Helping Protect The Things You Value Most

Medicare & Senior Plans

  • TRADITIONAL MEDICARE
  • MEDICARE ADVANTAGE
  • MEDICARE SUPPLEMENT INSURANCE (MEDIGAP) POLICIES
  • PRESCRIPTION DRUG COVERAGE-PART D
  • BASIC PLANS- NOT ACA COMPLIANT- NO TAX CREDITS FOR SENIORS OVER 65 YEARS OLD #MA11
  • SENIOR FIXED INDEMNITY PLAN- NOT ACA COMPLIANT- NO TAX CREDITS # MS11
  • EMPLOYER GROUP MEDICARE ADVANTAGE, DENTAL & VISION-FROM ALL PRIVATE CARRIERS
  • LONG TERM CARE-LTC
  • TRAVEL MEDICAL INSURANCE- GLOBE HOPPER FOR SENIORS 65+ #MG11
  • FOREING NATIONALS MAJOR MEDICAL INSURANCE-TO AGE 84 #HP2

Approaching 65? Have been receiving disability benefits for 24 months? Have earned 10 quarters to qualify for Medicare? We can help you with your MEDICARE application, explaining Social Security programs & benefits, time lines and eligibility guidelines.

Need financial assistance? Our social services team is dedicated to helping those in need. If you or a loved one is in need of Medicaid, Extra Help for reduced Prescription drugs cost or some other means: housing/rent, power/water, in-home services, food, transportation, phone bill and more we will be happy to assist you by connecting you to more than 2,000 local, state, and federal programs available to qualified individuals like you that will help save time and money!

Need Long Term Care but don’t know how to qualify? The Medicaid Institutional Care Program (ICP) is a state/federal program that pays most nursing home costs. The applicant must meet certain medical and financial criteria. The financial requirements are based on the "income cap" and "asset test" and are different for single people and for married people. The largest issue most people face is that you must meet strict financial guidelines in order to qualify.  However, should an individual qualify, Medicaid will pay for up to 100% of their nursing home costs. For many elderly, Medicaid becomes their only option if they have no medical coverage or as their long-term care funding runs out.  Our specialized Elder Law team can help safeguard your life savings by utilizing pooled income trusts, spousal refusal, gift note planning, and by understanding the 5 year look back rules and income resource allowance. It’s never too late: “Your loved one may qualify for assistance even though they are already living in a Nursing Home, or receiving home health care”. Please call Maria Gutierrez at 954-394-8672 or send your request to MariaInsurance@gmail.com to schedule your appt. and review your options. Medicare and Medicaid could be complicated if you don’t have the right team to guide you through the process!

IMPORTANT WEBSITES

Learn more about Medicare, Social Security Administration Florida Department of Children & Families and other financial assistance programs by clicking on the links below:

Official U.S. Government Site for People with Medicare, family members, and caregivers. Get the latest information on Medicare enrollment, benefits, and other helpful tools Medicare.gov

Centers for Medicare & Medicaid Services https://www.cms.gov/

Social Security Administration https://www.ssa.gov/

Special enrollment period SEP https://www.ssa.gov/hlp/isba/10/hlp-med003-partb2.htm

For definitions, coverage and where to get more information https://www.medicare.gov/Pubs/pdf/11474.pdf

Applying to Medicare https://www.ssa.gov/benefits/medicare/

https://www.medicare.gov/forms-help-and-resources/your-medicare-card.html New Medicare Cards-How to apply

Learn more about Medicare https://www.ssa.gov/pubs/EN-05-10043.pdf

Applying for Medicare only and delaying retirement benefits https://www.ssa.gov/planners/retire/justmedicare.html

Managing your benefits https://www.ssa.gov/onlineservices/current.htm

Related Programs-Financial Eligibility Standards https://www.dcf.state.fl.us/programs/access/docs/esspolicymanual/a_09.pdf SSI

Florida Department of Children and Families http://www.myflfamilies.com/

“Access Florida”Public Assistance http://www.myflfamilies.com/service-programs/access-florida-food-medical...

Social Security office https://secure.ssa.gov/ICON/main.jsp

How to qualify for Extra Help With Medicare Prescription Drug Costs https://www.ssa.gov/pubs/EN-05-10525.pdf

Application for Extra Help with Medicare Prescription Drug Costs https://secure.ssa.gov/i1020/start

Benefit Check up https://www.benefitscheckup.org/medicare-rx-extra-help-application/

Benefit finder in Florida https://www.benefits.gov/benefits/browse-by-state/state/150

Government benefits https://www.usa.gov/benefits

Refugee Center www.therefugeecenter.org/PublicBenefits

Florida Dept. of Elder Affairs http://elderaffairs.state.fl.us/doea/programs.php

Prescription drug assistance program https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Prescription-Drug Assistance-Programs/Overview.html

State Pharrmaceutical Assistance Program https://www.ncoa.org/economic-security/benefits/prescriptions/spaps-paps/

Emergency Preparedness for Residents at Risk http://www.broward.org/AtRisk/Pages/SpecialNeeds.aspx

TRADITIONAL MEDICARE

Due to and CMS guidelines and government regulations information provided under this category is strictly regulated and any publication must be previously approved. For further details please contact Maria Gutierrez/Licensed Medicare Agent to set a time for a face to face appointment, phone consultation at 954-394-8672 or MariaInsurance@gmail.com

Please click on the link below to access the “Official U.S. government Medicare handbook” Medicare & You | Medicare.gov to learn all about MEDICARE - Topics included:

https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf

Section 1 — Learn How Medicare Works

Section 2 —Signing Up for Medicare Part A & Part B

Section 3 — Find Out if Medicare Covers Your Test, Service, or Item

Section 4 — What’s Original Medicare?

Section 5 — Learn about Medicare Advantage Plans (Part C) & Other Medicare Health Plans

Section 6 — What are Medicare Supplement Insurance (Medigap) Policies?

Section 7 — Get Information about Prescription Drug Coverage (Part D)

Section 8 — Get Help Paying Your Health & Prescription Drug Costs

Section 9 — Know Your Rights & Protect Yourself from Fraud

Section 10 — Get More Information

Section 11 — Definitions

MEDICARE ADVANTAGE

Plans offered by PRIVATE INSURANCE COMPANIES

As previously stated: “due to and CMS guidelines and government regulations information provided under this category is strictly regulated” No specific plan details or premiums can be advertized on a public website unless is directly from the insurance company’s website. Click on the link: https://www.cms.gov/Medicare/Medicare.html Centers for Medicare & Medicaid Services to learn all about MEDICARE PLANS, learn more by clicking on the links below:

Medicare Advantage Applications

Medicare Advantage Prescription Drug Contracting (MAPD)

Plan Payment

A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. You’ll generally get your services from a plan’s network of providers. Remember, in most cases, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. Medicare Advantage Plans cover all Medicare Part A and Part B services In all types of Medicare Advantage Plans; you’re always covered for emergency and urgent care.

Medicare Advantage Plans must cover all of the services that Original Medicare covers. However, if you’re in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies. Most Medicare Advantage Plans offer extra coverage, like vision, hearing, dental, and other health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you might have to pay a monthly premium for the Medicare Advantage Plan.

What are the different types of Medicare Advantage Plans?

Health Maintenance Organization (HMO) plans: You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network (except emergency care, out-of-area urgent care, or out-of-area dialysis).

Preferred Provider Organization (PPO) plans: have network doctors, other health care providers, and hospitals, but you can also use out-of-network providers for covered services, usually for a higher cost.

Private Fee-for-Service (PFFS) plans: You can go to any Medicare-approved doctor, other health care provider, or hospital that accepts the plan’s payment terms and agrees to treat you. Not all providers will. If you join a PFFS plan that has a network, you can also see any of the network providers who’ve agreed to always treat plan members. You can also choose an out-of-network doctor, hospital, or other provider, who accepts the plan’s terms, but you may pay more.

Special Needs Plans (SNPs): You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network (except emergency care, out-of-area urgent care, or out-of-area dialysis).

HMO Point-of-Service (HMOPOS) plans: These are HMO plans that may allow you to get some services out-of-network for a higher copayment or coinsurance.

Medical Savings Account (MSA) plans: These plans combine a high-deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year. MSA plans don’t offer Medicare drug coverage. If you want drug coverage, you have to join a Medicare Prescription Drug Plan.

To learn more you can visit the Medicare Plan Finder at: https://www.medicare.gov/find-a-plan/questions/home.aspx

MEDICARE SUPPLEMENT INSURANCE (MEDIGAP) POLICIES

Plans offered by PRIVATE INSURANCE COMPANIES

What are Medicare Supplement Insurance (Medigap) Policies?

Original Medicare pays for much, but not all, of the cost for health care services and supplies. Medicare Supplement Insurance policies, sold by private companies, can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Medicare Supplement Insurance policies are also called Medigap policies. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. Generally, Medigap policies don’t cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

Medigap policies are standardized Every Medigap policy must follow federal and state laws designed to protect you, and they must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters A through D, F through G, and K through N. All policies offer the same basic benefits, but some offer additional benefits so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

To learn more you can visit the Medicare Plan Finder at: https://www.medicare.gov/find-a-plan/questions/home.aspx

PRESCRIPTION DRUG COVERAGE-PART D

Plans offered by PRIVATE INSURANCE COMPANIES

Medicare prescription drug coverage is an optional benefit. Medicare offers drug coverage to everyone with Medicare. Even if you don’t take prescriptions now, you should consider joining a Medicare drug plan. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare prescription drug coverage.

To get Medicare prescription drug coverage, you must join a plan approved by Medicare that offers Medicare drug coverage. Each plan can vary in cost and specific drugs covered. Visit the Medicare Plan Finder at Medicare.gov/find-a-plan for more information about plans in your area.

There are 2 ways to get Medicare prescription drug coverage:

1. Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) plans, and Medicare Medical Savings Account (MSA) plans. You must have Part A and/or Part B to join a Medicare Prescription Drug Plan.

2. Medicare Advantage Plans (like HMOs or PPOs) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A, Part B, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage. In either case, you must live in the service area of the Medicare drug plan you want to join. Both types of plans are called “Medicare drug plans” in this handbook.

To learn more you can visit the Medicare Plan Finder at: https://www.medicare.gov/find-a-plan/questions/home.aspx

BASIC PLANS- NOT ACA COMPLIANT- NO TAX CREDITS FOR SENIORS OVER 65  YEARS OLD  #MA11

For Senior who do not qualify for MEDICARE. Health plans available to enroll all year round. These are PPO nationwide networks of Doctors & Hospitals. Cover Individual MINIMUM ESSENTIAL HEALTH BENEFITS (MEC) Of all the plans this is the only one that is not going to be (ACA) tax penalty exempt but it will include 100% preventative wellness and 100% access to our First Call Telemedicine Service. It has all the benefits for first dollar coverage including PCP visits and urgent care visits with no deductible.

These plans are great for individuals just looking for the basics. Unlimited PCP visits with very low consultation fee (including chronic maintenance), Urgent Care visits, all labs and diagnostics included from PCP, Pediatric Visits and a lot more!

SENIOR FIXED INDEMNITY PLAN- NOT ACA COMPLIANT- NO TAX CREDITS  # MS11

For Senior who do not qualify for MEDICARE. Health plans available to enroll all year round. These are PPO nationwide networks of Doctors & Hospitals. The Fixed Indemnity Senior offers three, budget-friendly benefit levels that provide cash benefits without having to worry about meeting a deductible. The money can be used to pay unexpected medical costs or everyday living expenses. No Annual Deductible. Affordable plan that supplements other health insurance you may have. Benefits are paid directly to you - not your doctor or hospital. Flexible benefit options with three plans to choose from. This plan is not (ACA) tax exempt penalty.

The Fixed Indemnity Direct offers six, budget-friendly benefit levels that provide cash benefits without having to worry about meeting a deductible. Affordable plan that supplements major medical insurance with a high deductible. Benefits include: hospitalization up to 365 days per incident, surgery, ICU, outpatient surgery, ER, outpatient services, ambulance, doctors visits.

EMPLOYER GROUP MEDICARE ADVANTAGE, DENTAL & VISION-ALL MAJOR PRIVATE CARRIERS

Plans offered by PRIVATE INSURANCE COMPANIES For many employers, Medicare Advantage plans provide more efficient coverage for Medicare-eligible retirees, compared to Original Medicare and a secondary plan. Retirees and their spouses can enroll three months before or 3 months after their 65th birthday.

Group Medicare Advantage plans combine the benefits of Original Medicare and Medicare supplements in a single plan. For many employers, private carriers offer Medicare Advantage plans that provide more efficient coverage compared to Original Medicare and a secondary plan. Members remain in the Medicare program and continue to pay Medicare-applicable premiums; they just receive their Medicare benefits through a private insurance company. The plans may include Part D coverage, eliminating the need for freestanding pharmacy benefits. Private insurance companies offer Medicare Advantage plans to private- and public-sector employers, as well as other collectively bargained groups. Carriers offers a broad range of funding options, so your company can choose to fund all, part, or none of retirees' Medicare premiums. And if your company is not sure which funding level to choose, ask Maria Gutierrez/Licensed Medicare Agent contracted with top carriers so she can help you “shop around” so you make an informed decision.

LONG TERM CARE-LTC

LTC is an ever increasing product that many of us may need during our lifetime, and into retirement. Health insurance policies, neither Medicare nor Social Security cover this need. Two-thirds of single people and one-third of married couples exhaust their funds after just 13 weeks in a nursing home.  Within two years, 90% will be bankrupt. The average cost per year of nursing home care is $57,700. By 2030, the average nursing home stay will cost approximately half a million dollars.

Age is not a determining factor in needing long-term care. About 70% of individuals over age 65 will require at least some type of long-term care services during their lifetime. About 40% of those receiving long-term care today are between 18 and 64. So why wouldn't you insure your independence? Once a change of health occurs, long-term care insurance may not be available. Early onset (before age 65)   Alzheimer’s and Parkinson’s disease are rare but do occur. Long-term care is an issue because people are living longer. As people age, many times they need help with everyday activities of daily living or require supervision due to severe cognitive impairment. This impacts women even more since women often live longer than men and by default, they become caregivers to others.

In the United States, Medicaid will provide long-term care services for the poor or those who spend-down assets because of care and exhaust their assets. In most states you must spend down to $2,000. If there is a living spouse/partner they may keep an additional amount. A welfare program, Medicaid does provide medically necessary services for people with limited resources who "need nursing home care” but can stay at home with special community care services. However, Medicaid generally does not cover long-term care provided in a home setting or for assisted living. People who need long-term care often prefer care in the home or in a private room in an assisted living facility. Private long-term care (LTC) insurance is growing in popularity. Premiums, however, have raised dramatically in recent years even for existing policy holders. Coverage costs can be expensive, when consumers wait until retirement age to purchase LTC coverage. Consult with us to see how to properly price a product for you.

TRAVEL MEDICAL INSURANCE- GLOBE HOPPER FOR SENIORS 65+ #MG11

Two plan designs: Single-Trip and Multi-Trips

Globe Hopper Senior Single-Trip is extendable up to 12 months- Deductible options from $0 to $2,500- Maximum limits from $50,000 to $1,000,000

All the above plans you have access to Preferred Provider Organization PPO network available for treatment received within the U.S., and proprietary International Provider Access database of more than 17,000 accomplished physicians and facilities allows you to access quality care worldwide. “Teledoc” services to communicate with experienced health care professionals 24/7/365, regardless of your location allowing you to consult with board-certified physicians, licensed psychologists, pharmacists, dentists, eye doctors, alternative medicine doctors, dieticians and fitness trainers to assist you with any routine health related questions you have. Preferred Rx Listing, Preferred Dental Network, United Healthcare PPO or First Health PPO provider’s network and CoxHealth Network to obtain services from a participating provider/facility which may help to lower your total cost for services. 

FOREING NATIONALS MAJOR MEDICAL INSURANCE-TO AGE 84

Foreign Nationals visiting the USA.

Foreign Nationals moving to the USA.

Foreign Nationals employed by a US company who reside in their home country.

Foreign Nationals employed by a US company working outside their home country.

Foreign nationals traveling to the United States on business or for vacation may not be aware of the expensive cost of medical treatment in the US. Imagine the shock and stress that could overwhelm your foreign clients upon the realization that they are fiscally responsible for medical care in the event of an accident! With PIU’s International Major Medical plan you can help protect your clients in the event of an accident while they are traveling in the USA.

Based on deductibles with a maximum benefit of Up to $5,000,000 coverage in medical expenses (based on age). Covers hospitalization, emergency room, ambulance, medical evacuation, doctor services, skilled nursing facility, home health care, repatriation of remains, prescriptions, emergency return home, war & terrorism coverage and more!

ADDITIONAL PLAN AVAILABLE UPON REQUEST

Click HERE to CONTACT US for more information