Sergey Golub has been working in the Medicare market in California since 1999, which adds up to 25 years. He is a licensed and certified specialist in this field and possesses extensive knowledge about the Medicare program and its changes. Every year, changes may occur in plans and coverages, so it’s important to stay updated on the innovations
Sergey, you have been in the insurance business since 1999, and probably know everything about it. Can you tell us about Medicare, what is this program?
It’s impossible to know everything, but I’ll be glad if my many years of experience can help people obtain medical insurance through the Medicare program and protect themselves from huge medical bills and the stress associated with them. Medicare helps to reduce the financial burden on the elderly by covering a significant part of medical expenses such as hospitalization, outpatient services, and medications.
Medicare is a government program designed for those who are already retired or about to retire. The age requirement is 65 years, and this applies to both men and women. It is recommended to start exploring available plans three months before reaching the age of 65, to be able to choose the most suitable option. Legally, you can apply for Medicare three months BEFORE your 65th birthday, during the month of your birthday, and within three months AFTER your birthday. The government gives you 7 months to apply for Medicare and choose either Part A or Part B. I will provide help in choosing a plan and applying completely free of charge.
To avoid penalties, you need to apply for Medicare on time. If you have Creditable Coverage—coverage from your job if you continue to work, or from your spouse—it allows you to delay receiving some Medicare benefits. And with Medicare, there’s no need to rush.
Understanding the different parts of Medicare (A, B, C, and D) will help you determine which services and coverages you specifically need.
Tell us more about these components of the program:
Part A completely pays for your hospital stay: medications, meals, procedures, etc. This part is given for free to those who have worked 10 years or 40 quarters and paid taxes. Those who lack enough credits can buy this part, which will be specified by a Social Security worker, or the amount will be “voiced” in the online application. The amount will range from $278 to $505 depending on how many credits you have. If, as they say, you are a “person from the street” without employment history but are 65 years old, it will cost $505 per month, prices of this year.
Part B covers visits to the doctor, as well as vaccinations, the use of equipment, tests, services, and medications for diabetics, etc. This part costs $174.90. The price may vary depending on the income. If it is more than $103-130 thousand per year, the price may be higher. From $130 to $160 even higher, from $160 to 190 even higher, and so on up to half a million, the price will increase for Part B and, accordingly, for Part D. The cost is set according to the IRMA adjustment—a program for recalculating the cost of insurance depending on your income.
A and B are the basic parts that every participant in Medicare should have. However, for example, you can opt not to take Part B if you decide to keep working and you have some benefits from your employer that cover your health expenses. I discuss all the nuances during consultations.
Part D covers medications, regardless of whether you take the medications or not, you must have this part.
Part C – Medicare Advantage is a plan that goes through private companies like Anthem, Blue Shield, United Healthcare, Wellcare/Health Net, Imperial, Aetna, Alignment, Brand New Day, and many others. They have their plans. And, if a person has enrolled in Medicare, and there are Parts A & B, then he can get a Medicare Advantage plan (combines Parts A, B, and D). Typically, they cover services not provided to clients of the traditional Original Medicare plan, such as vision checks and assistance in purchasing glasses, hearing tests and assistance in purchasing hearing aids, massages, acupuncture, dental services, free fitness, taxis, etc. And therefore, these plans are very popular with most clients.
How to сhoose the right company when there are so many options? How not to make a mistake?
As a broker, I represent your interests before these companies to select the best plan that will work for you. Each approach is individual, so please contact me; I will always be glad to advise which parts to take and which can be put on hold and taken later to avoid penalties, as the government has the right to impose fines on those who do not register on time for one part or another. Each case is unique.
Every plan is assigned to the zip code in which you reside. It’s important to know which plan is available in your zip code. Plans have a “star-rating” – from one to five stars. I work only with those plans that have at least 3 stars and above. This rating is assigned by the CMS (Center for Medicare Services), which objectively assesses the services provided based on various characteristics from the past year.
How long does a plan last?
Each plan operates for a year. If you like it, it will automatically carry over to the next year. If the company decides to no longer support this plan or it ends at the end of the year, they will send you a letter in October stating that the plan operates until the end of the year, and there is time to choose a new one. The selection of new Medicare plans for 2025 will begin on October 15 and last until December 7. During this time, you can also consider which plans might be more interesting and better for you for the next year. They all take effect from January 1. To not miss the plan change, simply keep an eye on your mail: somewhere in late October, you should receive an ANOC (annual notice of changes) letter from the plan you are currently in. This letter will show changes in your plan (as it was in 2024 and how it will be in 2025), and if you want to change it, I will be happy to help.
Where can you find me and what is the cost of your services?
My services are free. You can find me on social networks, as well as by phone at 916 304 3220, I also have a free special line 1 800 717 4077 for those who want to call from a landline.
If I haven’t worked in America, can I get insurance?
To qualify for Medicare insurance, you must have lived in America for at least 5 years, have a green card or be an American citizen, and not have left the country for more than 30 days per year in the last 5 years, and you must be 65 years old at the time of application.
What documents are needed to start working with a client?
Documents: ID card, green card, Medicare card (A and B) – you apply through Social Security personally or online and receive it, and, if available, Medi-Cal from the state. I check all documents and help create a plan.
Do you only help with choosing a program or do you accompany a person at all stages and help solve all arising questions?
I help in various cases: in activating cards, I can help choose a doctor, for example, find a Russian-speaking one. It is very important to choose the right therapist, as all further management of you as a patient will go through the chosen doctor: appointments for procedures, for tests, referral to specialists. If for some reason the treating doctor does not suit you, you can contact me again and I will help you choose a new therapist. If you are not satisfied with your current plan, we can try a new plan, or return you to Original Medicare. To learn all the nuances and discuss all possible pros and cons of plans, I suggest you call me for a free consultation. I will gladly help and analyze your current situation. I can communicate in Ukrainian, Russian, and English.
Can we communicate online or can you come to a meeting in person?
I can physically come to areas from Los Angeles to San Francisco and am available via any communication channels (phone, Skype, Viber, WhatsApp, email) or in person. In any case, call me, write to me, and you will always receive feedback. Even if I’m at a conference, there’s always the opportunity to leave your contact details and you will receive a consultation later.
Starting October 1st, I will be organizing meetings where I will discuss the changes that will be in the programs for the year 2025. If you want me to come and explain to you and your neighbors, please contact me. I will hold meetings in senior homes where there are special rooms for gatherings. Just keep an eye on the announcements. The meetings are free. From October 1st, I can discuss what plans and changes we can expect starting January 1st next year. Stay healthy and take care!
We do not offer every plan available in your area. Currently we represent few organizations which offer several plans in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
