Medicare Plan Options

In Florida, Medicare beneficiaries have an abundance of health insurance options to choose from, so you can build a customized policy that accounts for your health care needs and budget. Original Medicare may be a good fit if you’re in good health and don’t require much coverage, or the Florida Medicare Advantage program is available if you want more comprehensive coverage. Many with Original Medicare save money by adding a Medicare Supplement Insurance policy. Opting for a plan that includes prescription drug coverage or adding this coverage to your policy may help you save money over time.

Original Medicare

Original Medicare is managed by the federal government and available to those aged 65 and over or who have certain disabilities. With this plan, you get a great deal of flexibility regarding health care services. You can go to any health care provider, hospital, or facility in the nation that’s registered with Medicare. You don’t need to choose a primary care doctor, and in most cases, you can schedule an appointment to see a specialist without a referral. Original Medicare is made up of two parts: Part A, which covers hospital bills, and Part B, which covers medical expenses such as doctors’ services, medical supplies, and preventative care.

Medicare Advantage Plans

Medicare Advantage Plans are alternatives to Original Medicare and include the benefits in Parts A and B. Plans may also have additional benefits, such as personal care services, vision and dental coverage, and prescription drug coverage. These plans are offered by private health insurance companies that follow the rules set by the federal government. Like employer-sponsored plans, Medicare Advantage Plans typically have closed or limited health care networks of doctors, hospitals, and specialists. Cost-sharing responsibilities, premiums, and rules about choosing a primary health care provider or referrals to see specialists vary across plans.

Medicare Prescription Drug Plans

Original Medicare doesn’t include prescription drug coverage, so if you take medication for health concerns or expect to in the future, you should consider adding prescription drug coverage to your policy. This coverage is optional and can be added to certain Medicare plans at any time, although you pay a late enrollment penalty if you don’t join during your initial Medicare enrollment period. To qualify for a prescription drug plan, otherwise known as Medicare Part D, you must have Original Medicare Parts A and B, a Medical Savings Account Plan, or specific private fee-for-service plans.

Medicare Supplement Insurance Plans

If you have Original Medicare, some of your out-of-pocket health care costs include copays and deductibles that must be met before your coverage kicks in. Because there are no annual out-of-pocket limits, these can become burdensome if you have extensive health care needs. Medicare Supplement Insurance, also called Medigap, covers some of your cost-sharing responsibilities to reduce your overall expenses. These policies are provided by private health insurance companies and have monthly premiums that you pay in addition to your Medicare premium.

Medicare in Florida by the Numbers

People enrolled in Original Medicare

Average plan cost

Annual state spending per beneficiary

Spending per beneficiary compared to the national average

2,381,102

Plan A: $0 to $471 per month*

 

Plan B: $148.50 per month**

$11,565

15.00%

*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.

Medicare Resources in Florida

With so many choices and factors to consider when evaluating your health insurance needs, signing up for Medicare plans in Florida can be confusing. Florida is home to several nonprofit organizations that can help you select the right Medicare policy for your needs and understand your benefits and cost-sharing responsibilities. There are also state-sponsored programs to help you recognize Medicare scams, fraud, and waste.

Florida SHINE

Florida SHINE is a statewide program that provides free health insurance counseling for those who qualify for Medicare. Through its network of trained volunteers, you can get answers to questions regarding Original Medicare costs and benefits, help identifying and comparing the Medicare Advantage Plans available in your region, and assistance with understanding medical billing statements. Volunteers may advocate on your behalf and help you dispute denied claims for covered services. The program also provides community and one-on-one education to recognize and prevent Medicare fraud through the Senior Medicare Patrol.

Contact Information: Website | 800-963-5337

ElderSource

ElderSource is one of the state’s 11 Area Agencies on Aging, which receive federal funds through the Older Americans Act to provide a broad range of services to those aged 60 and over. This AAA serves Jacksonville and the surrounding area and is a SHINE counseling site. Its volunteers provide free, unbiased Medicare counseling, helping you understand your health care coverage options. Services may be available over the phone or in person at one of the agency’s local senior centers.

Contact Information: Website | 888-242-4464

Bay Area Legal Services is a nonprofit law firm providing free civil legal services to those in the Tampa Bay area. Through the firm, you can get information on qualifying and applying for Medicare benefits, understanding what different Medicare plans cover, and identifying public benefits to help you cover health care expenses. The firm also operates the Florida Senior Legal Helpline, which is available to seniors throughout the state and answers Medicare questions. The helpline is operational on weekdays from 9 a.m. to 4:30 p.m. and is reached at 888-895-7873.

Contact Information: Website | 800-625-2257

Florida Department of Elder Affairs

The Florida Department of Elder Affairs provides various direct services to state residents aged 60 and over, including SHINE. Through this program, volunteers provide objective information about your Medicare options, helping you make informed decisions regarding your coverage. Volunteers aren’t affiliated with any insurance companies or licensed to sell policies. They can help you organize and settle medical bills, spot billing errors, dispute denied claims, and understand your Original Medicare benefits. Counselors can also help you identify the available Medicare Advantage Plans in your region and compare their prices and coverage options.

Contact Information: Website | 850-414-2000

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