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Medicare Advantage Plans in Florida
Medicare Advantage (MA) plans offer an alternative way to enjoy your Medicare benefits. Also known as Medicare Part C, the program grows in popularity every year as more and more plans become available. In 2019, there were over 22 million people enrolled in a Medicare Advantage plan. This page describes Medicare Advantage plans in Florida to help you find the best option for your unique needs.
What Is Medicare Advantage in Florida?
Every Florida Medicare Advantage plan must offer the same benefits as Original Medicare. This includes:
- Medicare Part A, hospital insurance
- Medicare Part B, medical insurance
However, coverage is not limited to what you get with Original Medicare. Most Advantage plans also provide additional benefits. The most common of these is prescription drug coverage, which is included in approximately 90 percent of all MA plans.
Florida Medicare Advantage Plans with Prescription Drug Coverage
Also known as all-in-one plans, Medicare Advantage Prescription Drug plans (MA-PD) combine your Original Medicare benefits with Medicare Part D prescription drug coverage.
Who Is Eligible for Medicare Advantage in Florida?
Once you enroll in Medicare Parts A and B, you are eligible for Medicare Advantage in Florida.
American citizens and permanent legal residents aged 65 and older qualify for Medicare. In addition, if you collect Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months, you may qualify for Medicare before turning 65.
When Can You Sign Up for a Medicare Advantage Plan in Florida?
Your Initial Enrollment Period (IEP) is when you may first join a Medicare Advantage plan in Florida. Your IEP lasts for a full 7 months, beginning 3 months before the month you become eligible. For example, if your 65th birthday or 25th month of collecting disability benefits occurs in April, your IEP begins on January 1 and ends on July 31.
If you didn't sign up for Medicare Part A and/or Part B during your IEP, you may do so during the General Enrollment Period from January 1 through March 31. After General Enrollment ends, you may join an Advantage plan from April 1 until June 30.
The Medicare Annual Enrollment Period (AEP) occurs every year between October 15 and December 7. You can make any coverage changes you want during AEP, including joining an Advantage plan.
Do you already have a Part C plan? If so, you can use the Medicare Advantage Open Enrollment Period from January 1 through March 31 to either switch to a new MA plan or return to Original Medicare. If you lose your prescription drug coverage after making that change, you can also join a standalone Medicare Part D plan.
Special Enrollment Periods (SEPs) allow people who experience certain life events, such as moving or losing their current coverage, to join a Medicare Advantage plan. Find the full list of qualifying special circumstances Medicare.gov.
Types of Medicare Advantages Plans in Florida
The four most common types of Medicare Advantage plans in Florida are:
- Health maintenance organizations: HMO plans have a provider network that may include doctors, hospitals, labs, and more. Out-of-network services are usually only covered in cases of emergency. HMOs also require members to choose a primary care doctor who coordinates their care and provides referrals.
- Preferred provider organizations: PPO plans do not require members to choose a primary doctor or get a referral to visit a specialist. They do, however, have a provider network. But plan members can use an out-of-network provider for a higher cost.
- Private fee-for-service: PFFS plans determine what they – and their members – will pay for covered services. Most use a provider network, but like PPOs, allow members to go outside the network for a higher share of the cost. However, providers who do not accept the plan may refuse to treat you (except in cases of emergency).
- Special needs plans: SNPs limit enrollment to Medicare beneficiaries who have certain chronic conditions, live in an institution, or who qualify for both Medicare and Medicaid.
How to Choose a Medicare Advantage Plan in Florida
To help ensure you get the best Medicare Advantage plan for your unique needs and budget, consider each of the following metrics:
- Coverage (including drug formulary if it's an MA-PD plan)
- Provider network
- Plan ratings
It's easy to compare Medicare Advantage plans in Florida with our Find a Plan tool. Simply enter your location information and estimated coverage start date to review Medicare plans in your area.
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