Florida Medicare Plans: Coverage, Advantage & State Options
Smart Insurance Agents is a respected agency offering trusted advice on Medicare plans in Florida.
Need Help With Medicare in Florida?
As you get closer to becoming eligible for Florida Medicare, you may have a lot of questions about how Medicare works and which plan is best for your needs. With so many options to consider, choosing the right Medicare plan can be overwhelming. At Smart Insurance Agents, we simplify the Medicare process and guide you every step of the way.
Our friendly team is here to answer all your questions and help you select a plan that fits your budget and healthcare needs as a Florida resident.
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What Is State of Florida Medicare?
Medicare is federal health insurance available to most people ages 65 and older and some younger people with disabilities.
It helps cover the cost of healthcare services like hospital visits, doctor appointments, care received at home, and preventive services.
Even though Medicare covers many essential medical costs, it does not cover all expenses or the full cost of care.
Are You Eligible for Medicare?
Generally speaking, you are eligible for Medicare if:
You’re 65 or older
You’re under 65 with certain disabilities and have received disability benefits for 24 months
You have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)
Some key points about eligibility include:
You can enroll in Medicare three months before your 65th birthday
If you are still working and have health insurance through your employer or spouse, you may be able to delay Part B enrollment without penalty
If you’ve had Social Security or Railroad Retirement Board disability benefits for 24 months, you are eligible for Medicare regardless of age
Medicare Advantage Plans in Florida
Medicare Advantage (also called Part C) is an alternative to original Medicare. These are health plan options approved by Medicare and run by private companies. They provide all your Part A and Part B coverage and often offer extras like dental, vision, fitness benefits, SilverSneakers, and more.
Common types of MA plans in Florida include HMO (Health Maintenance Organizations), PPO (Preferred Provider Organizations), and Private Fee-for-Service plans.
Medicare Supplement
Plans
Also called Medigap policies, these plans are sold by private insurance companies to fill gaps in original Medicare coverage like deductibles, copays, and coinsurance. Florida has 10 standardized Medigap plans available for you to choose from. These plans help pay for some healthcare costs not covered by Parts A and B.
Prescription Drug Plans
(Part D)
Part D coverage is available to everyone with Medicare. Prescription drug plans are approved by Medicare and offered by private insurers to help cover the costs of prescription medications. These plans have formularies that list covered drugs. Premiums and cost shares like deductibles vary by plan. Many Medicare Advantage plans now also include drug coverage.
How Do You Compare Medigap (Supplement) Plans?
When researching Medigap policies, it’s important to compare the different plans side by side to understand what each covers and how much they cost. Each plan has a specific letter and covers different gaps in original Medicare. Plans A-D are basic benefit plans that cover fewer gaps, while Plans K-N provide high deductibles or copay amounts for certain healthcare services.
How Does Original Medicare Work?
With original Medicare, the government handles your claims directly. You have the freedom to visit any doctor or hospital that accepts Medicare nationwide. This includes Part A (hospital insurance) and Part B (medical insurance) coverage.You pay a deductible up front and then typically 20% of costs for services.
Medigap or Medicaid can help pay this 20% if needed.
You need a separate Part D plan for prescription drug coverage.
What Happens if You Need Help Paying for Medicare Costs?
Medicare Savings Programs can cover Part A/B costs for those at or below 135% of the Federal Poverty Level
Medicaid may help pay premiums, deductibles, copays, and cover services not covered by Parts A or B
Medicare Diabetes Prevention Program
What’s Not Covered by Medicare Part A and Part B?
Long-term custodial care at home or in a nursing home
Dental cleanings or dentures
Vision exams and eyeglasses
Hearing aids and exams
Private nursing care or non-medically necessary services
Acupuncture, cosmetic surgery, and most foot care are also typically excluded. That’s why Supplements, Medicare Advantage, and other options can provide additional value. Our advisors will ensure you understand the gaps so your health costs remain affordable.
Overview of Medicare Advantage Plan Choices
Choosing the right Medicare plan is an important decision with significant implications for your health and finances. That’s why we provide Florida seniors with clear, impartial guidance every step of the way. Our licensed insurance advisors understand every part of the process and will ensure you get maximum value from your Medicare coverage.
Learn More About Medicare Coverage in Florida
If you’d like to learn more about Florida Medicare, please get in touch. We look forward to helping you select the best plan and securing your peace of mind now and into retirement.