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Our job is not to sell insurance; it’s to help our clients make an educated decision about their health insurance options.

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    Local Medicare Help
    New Port Richey, Florida

    Medicare coverage options can vary significantly depending on the county you live in. What’s available in one area may not be in another, and coverage changes annually.  Working with a local Medicare specialist helps ensure your doctors, hospitals, and prescriptions are properly reviewed and aligned before you enroll.

    Capstone Health is a local, family-owned Medicare agency based in New Port Richey. We provide year-round guidance for Medicare Advantage, Medicare Supplement (Medigap), and Medicare Part D prescription drug plans; helping you make informed decisions based on what’s important to you.

    If you’re still learning how Medicare works before choosing a plan, our Medicare 101 page explains the basics of Parts A, B, C, and D. Or visit our Medicare Education Center page for free tools, guides and videos to help learn at your own pace.

    //Why the Agent Matters

    How Medicare Expertise Guides Your Decisions

    Every Medicare appointment starts with the same approach. Before discussing specific plans, we focus on understanding what matters most to you. Medicare options can change from year to year, networks can shift, and new plans may appear depending on where you live. Because of that, our process stays consistent.

    We begin by learning about your doctors, medications, budget, and the type of coverage you feel most comfortable with. These conversations help us evaluate how different Medicare plans align with your needs today while also preparing for changes that may happen in the future.

    By focusing on these core areas - your preferences, providers, prescriptions and price - we’re able to guide you toward coverage that fits your situation instead of pushing a one-size-fits-all plan. It’s a straightforward process designed to help you make informed decisions with confidence..

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    Choosing the Right Medicare Agent Matters More Than Most People Realize

    A local, experienced Medicare agent can help you:

      • Verify that your doctors and specialists participate in the plans you're considering
      • Understand which hospital systems and medical groups are in each network
      • Stay informed about local carrier changes and plan updates each year
      • Review your coverage annually as benefits and networks evolve
      • Work with a consistent agent who can guide you as your needs change over time
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    //Medicare Plans Can Change by ZIP Code

    Work With a Local Agent Who Understands Your Medicare Options

    I’ve been helping Medicare clients since 2005. I grew up in Pinellas County and now raise my family here in Pasco County, where we opened our local office in New ...

    Will Smith

    Independent Medicare Agent – New Port Richey, Florida
    1+

    Years Specialized in Medicare

    1+

    Years as Independent Agent

    0+

    Active Medicare Clients

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    Medicare Plans Available in New Port Richey

    Residents in New Port Richey typically choose between two primary Medicare coverage paths:

    • Medicare Supplement (Medigap) plans paired with a separate Part D drug plan
    • Medicare Advantage (Part C) plans that may include drug coverage

    Each option offers different cost structures, provider flexibility, and long-term considerations. The right choice depends on your budget, provider preferences, and coverage priorities.

    For a more detailed breakdown of Medicare premiums, deductibles, IRMAA adjustments, and prescription drug costs, see our Medicare Coverage and Costs Deep Dive page.

    For a more detailed breakdown Medicare Supplements (Medigap) compared to Medicare Advantage plans, see our Medigap or Medicare Advantage: Which is Right for you page.

    //Why Capstone Health

    Insurance Plans and Agents
    Are Not All The Same

    Independent is Best

    Capstone Health is an independent Medicare agency led by Will Smith in New Port Richey. Unlike captive agents who represent only one company, we compare Medicare Advantage, Medigap, and Part ...

    Support Beyond Enrollment

    Many people only hear from their agent when they enroll. At Capstone Health, Will Smith, your local Medicare agent in New Port Richey, provides ongoing support long after your coverage ...

    Local Office – Local Medicare Expertise

    Capstone Health is a locally owned Medicare agency based in New Port Richey, led by independent agent Will Smith. Instead of calling a national hotline, you work directly with a ...

    Speak With a Local Medicare Specialist

    If you live in New Port Richey or the surrounding Tampa Bay area and want to ensure your doctors, hospitals, and prescriptions are properly reviewed before enrolling in a Medicare plan, we’re here to help.

    Medicare decisions should be based on accurate provider verification, clear cost understanding, and long-term planning; not guesswork.

    Contact Will Smith from Capstone Health for personalized Medicare guidance.

    Book an Appointment

    Capstone Health

    7206 Massachusetts Ave, New Port Richey, FL 34653

    Office: (727) 339-0456

    Cell: (727) 859-3195

    Email: will@capstoneinsurance.health

    //Price and Priorities

    Balancing Medicare's: Price and Preferences

    Choosing the right Medicare plan is a balance between what you spend and what you value. Consider your monthly premium against your anticipated healthcare needs. Think about whether you need flexibility in choosing providers or if a lower-cost network fits your lifestyle. By aligning price with what matters most, you can confidently select a plan that suits both your budget and priorities.
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      • Assess monthly premiums and out-of-pocket limits.
      • Align plan features with your healthcare priorities.
      • Ensure your preferred providers fit your choice.
    //Providers and Prescriptions

    Balancing Medicare's: Providers and Prescriptions

    Your plan should cover your trusted doctors and essential medications. Confirm that your preferred providers are in-network and that key prescriptions are included. This ensures smooth care and avoids unexpected costs.
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      • Verify your doctors are in-network
      • Confirm prescription coverage
      • Avoid out-of-network surprises

    Frequently Asked Questions About Medicare Networks & Coverage

    Does it matter whether I work with a local independent Medicare broker versus a call center or captive agent?

    es — the structure of the agent you work with can directly impact your plan options and long-term support.

    Captive agents are limited to one insurance company’s plans. While knowledgeable about their specific products, they cannot compare competing carriers that may offer broader provider networks or more stable long-term pricing.

    Call centers often focus on high enrollment volume during peak seasons. While they may present multiple carriers, relationships are typically short-term and may not include ongoing annual plan reviews, local provider familiarity, or continuity if representatives change.

    A local independent Medicare broker compares multiple carriers, understands local provider networks, and provides year-round support. Medicare plans change annually (networks, drug formularies, and benefits) so having a consistent local independent agent ensures your coverage continues to match your healthcare needs.

    Choosing the right Medicare plan is important. Choosing the right guide is critical.

    The main difference between Medicare Supplement (Medigap) and Medicare Advantage plans is how you receive your Medicare benefits and how costs are structured.

    Medicare Supplement (Medigap) plans work alongside Original Medicare (Part A and Part B) and help cover out-of-pocket costs such as deductibles, copayments, and coinsurance. With Medigap, you can typically see any doctor nationwide who accepts Medicare, and referrals are not required. Medigap plans generally have higher monthly premiums but lower out-of-pocket costs when you receive care.

    Medicare Advantage (Part C) plans are offered by private insurance companies as an alternative way to receive your Medicare benefits. These plans replace Original Medicare and often include additional benefits such as prescription drug coverage, dental, vision, and hearing. Medicare Advantage plans may have lower monthly premiums but require you to use a provider network (HMO or PPO), and costs can vary depending on the services you use.

    Choosing between Medicare Supplement and Medicare Advantage depends on your budget, provider preferences, prescription needs, and long-term coverage goals.

    A Medicare Supplement (Medigap) plan is private insurance that works alongside Original Medicare (Part A and Part B) to help cover out-of-pocket costs such as deductibles, copayments, and coinsurance. Medigap plans are standardized by the federal government and identified by letter names such as Plan G, Plan N, and others.

    With a Medigap plan, you can generally see any doctor or hospital nationwide that accepts Medicare, and referrals are not required. Unlike Medicare Advantage plans, Medigap does not replace Original Medicare—it supplements it by reducing financial exposure from uncovered expenses.

    Medigap plans do not include prescription drug coverage, so beneficiaries typically enroll in a separate Medicare Part D plan for medications.

    Because Medigap plans offer predictable out-of-pocket costs and broad provider access, they are often chosen by individuals who want flexibility and nationwide coverage.

    No, Medicare Supplement (Medigap) plans do not include prescription drug coverage. Medigap policies are designed to work alongside Original Medicare (Part A and Part B) to help cover out-of-pocket costs such as deductibles, coinsurance, and copayments, but they do not cover outpatient prescription medications.

    If you enroll in a Medigap plan and want coverage for prescription drugs, you must enroll in a separate Medicare Part D prescription drug plan. Medicare Part D plans are offered by private insurance companies approved by Medicare and help cover the cost of medications listed on the plan’s formulary.

    It’s important to enroll in a Medicare Part D plan when you are first eligible, even if you take few or no medications, to avoid the Medicare Part D late enrollment penalty unless you have other creditable prescription drug coverage.

    Yes, you can switch Medicare Supplement (Medigap) plans, but approval is not always guaranteed. Unlike Medicare Advantage plans, Medigap plans do not have an Annual Enrollment Period for switching. In most states, changing Medigap plans after your initial enrollment period requires medical underwriting, meaning the insurance company can review your health history and may approve, deny, or charge a higher premium based on your medical conditions.

    Your best opportunity to enroll in or change to a Medigap plan without underwriting is during your six-month Medigap Open Enrollment Period, which begins when you are age 65 or older and enrolled in Medicare Part B. During this time, you have guaranteed issue rights and cannot be denied coverage for pre-existing conditions.

    In certain situations (such as losing employer coverage or leaving a Medicare Advantage plan) you may qualify for special guaranteed issue rights that allow you to switch Medigap plans without underwriting. Because rules vary by state and timing matters, it’s important to review your options carefully before making a change.

    Medicare Supplement (Medigap) Plan G is one of the most comprehensive Medigap plans available. It works alongside Original Medicare (Part A and Part B) to help cover out-of-pocket costs such as deductibles, coinsurance, and copayments.

    Plan G covers nearly all Medicare-approved expenses except the Medicare Part B annual deductible. Once the Part B deductible is met, Plan G typically pays 100% of covered services for the remainder of the year, including hospital stays, skilled nursing facility coinsurance, and excess charges (if a provider bills above the Medicare-approved amount).

    Because of its broad coverage and predictable out-of-pocket costs, Medigap Plan G is often considered a popular alternative to the discontinued Plan F for individuals who want maximum coverage and nationwide access to providers that accept Medicare.

    Medigap Plan G does not include prescription drug coverage, so beneficiaries typically enroll in a separate Medicare Part D plan for medications.

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    Telephone

    727-339-0456

    Time Schedule

    Office Time

    Mon - Fri: 9:00 - 5:00