Ranked as the second state in the United States with the highest proportion of retirement-age residents, there’s no wonder why more than 22% percent of the state’s total population is enrolled in Medicare. Medicare plays a key role in providing health and financial security to beneficiaries residing in Florida. With more than 4.6 million Florida beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Florida. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Florida?

Medicare covers most Florida residents who are 65 or older, and it also covers disabled Florida residents. In general, Medicare enrollment in Florida works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Florida Medicare Enrollments

2,381,846

Original Medicare Plans
(Part A and B)

2,253,075

Medicare Advantage & Other Health Plans

3,616,999

Stand-alone Medicare
Part D (Drug plans)

4,634,921

Total Medicare Beneficiaries
in Florida

Florida Medicare Advantage Plans (Part C)

More than 46% of Florida Medicare beneficiaries selected Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Florida who are already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

As of 2020, 474 Medicare Advantage plans are available in Florida. In fact, this number is very high compared to other states. Florida has more Medicare Advantage plans available than many other states since it attracts more retirees than others.

The average monthly Medicare Advantage premium in Florida changed from $8.45 in 2019 to $8.38 in 2020. Once retired, many people with low or fixed incomes may qualify for a Low Income Subsidy that gives them a reduced or even a $0 monthly premium for their Medicare Advantage plan in Florida. 100% of people with Medicare have access to a Medicare Advantage plan without a change in premium due to their age. 

According to Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 2,253,075 beneficiaries enrolled in Medicare Advantage and other plans in Florida. Medicare Advantage is more popular in Florida than it is nationwide.

Florida Medicare Supplement (Medigap) Insurance Plans

Florida law guarantees access to Medigap plans for enrollees under age 65; however, premiums are higher.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

Florida Medigap insurance is available to everyone with Medicare in the state, including those who are under 65 and are enrolled in Medicare. Often, Medigap plans in Florida can be more expensive if you don’t enroll during your Initial Enrollment Period and wait for an Annual Open Enrollment Period. 

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting.

Florida Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of 2020, there are 1,494,336 Medicare beneficiaries in Florida enrolled in stand-alone Part D plans and 2,129,273 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 27 stand-alone Part D plans available in Florida, with premiums ranging from about $13 to $156 per month.

Nearly 95% of people with a stand-alone Part D plan have access to a plan with a lower premium than what they paid in 2019. About 28% of people with a Part D plan receive Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Florida

  • Florida’s Serving Health Insurance Needs of Elders (SHINE): SHINE is a free program offered by the Florida Department of Elder Affairs and your local Area Agency on Aging. Specially trained volunteers can assist you with your Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information. SHINE services are free, unbiased, and confidential. Contact: Call 1-800-963-5337

  • Senior Medicare Patrol: Florida’s Department of Elder Affairs helps protect seniors against Medicare Advantage fraud, misuse, and over-billing through the Senior Medicare Patrol program. Administered in conjunction with the SHINE program, Senior Medicare Patrols (SMPs) empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education. SMPs are grant-funded projects of the federal U.S. Department of Health and Human Services (HHS), U.S. Administration for Community Living (ACL). Contact: Call 1-800-963-5337. FL-SMP services are also available through local Area Agencies on Aging, also known as Aging and Disability Resource Centers (ADRCs).

  • Senior Legal Helpline: The Senior Legal Helpline provides free legal advice and brief services by telephone appointment to eligible Florida residents age 60 and older, for civil (not criminal) legal problems. The Senior Legal Helpline also makes referrals to state and local regulatory agencies and, when it is determined that court representation is necessary, helps seniors find legal providers in their communities. Contact: Call 1-888-895-7873

  • Medicare Savings Program: The Medicare Savings Program is a state-sponsored subsidy program for low-income seniors who have difficulties covering the cost of Medicare. If you are struggling with the costs of Medicare and have limited income and resources, you may qualify for a Medicare Savings Program. Medicare and the state Medicaid program provide assistance with paying your Medicare premiums, deductibles, coinsurance, and copayments through four different programs. Contact: Call 1-800-963-5337 or book a one-on-one appointment with a SHINE counselor through your local Area Agency on Aging.

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Florida. Our process makes it easier for you to access your Medicare eligibility in Florida so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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