Medicare Advantage Plans Florida
Medicare Advantage is also known as Medicare Part C. It is an alternate option to obtain your Part A and Part B coverage. With this plan, you will get your Original Medicare benefits through your Medicare Advantage plan. But your Original Medicare benefits are intact. If you have one of the Medicare Advantage plans in Florida, you get extra benefits that are not part of the federal program. These would include prescription drug coverage.
Seniors with active Medicare and live in Florida can sign up for a Medicare Advantage plan after they have enrolled in Original Medicare. The extra benefits will depend on where you live and the type of MA plan you have signed up for.
How You Can Use Medicare Advantage in Florida?
Medicare Advantage in Florida has the same guidelines as the ones being followed by the rest of the United States. One of them is that the plan must offer the same hospitalization and healthcare benefits as Part A and Part B. However, hospice care will still be under Original Medicare. It means that you can get it from the federal government.
When you shop for MA plans in Florida, you will find that some of them offer extra benefits, such as hearing, routine vision, dental and wellness programs. Most of the MA plans have Medicare Advantage Prescription Drug plans. These plans will include coverage for your prescription medicines.
If you are interested in enrolling in one of the Medicare Advantage plans, you should have an active Original Medicare first. It means that you must have Part A and Part B benefits. Furthermore, you should live in the area of the plan and you don’t suffer from end-stage renal disease. However, there are some exceptions to this rule.
You can sign up for Original Medicare during the first or initial enrollment period. It starts three months before you will turn 65 years old, including your birthday month. Then, you have another three months after your birthday month.
On the other hand, you can enroll earlier if you have a form of disability. If you qualify for Medicare disability benefits, you can enroll in Medicare plan three moths before the 25th month of your disability benefits. It will include the 25th month. Then, you have another three months after that month.
However, if you failed to sign up for Medicare during your initial enrollment period, you will get a late-enrollment penalty should you decide to enroll later on. You can enroll during the yearly enrollment period. It happens every January 1 and ends on March 31. When you decide to enroll during this period, you will pay for the late-enrollment penalty fee. And you will pay this fee as long as you are enrolled in Medicare.
However, there are some cases where you can still apply for an MA plan without having to pay a penalty. For instance, if you are still working at 65, you can delay your application for an MA plan. It is also the same rule if you have employer-based health coverage.
If you have signed up for Medicare Part A and Part B, you can get Medicare Advantage, provided you have met the eligibility requirements, like not having an end-stage renal disease and residing in a network area of the plan. The first coverage enrollment window happens when you first qualify to enroll in an MA plan.
Once you have a Medicare Advantage plan in Florida, you can switch to another MA plan if you are no longer satisfied with it. But you can only do so during the yearly election period. It is also known as the fall open enrollment that happens every October 15th to December 7th.
Your new plan will take effect on the first day of the following year. This period will also allow you to disenroll from your plan so you can go back to Original Medicare.
There are also special election periods that let you switch Medicare Advantage plans in Florida. But you can only take advantage of these periods when you are experiencing life-changing events.
For instance, if you have lost your current coverage or if you move to a new state and your old plan is not available in your new location, you can switch MA plans. Switching plans during these events will vary according to your qualifying situation.
If you live in Florida, you can go back to Original Medicare from Medicare Advantage only during the Medicare Advantage Disenrollment Period. It starts from January 1 to February 14 every year. When you disenroll from your MA plan, you can take this opportunity to enroll in a separate prescription drug plan. In that way, your prescription drugs will still be covered. Although Original Medicare has prescription coverage, it is limited.
What are the types of Medicare Advantage Plans in Florida?
Before you even get an MA plan, you should first evaluate the types of plans that you can get in Florida. The following are the plans available in Florida:
Health Maintenance Organization is quite limited. With this plan, you can only visit a doctor or a healthcare provider within your plan’s network to get full coverage. If you go outside of your plans’ network, any service rendered will not be covered, unless it is an emergency or urgent service. Each time you go to a specialist, you will need a referral from your primary care physician to get coverage for a certain healthcare service.
It is HMO Point-of-Service that lets you enjoy better flexibility than you would if you chose HMO. Most of these plans will allow you to go to an out-of-network facility to obtain health service. However, you will pay a certain, pre-determined fee.
It offers the most flexibility than HMO and HMO-POS. With this type of plan, you don’t need a primary care physician to supervise your healthcare. You can go to any doctor or a specialist without obtaining a referral from a primary care doctor.
However, with greater flexibility comes higher-out-of-pocket costs. If you go to a healthcare provider within or outside your network plan. However, going to a healthcare facility that is part of your plan’s network is cheaper as the costs of copayments and coinsurance are lower.
A private fee for service is a plan that decides how much you will pay for your healthcare provider, hospital visits, and doctor. It also determines the sharing cost of each expense.
Each time you use a provider, the provider must agree to accept your plan’s terms per case. The provider must also agree to treat you.
Furthermore, the provider may not treat you even if he or she has seen you in the past or agreed to treat you in the future. But some of these plans have networks of doctors and hospitals that agreed with the plan to always treat you.
Medicare savings account is a high deductible plan with a savings account. With this plan, you may use the money that you deposit in your savings accounts to pay for your healthcare expenses. You can do so even if you have not reached your deductible.
It is reserved for those with chronic or disabling health conditions. You may also become eligible for this plan if you have Medicaid and Medicare.
SNPs are customized to suit your special needs. They include plans for patients who suffer from chronic or disabling diseases, like HIV/AIDs. You can also get a Special Needs Plan if you live in a nursing home or any type of long-term care.
Medicare Advantage Part D
It is a Medicare Advantage plan with a Prescription drug program. Here, you get health and prescription drug coverage or Part D, which can be bought separately. Any of the above types may have prescription drug coverage, except for the MSA plan.
Compare Medicare Advantage Plans in Florida Before Making a Final Decision
If you are a Medicare beneficiary in Florida, you can enroll in one of the Medicare Advantage plans. However, you should first compare these plans in your area.
The cost of MA plans varies depending on your county and state you live in. It is common to see premiums of an MA plan having the same coverage and benefits but they differ depending on counties in the state of Florida.
For instance, you will find that some MA plans in Florida have premiums that are as low as $0. But despite such a low amount, you will still have to pay the premium for Part B to keep your Original Medicare coverage.
Furthermore, there are MA plans that include extra benefits that are not included in Original Medicare. For that reason, you should know what kind of coverage you need and determine whether or not you can take advantage of prescription drug coverage to go along with your MA plan.
Because there are several options available in Florida, it is a good idea to compare plans to know the costs and benefits that suit your needs best.
You may use our online free tool in comparing Medicare Advantage plans in Florida. Simply enter your zip code in our tool to give you a customized list of plans in your area. You may also enter your prescription drug needs if you wish to customize your search estimates.
There are several options to choose from when you shop for Medicare Advantage plans in Florida. That’s why it is best that you compare prices and plans to help you choose the right plan that works best for your needs. If you need further assistance to answer your Medicare questions, please feel free to call us.