Sandra Duran, Medicare Insurance Agent
Sandra Duran
Medicare Advisor/ Pinnecle Sevices
Bilingual English & Español
Medicare Agent Licensed in NY, CT and NJ
Contact Details
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Location
Bronx, NY
Sandra Can Help With:
About Me
Licensed Medicare Insurance Agent proudly serving New York, New Jersey, and Connecticut. I specialize in helping individuals turning 65 and Medicare beneficiaries navigate their coverage options with clarity and confidence. Whether you’re new to Medicare, reviewing your current plan, or exploring Medicare Advantage, Medicare Supplement (Medigap), Part D prescription drug coverage, Medicare Savings Programs, or Medicaid, I provide personalized guidance tailored to your needs.
My commitment is to make the Medicare process simple, transparent, and stress-free by educating clients, answering questions, and helping them choose coverage that fits their healthcare and financial goals. I believe in building lasting relationships through honesty, professionalism, and exceptional service—before, during, and after enrollment.
Q&A with Sandra Duran
Does Medicare cover ProAir inhalers (HFA and Digihaler)?
Answer: Yes, Medicare Part D or a Medicare Advantage plan with drug coverage may cover albuterol inhalers, but coverage depends on the plan’s formulary. ProAir HFA and ProAir Digihaler have been discontinued, so the plan may cover another albuterol HFA inhaler or generic equivalent instead.
What happens when my Medicare hospital days run out?
Answer: Original Medicare Part A covers hospital stays by benefit period. After your regular covered days and 60 lifetime reserve days are used, Medicare generally stops paying for additional inpatient hospital days during that benefit period. You would be responsible for the costs unless you have other coverage, such as Medigap, Medicaid, or another plan that provides additional benefits.
I don't understand how my friend pays nothing for their plan and I pay over $200-are these plans just totally random by ZIP code?
Answer: No, Medicare plan costs are not random. They can vary by location, plan type, benefits, and whether someone qualifies for Medicaid or Extra Help. Some Medicare Advantage plans have a $0 premium, but that doesn’t necessarily mean $0 total Medicare costs.
Does Medicare cover memory assessments or neurologist visits?
Answer: Yes. Medicare generally covers memory assessments and visits with a neurologist when they are medically necessary and ordered by a doctor. Depending on whether you have Original Medicare or a Medicare Advantage plan, you may have copays, need a referral, or need to use providers in your plan’s network.
I live in California but might move to another state next year. How will my Medicare coverage change if I relocate?
Answer: If you move to another state, Original Medicare will generally continue to cover you nationwide, but Medicare Advantage and Part D plans are based on service areas. You may qualify for a Special Enrollment Period to choose a new plan available in your new state, so it’s important to review your options before or soon after you move.
How can I find out if Medicare will cover a specific procedure or treatment?
Answer: The best way to find out if Medicare covers a specific procedure or treatment is to check your plan’s coverage details and confirm that the service is medically necessary. It’s also a good idea to ask your doctor and the insurance company before scheduling the procedure, since some services may require prior authorization or have certain coverage rules.
My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?
Answer: The Medicare “donut hole” is going away because there is now a limit on how much you have to pay out of pocket for covered Part D prescription drugs each year. This means that once you reach that limit, you won’t have to keep paying for covered medications for the rest of the year, which can make prescription costs more predictable and affordable.
How do I report a suspicious Medicare billing error without getting in trouble myself?
Answer: You can answer:
If I notice a suspicious Medicare billing error, I would report it through the proper Medicare channels and provide the facts I have. Reporting something in good faith helps protect Medicare beneficiaries and the program, and I would avoid making accusations without evidence.