If you’re shopping for Medicare coverage in Florida, you’ve got a lot to consider when selecting a plan. Medicare is a health program offered through the federal government to people 65 and older as well as people with certain disabilities. You can get coverage directly from the government or through a private insurance company.
Medicare is more than just one plan. There are different plans and components that cover different things.
Original Medicare is managed by the federal government. It includes two main parts, Part A and Part B.
Part A covers hospital services. This includes inpatient care you receive in a hospital or skilled nursing facility, as well as some home health services. You may not need to pay a premium for Part A if you or a spouse paid into Medicare through a payroll tax during your working years. This applies to most people with a work history.
Part B covers more general medical costs, such as services you receive at a doctor’s office, outpatient care, medical supplies, and preventive care. You typically do pay a premium for Part B coverage.
Depending on your health needs, original Medicare may not provide enough coverage. It doesn’t include coverage for prescription drugs, for instance. And out-of-pocket costs such as copayments, coinsurance, and deductibles add up, which can be expensive if you use healthcare a lot.
There are also options for adding additional coverage to your Medicare plan, which you can purchase from a private insurance company:
- Medicare supplement plans, sometimes called Medigap plans, help pay costs that original Medicare doesn’t cover.
- Part D plans add coverage for prescription drugs.
Alternatively, you also have the option for a single comprehensive plan known as a Medicare Advantage plan.
What is Medicare Advantage?
Medicare Advantage plans are plans offered through private insurance companies and are a full replacement for original Medicare. These plans cover all of the same benefits of parts A and B, and then some.
Medicare Advantage plans typically include coverage for prescription drugs, vision and dental care, health management and fitness programs, plus additional perks.
A number of insurance carriers are offering Medicare Advantage plans in Florida in 2020. They include the following companies:
- Humana Medical Plan Inc.
- UnitedHealthcare Insurance Company
- Preferred Care Partners Inc.
- CarePlus Health Plans Inc.
- Aetna Life Insurance Company
- WellCare of Florida Inc.
- Freedom Health Inc.
- Florida Blue Medicare Inc.
- Sierra Health and Life Insurance Company Inc.
- Blue Cross and Blue Shield of Florida Inc.
- Simply Healthcare Plans
- Optimum Healthcare Inc.
- HealthSpring of Florida
- Healthsun Health Plans Inc.
- Medica Healthcare Plans Inc.
- Health First Health Plans
- AvMed, Inc.
These companies are listed in order from highest enrollment in the state to lowest. It’s important to note that Medicare Advantage plan offerings vary by county.
Medicare coverage is available to individuals who:
- Are age 65 or older
- Are under age 65 and have certain disabilities
- Are any age and have end stage renal disease (ENRD)
For most people, your initial Medicare Florida enrollment period begins 3 months before you turn 65 and lasts for 3 months after you turn 65.
If you choose not to enroll during your initial enrollment period, you’ll have a chance again during the open enrollment period, which runs from January 1 through March 31 each year.
If you or a spouse continue working, you may choose not to enroll in Medicare medical coverage (Part B) just yet. In these cases, you may be eligible for a special enrollment period to opt in later on.
But keep in mind, you don’t have to stay enrolled in your employer’s group health plan. You may find that Medicare offers better coverage for less money even while you stay employed full-time.
The Medicare plan that’s best for you depends on a number of factors that may vary depending on your preference or situation. Consider the following when selecting a plan:
- Compare plan structures. If you’re choosing a Medicare Advantage plan, know that these plans come in a variety of plan designs. It’s essential to understand how a plan works and how that might affect your care. Do you prefer to have a primary care physician overseeing your care (HMO)? Or would you rather be able to see any specialist in a network without getting a referral (PPO)?
- Consider costs. How much are premiums, copayments, deductibles, or other costs? If you qualify for coverage through an employer, how do those costs compare to your current group coverage options?
- Check reviews. See what other consumers are saying about their plans. Does the claims process work smoothly? Is customer service friendly and efficient? Read reviews online or ask around if you know other people enrolled in Medicare Advantage plans.
- Review the provider network. If you have a preferred physician, look for a plan that includes them in the Medicare Florida network. Some plans may have more narrow coverage areas that aren’t geographically convenient. The time to find out is before you enroll.
- Shop for perks that suit you. Medicare Advantage plans usually include a lot of extras — discounts and programs that can help you stay healthy and thriving. Look for ones that fit your lifestyle and will be useful to you.
To learn more about Medicare plans in Florida, check out these resources:
Ready to take the next steps in enrolling in a Medicare plan in Florida? You may want to consider these actions:
- Get in touch with a Medicare Florida insurance agent who can help you understand your Medicare options and get you quotes from different plans to help you compare.
- Look up plan information online through local insurance carriers.
- Fill out an online Medicare application through the Social Security Administration. You can fill out the form in as little as 10 minutes and you don’t need to submit documentation right away.