A Guide to Find Medicare Plans in Florida
Medicare, the federal health insurance program in Florida, provides coverage for almost 5 million people in the State. Medicare services are available for all legal US citizens aged 65 and above, certain adults living with disabilities, and people with end-stage renal disease (ESRD).
Florida boasts the highest proportion of senior residents aged 65 and above. With this demographic constituting 19.36% of the State’s total population, Medicare coverage is essential for cost efficiency in healthcare management.
Most people across Florida have Medicare plans to manage the costs associated with healthcare. Florida alone has about 4.91 million beneficiaries.
A whopping 42% of this total Florida medicare beneficiaries are enrolled in Medicare Advantage plans. Let us look into the various medicare plans offered in Florida and how they help cut down healthcare costs for beneficiaries.
Medicare Options in Florida
Medicare beneficiaries can choose Original Medicare (Part A and B), Medicare Advantage Plans (Part C), Medicare prescription drug plans, and Medicare Supplement.
Here is a comparison to help you understand your Medicare options in Florida.
Original Medicare
Original Medicare offered by the federal health program is your basic Medicare plan comprising Medicare Part A and Part B.
Part A (hospital insurance) covers inpatient care such as hospital stays, skilled nursing facilities, and home health care. Therefore, Part A helps lower the cost for all of your basic hospital insurance including medicines, drugs, hospital meals, semi-private rooms, etc. If needed, Part A insurance also covers your stay in mental health care departments and hospitals.
In contrast, Medicare Part B covers outpatient care such as doctor’s services, medical supplies, and medical equipment. Sometimes, Part B may also cover preventive care, such as screenings for tumors, cancer, or mental illnesses, depending on your medical needs.
If you have access to Original Medicare you can also enroll into a Medicare Advantage plan. This way, your insurance provider gives you access to both Part A and B.
But accessing Original Medicare requires paying deductibles in addition to the fee incurred during your inpatient/outpatient care. Original Medicare provides numerous advantages for beneficiaries residing in Florida.
Original Medicare plan is an ideal choice for beneficiaries looking for flexibility in choosing a healthcare professional anywhere in the US.
Besides, Original Medicare does not have a set limit for out-of-pocket expenses. However, it’s ideal to purchase drug coverage separately for maximum cost-efficiency.
Medicare Advantage Plans (Part C)
Medicare Advantage plans offered by private health insurance companies are approved by Medicare. These plans include Medicare Part A and B with additional benefits, including vision, hearing, dental, and health wellness programs.
Some of the private health insurance companies also offer Medicare prescription drug coverage (Part D) under Medicare Advantage plans.
To explore your Medicare Advantage options in Florida, you must become familiar with the idea of a limited provider network associated with Medicare Advantage plans.
Since Medicare Advantage plans are offered by private health insurance companies collaborating with Medicare, these plans work within a specific network.
This means that beneficiaries can only seek treatment from a healthcare provider within the network of choice. Although Medicare Advantage comes with this limitation, it does provide additional benefits to enrollees.
For example, some Medicare Advantage plans may cover gym memberships, wellness programs, and transportation to and from medical appointments. Therefore, Medicare Advantage plans are an excellent choice for people looking for an all-in-one coverage solution for healthcare needs in Florida as they work as bundled healthcare with drug benefits.
Types of Medicare Advantage Plans
There are several types of Medicare Advantage plans, allowing eligible seniors to easily choose a plan that best suits their healthcare needs.
Here is a list of the most suitable programs the Medicare Advantage plan offers in Florida.
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Special Needs Plans (SNPs)
- Private Fee-For-Service Plans (PFFS)
- Medical Savings Accounts (MSAs)
Medicare Prescription Drug Coverage (Part D)
Numerous Medicare Advantage plans have drug coverage (Part D), but medicare prescription drug coverage is also available to everyone with Original Medicare.
Part D is offered by private health insurance companies in Florida. This plan helps cover the cost of prescription medicines, significantly lowering drug costs associated with treatments.
However, Medicare Part D may not cover the same drugs as Medicare Advantage plans since they are offered by private health insurance companies. Part D coverage also requires deductibles, copays, and coinsurance.
Having Part D coverage is an excellent choice if you have Original Medicare or you’re enrolled in a Medicare Advantage plan without drug coverage, such as a PPO (preferred provider organization) or HMO (health maintenance organization).
Another crucial aspect that you must keep in mind is the penalty that you must pay if you wait to enroll in a Part D plan. If you don’t have drug coverage, it is best to enroll yourself into a low-premium coverage plan to avoid late enrollment penalties.
Medicare Supplement (Medigap)
Medicare Supplement insurance, also known as Medigap, is a secondary coverage plan offered by private health insurance companies in collaboration with Medicare.
Medigap primarily provides additional health insurance for out-of-pocket expenses for treatments Original Medicare does not cover. This means Medicare Supplement only provides coverage for what isn’t covered by Medicare Part A and B.
Some seniors in Florida prefer to have Medicare Supplement insurance to fill the gaps Original Medicare has. However, you must know that you can’t have Medigap coverage with Medicare Advantage plans because choosing a Medicare Advantage plan works as an alternative to Part A and Part B with additional coverage for hearing, vision, and dental care.
But if you enroll in Medigap, you get coverage or what’s not covered by Original Medicare. Thus, it’s necessary for you to have an Original Medicare plan with supplemental Medicare, as it is not a stand-alone insurance policy.
Medicare Supplement plans cover the cost of out-of-pocket expenses, including co-payments, coinsurance, and deductibles.
- Deductibles are costs that you cover before Medicare provides coverage for health services. Thus, deductibles apply to all Medicare Parts.
- A co-payment is like a fixed payment for a doctor’s visit. This amount is paid only after you pay your deductibles.
- Coinsurance is an effective cost-sharing method where you have to pay a small percentage of the total amount for specific services after paying your deductibles. The rest of the cost is covered by your Medicare insurance plan.
Enrollment Periods for Medicare in Florida
Medicare has an Initial Enrollment Period (IEP) of about 7 months that starts 3 months before you turn 65. Besides this, Medicare has a General Enrollment Period, so if you miss your IEP, you can sign up for Medicare anytime between January 1st and March 31st every year.
During the general enrollment period, you can switch from one Medicare plan to another. For example, if you have Original Medicare, you can enroll yourself into a Medicare Advantage plan or join a separate Medicare drug plan for the following year.
Medicare in Florida by the Numbers
According to the 2023 demographics, the total number of Medicare beneficiaries in each plan is as follows.
| Total number of people enrolled in Medicare | Medicare Advantage plans | Prescription drug plans |
| 4.91 million | Nearly 42% of all Florida residents with Medicare are enrolled in private Medicare Advantage plans. | 1.4 million Medicare beneficiaries are enrolled in stand-alone Medicare Part D. |
Comparison of Key Statistics & Trends in Florida
| Plan Type | Number of Enrollees | Percentage of Total Medicare Population | Average Cost Breakdown in Florida |
| Original Medicare | 2.5 Million | 58% | Part A: $0 Part B: $164.90 |
| Medicare Advantage | 2 Million | 42% | Average premium: $67 |
How Much Does Medicare Cost in Florida?
Medicare in Florida does not have Part A premiums if you have contributed to Medicare and Social Security payroll taxes for a minimum of 10 years.
However, you must pay a Part B premium on a monthly basis. Medicare Part B premiums have a cost based on your income. Thus, the cost of Medicare in Florida begins with your Part B premium. However, additional facilities, medicare plans, and factors such as your social security taxes may impact Part B premiums.
Part B premiums may cost $164.90 per month and even more, depending on your monthly income. Medicare premiums also increase or decrease every year.
Here is the cost for medicare premiums in Florida over the last three years to help you get an idea.
| Year | Part B Premium |
| 2024 | $174.70 to $594 |
| 2023 | $164.90 to $560.50 |
| 2022 | $170.10 to $578.30 |
Medicare Eligibility in Florida
What makes you eligible for Medicare in Florida? Medicare has the same eligibility criteria across all the States. You qualify for Medicare if:
- You are 65 years old or above
- You have a medical disability
- You have end-stage renal disease (ESRD)
- You have amyotrophic lateral sclerosis (ALS)
You must be approved by the Social Security Administration for either your age or disability to be eligible for Medicare.
Applying for Medicare in Florida
You can apply for Medicare online or by mail. If you’d like to have a walk-in option, you can apply at the nearest Social Security office. There are Medicare enrollment periods during which you can sign up.
If you have been receiving your social security benefits, you will automatically be enrolled in Parts A and B. In this case, you receive your medicare ID card in the mail before you turn 65.
However, if you need to enroll in Medicare for the first time, you have to look into the initial enrollment period, beginning three months before your 65th birthday.
For a seamless application process, Silveredge’s licensed advisors can help resolve your queries. You can contact the advisors to understand your application procedure.
Why Florida Attracts a High Number of Seniors Seeking Medicare and Why It’s a Suitable Option
Florida, a sweet spot for older residents, houses about 4,346,965 senior citizens. Individuals aged 65 and above seek Medicare due to multiple reasons.
The State of Florida has abundant retirement communities and older adults seeking healthcare facilities every day. Medicare plans efficiently cut down costs associated with frequent treatments. Thus, it proves advantageous for seniors residing in Florida.
Since Florida’s climate has unique health implications, such as high temperature, humidity, and sudden breezes, it can aggregate certain medical conditions, such as asthma, bronchitis, and other respiratory problems.
However, Florida’s healthcare system addresses the needs of its considerable senior population by the provision of Medicare plans and other healthcare services suited to their medical needs.
Seniors seeking Medicare lie in Florida’s comprehensive healthcare infrastructure tailored for the elderly, warm climate, and vibrant retirement communities. This combination enhances the quality of life for residents 65 and above, making Medicare plans a suitable option for accessing a wide range of medical services and specialized care.
Key Factors to Consider When Choosing the Right Medicare Plan in Florida
- Health Care Needs: Consider your current health status and future medical needs.
- Budget: Consider Medicare premiums, deductibles, coinsurance, and co-payments.
- Provider Flexibility: Look into the plan’s network to know more about healthcare professionals within your reach.
- Additional Benefits: Consider Medicare Advantage plans if you require extra benefits that Original Medicare doesn’t cover.
Find the Right Medicare Plan in Florida with Silveredge
In the vibrant community of Florida, US, a multitude of senior healthcare facilities are available. From Original Medicare, Medicare Advantage plans, to Medigap, health insurance companies in Florida offer a range of coverage options to accommodate older adults.
Senior adults must find the best Medicare option for their healthcare coverage. Securing health coverage through personalized assistance and detailed guidance can help make informed decisions.
Silveredge offers experienced advisors who provide counseling to help resolve queries. Don’t navigate through Medicare complexities alone—reach out to Silveredge for the informed support you deserve.
