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If you need Medicare in Florida, you have many choices available. In this guide we'll review some of your private health insurance coverage options.

By Joseph Arroyo
Updated June 24, 2020

Key Takeaways:

  • More than 4 million people have Medicare coverage in Florida

  • Florida has more than 470 Medicare Advantage plans for 2020

  • Florida has 27 Part D drug plans for 2020

  • Florida's Medicare Advantage plans have low out-of-pocket maximums

Florida has a well-deserved reputation for being a retirement haven, so it's no surprise that many Medicare options exist in this state. For every budget and preference, there's a Medicare plan for you in Florida.

Medicare Options in Florida

I recommend my clients consider adding private coverage to Original Medicare. Since there are significant gaps in both Part A and Part B, getting help with those out-of-pocket expenses can be a great relief.

There are three main plans available to help cover what Original Medicare doesn't:

  • Medicare Advantage plans

  • Standalone Part D drug plans

  • Medicare Supplement insurance

We'll discuss each of these in turn, focusing on eligibility and the kinds of benefits they provide.

Medicare Advantage Florida

Medicare Advantage plans, or Part C plans as they're also known, are offered by private insurance companies in Florida. These plans combine the coverage available from Medicare Part A, Part B and sometimes Part D. This means that Medicare Advantage plans cover:

  • Hospital benefits

  • Outpatient benefits

  • Drug benefits (in some cases)

Medicare Advantage plans also tend to offer what are often called extra benefits. These are benefits that are not available under Original Medicare. Many of my clients choose Medicare Advantage plans because of these benefits. Extra benefits can include:

I always tell my clients that these benefits are not guaranteed. They can, and sometimes do, change from year to year. However, the general trend in Medicare is for more extra benefits to be available, not less, so you should expect to see these kinds of extras available in the future, too.

The two most important features of Medicare Advantage plans directly address gaps in Original Medicare:

  • Part C plans have an out-of-pocket maximum (OOPM) cap

  • Many Part C plans offer prescription drug coverage

Out-of-pocket maximums are set by each insurance company. They tend to be lower in higher population states and counties. In Florida, they are among the lowest in the country. Not every Medicare Advantage plan covers medications. Make sure any plan you're interested in does if you need drug coverage.

Medicare Part D Plans in Florida

For Floridians who don't want a Medicare Advantage plan but need drug coverage, you can enroll in a standalone Part D drug plan. These drug plans are also offered by private insurance companies. Part D drug plans help reduce the cost of your prescriptions.

With Part D plans, you can expect to pay the following costs:

  • Monthly premium

  • Annual deductible (not more than $435 for 2020)

  • Copayment or coinsurance for each filled prescription

You can compare Part D drug plans on the basis of their premiums, deductibles and the specific drugs they cover (called the plan formulary). It's important to know Part D plans are not required to cover every drug on the market. You must make sure your plan covers any medications you take.

Also keep in mind that there is no out-of-pocket cap on drug spending. You will pay for every prescription you fill during the year. However, with a Part D drug plan you will always pay less than full retail cost for every medication you need.

Medicare Supplement Insurance in Florida

Florida is one of the 47 states that offer standardized Medicare Supplement insurance plans. This means the benefits for each Medicare Supplement plan is the same in all 47 states. These plans, which are also called Medigap plans, are known by letter: Standardized Medigap Plans A, B, C, D, F, G, K, L, M and N.

Each of the standardized Medigap plans covers a different mix of gaps in Original Medicare. Plan A has the most basic coverage while Plans F and G are the most comprehensive. Besides lowering or eliminating your out-of-pocket costs, some of the benefits of Medigap plans include:

  • Maximum flexibility, with no networks or referrals needed

  • The possibility of international emergency coverage

  • Portable coverage — you can use your plan anywhere in the United States

Medicare Supplement insurance plans don't come with extra benefits like Part C plans do, but they do provide discounts on prescription drugs, eyewear and sometimes fitness memberships. You need to remember Medigap plans don't cover prescription drugs, so you'll need to enroll in a Part D drug plan, too.

How to Apply for Medicare in Florida

You can apply for Medicare online or by calling 1-800-MEDICARE. In the current environment of social distancing, this is the best way to go. You can apply on the Social Security Administration's website. Please keep in mind you don't have to receive Social Security to enroll in Medicare. There is a specific link on the website for those who want to enroll in Medicare only.

I encourage everyone I talk to to enroll in Medicare Part A when you first become eligible. You can do this up to three months before your 65th birthday. By doing this, you give yourself maximum flexibility. Even if you choose to delay taking Part B, you can always add it later with a simple online or mail-in application. If you don't enroll in Part A by your 65th birthday, you'll have to go to a Social Security office and enroll in Medicare in-person.

When shopping for a private Medicare plan in Florida, always be sure that your doctors will accept it. A great way to do this is by working with a licensed professional. They can help you choose the best plan for you, and help you enroll in it. They can also make sure your medications will be covered by any plan you're interested in.

Joseph Arroyo is a licensed Medicare insurance specialist who lives in Hilton Head, South Carolina. Arroyo is certified to sell Medicare products including Medicare Supplement insurance, Medicare Advantage, and prescription drug plans.