Medicare

Medicare: Navigating Your Path to Comprehensive Health Coverage with Gary Millstein

Turning 65 or facing a qualifying disability can mark a significant milestone, opening the door to Medicare—the federal health insurance program for seniors and certain younger individuals with disabilities. While Medicare provides essential coverage, understanding its various parts and choosing the right plans can be incredibly complex. As your dedicated insurance advisor, I, Gary Millstein, at Benefits Health Insurance Services, specialize in demystifying Medicare. My passion is to guide you through every option, ensuring you gain comprehensive, personalized coverage that perfectly aligns with your health needs, lifestyle, and budget—allowing you to enjoy your health and retirement with peace of mind.

Medicare is divided into several key parts, and understanding each one is the first step toward building your ideal coverage plan. Medicare Part A covers hospital insurance, including inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health services. For most individuals who have worked and paid Medicare taxes for at least 10 years, Part A is premium-free. Medicare Part B is your medical insurance, covering doctor visits, outpatient care, preventive services, and some medical supplies. Together, Parts A and B form what is known as “Original Medicare.” While Original Medicare provides fundamental coverage, it doesn’t cover everything and has no out-of-pocket maximum—making supplemental coverage essential.

Medicare Advantage (Part C) and Medicare Supplement (Medigap) Options

There are two main ways to enhance Original Medicare coverage: through Medicare Part C (Medicare Advantage) or Medicare Supplement Plans (Medigap). Medicare Advantage Plans are offered by private insurance companies approved by Medicare. These plans combine Part A and Part B coverage, often include Prescription Drug Plans (Part D), and may provide additional benefits like vision, hearing, dental, and fitness programs. They can be an appealing option due to convenience and lower monthly premiums. However, most operate within specific provider networks and may require referrals. As your Medicare Advantage expert, I help you evaluate plan networks, copayments, and benefits to determine if this all-in-one approach fits your healthcare needs.

Alternatively, many individuals choose to stay with Original Medicare (Parts A and B) and add a Medicare Supplement Plan or Medigap policy. These private plans cover out-of-pocket costs such as copayments, coinsurance, and deductibles. Medigap plans allow you to visit any doctor or specialist who accepts Medicare, without referrals, and typically offer predictable costs at the point of care. They do not include prescription drug coverage, so a standalone Part D plan is required. As your Medicare Supplement advisor, I help you compare the available Medigap plans (A, B, C, D, F, G, K, L, M, N) to find the one that best suits your healthcare usage and budget.

Prescription Drug Coverage (Medicare Part D)

Prescription Drug Plans (Medicare Part D) are crucial for managing the cost of medications. Whether you choose a standalone Part D plan with Original Medicare or a Medicare Advantage plan that includes drug coverage, selecting the right plan is vital. Each plan has its own formulary (list of covered drugs), tiers of copayments, and deductible structures. I assist you in reviewing your current prescriptions and matching them to a plan that provides the best coverage at the most affordable cost—helping you avoid unexpected expenses in the coverage gap or “donut hole.”

Enrollment Periods and Personalized Guidance

Enrolling in or changing your Medicare plan must be done during specific enrollment periods. These include the Initial Enrollment Period (IEP), Special Enrollment Periods (SEPs), and the Annual Enrollment Period (AEP)—each with unique deadlines and rules. Missing these windows can lead to penalties or delays in coverage. As your Medicare expert, I ensure you understand these critical timelines and handle the process seamlessly to prevent gaps in your essential coverage.

My approach is always personalized. I take the time to understand your health priorities, preferred doctors, financial situation, and lifestyle. Then I clearly explain your options, compare plans from leading providers, simplify complex terms, and answer all your questions—so you can make confident, informed decisions. With Gary Millstein and Benefits Health Insurance Services, navigating Medicare becomes a clear, stress-free journey toward comprehensive health protection and peace of mind.