.S. citizen or permanent, legal U.S. resident, who is (or are turning) 65 years old, can receive Medicare Part B. There are also some exceptions for people who are under the age of 65 and who have certain disabilities or health conditions who can also receive Medicare Part B.

How to sign up for Medicare Part B?

Most people automatically be signed up for Medicare Part B during their Initial Enrollment Period (IEP). If you are automatically enrolled, your Medicare card will arrive in the mail 3 months prior to your 65th birthday. If you chose to delay Part B enrollment, due to a special circumstance (such as staying on an employer plan), you can enroll in Part B during a Special Enrollment Period (SEP). The first place to start is by contacting Social Security and filling out this form.

If you did not sign up for Medicare Part B when you were first eligible, and you do not have a special circumstance (SEP) to enroll midstream, you will need to sign up during the General Enrollment Period (GEP), which is January 1st- March 31st of each year. If you enroll during GEP, your Part B coverage will begin the month after you enroll during the GEP.

How much does Medicare Part B cost?

Medicare Part B recipients pay a monthly Part B premium. The price of the Part B premium is dependent on the your annual income (as indicated on your individual or joint tax return). The standard Part B premium amount in 2025 is $185. Most people pay the standard Part B premium amount however if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

Also, it’s important to know that there is a deductible that individuals are required to pay before Medicare begins to pay their share of all services covered by Medicare Part B. After the deductible is paid, recipients pay 20% of what Medicare deems to be a “reasonable charge” while Medicare pays the remaining 80%. In 2025, the deductible amount is $257.

Doctors Choice
Individuals can select their preferred doctors and hospitals, (so long as they accept Medicare patients)
Convenience
Virtually no claim forms to file
Guaranteed Renewals
Medicare supplement plans are automatically renewed, so long as individuals continue to pay their premium on time, without misstating one or more material facts upon initial enrollment
Access to Specialists
Individuals can see specialists without needing a referral
Freedom
Coverage that travels with you anywhere in the U.S.

A Medicare Supplement Plan, also known as a Medigap Policy, is designed to help pay for some of the costs that Original Medicare does not cover
Medicare Supplement Plans are offered by private insurance companies and available to individuals who are eligible for Medicare. A Medicare Supplement Plan will help limit out-of-pocket medical expenses such as copayments, coinsurance and deductibles.

The total cost of the deductibles, premiums and co-pays that an individual will pay using an Advantage plan is often lower than the total cost for those same expenses under Original Medicare.
The advantage plan combines Parts A, B, and D into one plan with one Medicare ID Card.

When deciding on which Medicare Advantage plan to choose, you should consider speaking with a local Medicare agent to answer the following questions:

Are my doctors covered as In-Network providers?
Do I need a referral to see a specialist?
What happens if I want to go to a doctor outside the network?
What are the costs (copays, deductibles) associated with services provided in the summary of benefits by the plan?
Does the plan offer drug coverage? What tier do my drugs fall into and what are the copays associated with them?
What additional benefits are offered by this plan?

You may be eligible for extra help or cost sharing assistance from the government if you meet certain income requirements.
The Part D monthly premium varies by plan (higher-income consumers may pay more).
It is possible to have your Part D premium automatically deducted from your monthly Social Security/Railroad Retirement Board benefit check.
A late enrollment penalty can be added at any time after your initial enrollment period (IEP) unless you have creditable drug coverage (ie: an employer sponsored plan).
You cannot have a Medicare Advantage Plan (Part C) and separate Part D prescription drug plan at the same time.
Review your Medicare drug plan every year, as plan formularies can change.
You are eligible to change, add or drop your Part D plan during the Open Enrollment Period every year (OEP)(AEP).
You can enroll into a Part D plan by calling (800) 235-1757, (516) 749-2934, (954) 737- 7877 directly, or working with an agent who can help guide you to a plan that fits your specific needs.

How Do I Get Medicare Prescription Drug Plans?

An individual can purchase it as a stand-alone Medicare Prescription Drug plan (also know as PDP). Most people who purchase a stand-alone drug plan typically purchase it with a Medicare Supplement plan , which does not include the drug coverage. The two are purchased separately.
An Individual can get a Medicare Part D plan through purchasing a Medicare Advantage Plan Part C (also known as an MA-PD plan).

The costs for Part D Medicare will vary amongst which private companies’ plan you choose and what kind of drug are covered.

The Three Coverage Stages of Medicare’s Part D Program

Throughout the year, your prescription drug plan costs may change depending on the coverage stage you are in. If you have a Part D plan, you move through the CMS coverage stages in this order: deductible (if applicable), initial coverage, and catastrophic coverage.

Select a stage to learn more about the differences between them

Annual Deductible

Begins: with your first prescription of the plan year.

You pay the full cost of your prescriptions until your spending adds up to the amount of your deductible. So, if your plan has a $0 deductible, you skip straight to the next stage. Keep in mind that some deductibles may only apply to drugs on specific tiers, which means you may not have any deductible if you do not take any medications on those tiers. Any payments for your monthly premium or for medications on tiers that do not apply to the deductible are not counted toward reaching the deductible.

Initial Coverage

Begins: immediately if your plan has no deductible. Or, when the prescription payments you have made equal your plan’s deductible.

Your plan pays for a portion of each prescription drug you purchase, as long as that medication is covered under the plan’s formulary (list of covered drugs). You pay the other portion, which is either a copayment (a set dollar amount) or coinsurance (a percentage of the drug’s cost). The amount you pay will depend on the tier level assigned to your drug.¹ This stage ends when the amount spent by you and your plan on your covered drugs adds up to equal the initial coverage limit set by Medicare for that year. In 2025 that limit is $2,000. Your monthly premium payments do not count toward reaching that limit.

Catastrophic Coverage

Begins: when your out-of-pocket costs reach $2,000 on covered drugs.

Starting in 2025, all Medicare plans will include a $2,000 cap on what you pay out-of-pocket for prescription drugs covered by your plan. If your out-of-pocket spending on covered drugs reaches $2,000 (including certain payments made on your behalf, like through the Extra Help program), you’ll automatically get “catastrophic coverage.” That means you won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.

Dental Insurance

We offer a variety of Dental plans that fit any budget. Choose from traditional PPOs which allow you to visit any dentist and covers preventative, basic and major care or lower cost options with in-network dentists.

A young woman looks after an elderly woman

Long Term Care Insurance

Educate and enroll in a long term care plan that ensures you will be taken care of in case you become unable to perform activities on your own. LTC insurance covers care that is generally not covered by Medicare, Medicaid, or Health Insurance.

Asset & Retirement Planning

Work with a local financial advisor to update your will, manage, transition and maximize your Social Security, pensions, IRAs, 401ks and other financial assets. Ensure that you don’t prematurely bankrupt your retirement plan. Find a preferred way to leave assets (or an income stream) to your spouse, children or grandchildren.

Group Health Plans

We offer group health plans for businesses of any size. Our health insurance advisors can find the best plan insurance plans for your business.

Life Insurance

Our life insurance agents will help you provide financial security for your family and loved ones. We offer a simplified application and underwriting proces with no medical exam required.

Annuities For Retirement

Our financial advisors can help you guarantee a steady stream of income for life. Annuities are a great alternative to Bank CD’s.

BENEFITS OF A GROUP PLAN FOR YOUR ORGANIZATION:

Huge potential cost savings!
Offer the best possible health insurance to retiring employees as part of your benefits package, at no extra cost
Simple, streamlined administration and management (let retirees liaise directly with the insurance provider, not your HR team)
In-depth transition planning, implementation, and education for employees and retirees
Variety of coverage options
Nationwide solutions
Fast claims processing
Excellent customer service
Incentive to attract and retain top talent

As the population of retirees grows each year, and the economy continues to fluctuate, there is more pressure than ever on organizations to find great health care coverage for retirees.
Most company’s retiree benefit packages were designed years ago, and many may be completely outdated, and costing hundreds of unnecessary dollars, or even worse, not offering retirees any health care benefits.

Did you know that there are great, reasonably priced, group retiree Medicare plans from UnitedHealthcare®, that won’t break your organization’s budgets, and gives retiring employees the best possible coverage available?

Whether your organizations goal is to maintain benefit levels at lower costs, transition retirees to individual Medicare coverage plans, move retirees to an exchange, offer subsidy, or not, there are great options available to help you achieve your goals.

BENEFITS OF A GROUP PLAN FOR RETIREES:

Huge potential cost savings & value adds
Access to the best possible insurance on the market
Dedicated customer service team on the account, no more hassling with tele-sales
Flexibility to be covered anywhere in the U.S. and options for foreign travel emergency choice of plans to best suit their needs and budgets
No copays, deductibles or co-insurance