When Gena J. first approached us, she was facing a perplexing situation. Despite being on Medicare, she had not been prescribed any medications and was adamant about not getting a Part D stand-alone prescription drug plan.

Understanding her concerns, we took the time to explain the potential consequences of delaying enrollment in a prescription drug plan. We emphasized that for every month she remained without coverage, a 1% penalty would be added to her premium in the future—a penalty that could last for the rest of her life on Medicare. This revelation was an eye-opener for Mrs. Johnson, who had not fully grasped the long-term implications of her decision.

Rather than pressuring her into a costly plan, we offered Mrs. Johnson an alternative that not only ensured compliance with Medicare regulations but also eased the financial burden. We identified a prescription drug plan that cost her $0 per month, providing the necessary coverage without any out-of-pocket expense. This decision not only shielded her from potential penalties but also gave her peace of mind, knowing she had access to essential medications without breaking the bank.

Mrs. Johnson’s story is a testament to our commitment to finding personalized solutions for each client. We believe in empowering individuals with the knowledge and options they need to make informed decisions about their Medicare coverage. If you or someone you know is navigating the complexities of Medicare, we’re here to help.

If you are on Medicare already but are looking for ways to minimize your costs, the following study might interest you. We have clients, a married couple in their late 70’s, named Joe and Terry, who were happy with the plan G they were initially enrolled in. However, one year after Joe and Terry retired and transitioned to a fixed income, they started to feel burdened by the monthly premiums. It didn’t seem like their income was matching the increase in their monthly costs and they felt a tightening in their finances as a result. As part of their overall assessment in how to save money, Joe and Terry reached out to Ethan Sholom, VP of Seniorstar Insurance Group with their concerns to see if there were any options to save in their Medicare coverage.  They were seeking to duplicate their current insurance as closely as possible but at a lower monthly spend than they were paying at the time. This is where Ethan and Seniorstar came into their lives.   

Understanding the delicate balance between coverage and affordability, Ethan listened to what Joe and Terry said and assessed their needs accordingly.  Realizing that it was still vitally important for them to have complete freedom in choosing their medical providers, Ethan proposed moving them from their current Medigap plan G to Medigap plan N. He explained that while plan N has up to $20, copays for office visits, it offered enough of a reduction in their monthly premiums to make a difference. Ethan further explained that they were still just as protected for major hospital and outpatient expenses and could keep their existing providers. 

Furthermore, Ethan showed Joe and Terry that in addition to the lower monthly premiums, they would have more savings in plan N if they enrolled in the same insurance company by taking advantage of a 7% household discount. They had no idea this was possible. Joe and Terry were delighted when they were approved to move to a Plan N. They were so happy with Ethan’s know-how, and the personalized service Ethan provided that they immediately referred Seniorstar Insurance Group to their friends who had similar circumstances. This case study highlights the importance of getting personalized care from a Medicare agency, with the knowledge and ability to save you money without compromising your needs.

Recently, our client Frank contacted us with concerns about potential health expenses, particularly regarding the possibility of facing cancer-related costs. Despite being enrolled in a comprehensive Medicare Supplement Plan G and a prescription drug plan, Frank remained worried due to his family’s history of cancer, including a recent diagnosis in a sibling.

I reassured Frank that his medical expenses, such as chemotherapy, radiation, hospital stays, and surgeries, were covered by original Medicare and his Medigap Plan G. However, there were still indirect expenses not covered, such as travel costs, lost wages for him or a family caregiver, professional caregiving fees, and certain cancer drugs. To illustrate this, I shared the experience of another client who incurred significant travel and lodging expenses in receiving her cancer treatments at a specialty clinic out of state.

To address Frank’s concerns, I informed him about an affordable option: a cancer coverage policy. These policies entail modest monthly premiums based on the benefit amount, providing a lump sum payment upon a diagnosis of any internal cancer or melanoma. This lump sum can be used at Frank’s discretion, covering expenses like travel, accommodation, unforeseen out-of-pocket costs during his cancer journey.

Today, Frank enjoys the security of both his Medicare and Medigap Plan G coverage, along with the peace of mind knowing his cancer policy will support him if needed. By alleviating the potential financial strain of a cancer diagnosis, Frank can focus on healing and recovery.

If you’re facing similar concerns or need guidance on optimizing your Medicare coverage, please reach out. Your peace of mind is our priority.

Recently, we had the privilege of assisting a client, Patricia, who was facing challenging circumstances. Patricia, a low-income beneficiary, was struggling to navigate the complexities of Medicare and find a solution that would meet her healthcare needs without burdening her limited financial resources.

She was on a low fixed income and needed affordable refills for five medications, that including costly drugs. After understanding her needs, we suggested Patricia might qualify for a low-income subsidy (LIS) through New Jersey’s Pharmaceutical Assistance to the Aged and Disabled (PAAD) program, which she was unaware of. We guided her through the NJ PAAD enrollment, then helped her discover a Medicare Advantage plan tailored for LIS beneficiaries in Middlesex County, offering extra benefits, lower copays, and waived monthly premiums.

Typically, we avoid recommending Medicare Advantage plans with premiums, but the unique situation of LIS qualification allowed us to secure a plan that came at no additional cost for our client. This meant that they not only received the standard benefits of a Medicare Advantage plan with a $0 premium but also gained access to additional perks tailored to their healthcare needs.

This case underscores the transformative power of understanding and leveraging available resources. By strategically utilizing the LIS program we were able to provide our client with a comprehensive healthcare solution that not only addressed their immediate challenges but also improved their overall well-being.

If you or someone you know is navigating similar Medicare complexities, please don’t hesitate to reach out. We are here to help you find personalized solutions that make healthcare more accessible and affordable.

Meet Roger, a teacher with 40 years of service in the NJ School system. As retirement approached, Roger faced the daunting decision of whether he should transition to Medicare or stay on his NJ state-run teacher’s health plan, into retirement. He was uncertain how his retirement benefits would align with Medicare, prompting him to seek our guidance.

When we took a closer look at this with Roger, we discovered that Roger was in great shape. His retirement plan was tailored to cover the copays and deductibles that original Medicare, parts A & B, doesn’t cover, which effectively served as a Medicare supplement policy.

While we couldn’t help Roger with enrollment in any coverage that would be better than he already had, we were happy to clarify his options for him and are glad to have created another connection. At Seniorstar Insurance Group our goal is never just to enroll someone, it is to start a dialogue and to help equip the Medicare beneficiaries in our community with the knowledge needed to make informed healthcare decisions. Your best interest will always come before our need to close a sale.  In the end we also benefited from our connection with Roger because he soon referred a close friend and a relative to us who we enrolled in a variety of healthcare and retirement products

If you have any questions about Medicare or if you need assistance, please don’t hesitate to contact us. There is no obligation or fee and we will always give you the personalized attention you deserve,

Three years ago, our client Charlene faced a pivotal moment in her healthcare journey. Initially content with her Medicare Advantage plan, a significant medical event experienced by her sister, Amanda, prompted Charlene to reassess her coverage. Amanda’s cancer diagnosis and subsequent treatment under original Medicare with a Medicare supplement plan G showcased the stark differences in their coverage.

Thankfully, Amanda’s successful treatment, including surgery, a hospital stay, and inpatient rehab, incurred no out-of-pocket costs. Witnessing this, Charlene realized the potential financial burdens she could face under her current plan for similar circumstances.

Recognizing the importance of acting swiftly to secure a Medicare Supplement plan before facing potential medical underwriting challenges, Charlene approached us for guidance. Having already experienced some health issues, she was aware that securing coverage might not be straightforward. However, armed with our extensive local knowledge and a diverse range of contracts, we were determined to find the best possible solution.

Navigating through various options, we identified a few companies willing to accept our client despite their existing health issues. While the selected Medicare Supplement plan might not have been the least expensive in the market, it was undoubtedly the most cost-effective option available to them given her unique situation. Our ability to provide this level of flexibility stems from our deep-rooted understanding of the local healthcare landscape and the extensive contracts we maintain.

While Medicare Advantage remains optimal for many, Charlene’s experience underscores our commitment to listening to individual needs and providing comprehensive education on available Medicare options.

If you’re contemplating changes to your Medicare coverage, don’t hesitate to reach out. We’re here to support you every step of the way.

We often encounter clients facing complex situations that demand personalized solutions. One such case involved a husband who, at 65, was ready to embark on his Medicare journey, while his wife was still under 65. The husband wasn’t happy with his job’s health plan, but his spouse still relied on it, so they had to carefully manage in order to secure the coverage they both needed.

Upon meeting the couple, we empathized with their concerns and assured them that we could provide a seamless transition for the husband onto Medicare while ensuring a smooth management of the under-65 insurance for his wife. Our commitment to understanding their unique circumstances allowed us to devise a comprehensive strategy tailored to their specific needs.

Navigating the intricacies of both Medicare enrollment and under-65 insurance, we worked closely with the couple to explore alternative options that would offer better coverage and meet their preferences. Through clear communication and a thorough understanding of the Medicare landscape, we were able to alleviate their worries and provide them with a customized insurance plan.

Ultimately, our dedication to the couple’s well-being ensured that both the husband, at 65, and his wife received the coverage that made the most sense given their circumstance. This success story reflects our commitment to going above and beyond, demonstrating how, as independent Medicare agents, we can make a significant positive impact on the lives of our clients during crucial periods of transition.

What Questions Should I Ask If I’m New to Medicare?

Medicare can be confusing, especially when you are new to it. During your Initial Enrollment Period (IEP), you should ask key questions to prepare for choosing your coverage.

What are the Medicare basics?

We know Medicare can be confusing – a vital place to start when you are new to Medicare is getting to know the difference between Medicare & your current health insurance options. Understand what defines Medicare eligibility, what is covered in each part of Medicare covers, the different enrollment periods, & penalties that can come from enrolling outside the enrollment periods. Understanding all these key points are the first step in creating a seamless transition from your current health insurance to Medicare.

What are my Medicare coverage options?

Medicare is not a one-size-fits-all approach – the coverage that is right for you that may not be the right coverage for your friends and family and vice versa. Does Original Medicare or a Medicare Advantage plan make more sense for you? If you have current employer coverage, it may not be the best decision to enroll in Medicare until after you retire. If you’re already retired, you might find out that Original Medicare paired with a Medigap plan works better than Original Medicare with retiree insurance (or vice-versa). Make sure you know all of your coverage options before choosing coverage.

Should I Enroll in a Medicare Part D Prescription Drug Plan?

If you do not have other creditable drug coverage, enroll in Part D Prescription Drug Coverage when you become Medicare eligible. There are many options available when choosing Part D Prescription Drug Plans. Many retiree plans also offer drug coverage that is as good as or better than Medicare Part D, so you may not need to enroll immediately. There are also programs to help reduce drug costs if you have difficulty affording your prescription drugs.

Am I Eligible for Programs that Will Help Lower my Medicare Costs?

There are several programs, both federal and state specific, that help low-income individuals cover medicare-related costs like copays and premiums. Find out whether or not you meet the eligibility requirements to take full advantage.

What Resources are Available to Help Me Navigate Medicare?

Medicare can be complicated and confusing to understand on your own. There are a variety of sources that can help you decipher and navigate your rights and options, including:

• 1-800-MEDICARE
• Social Security Administration
• State Health Insurance Assistance Program (SHIP)
• Medicare Rights Center

The team at Seniorstar Insurance Group can also help you navigate Medicare. Call us today or schedule an appointment to review your options. We can help you find coverage that meets your needs and budget.