Many Florida seniors choose Florida Blue Medicare Advantage Plans for their health insurance plan, and with good reason. With premiums as low as $0, Florida Blue Medicare Advantage Plans usually offer more benefits than Original Medicare. Medicare Advantage plans typically bundle your health care coverage into one plan, provide flexibility, and cap your annual maximum out-of-pocket expenses.
Pros and Cons of Florida Blue Medicare Advantage Plans
Florida Blue Medicare Advantage Plans are a good fit for many Florida beneficiaries, but like all health plans, they have advantages and disadvantages. Here is a brief look at the major highlights.
- Large provider network
- Plan available statewide
- Offers extra benefits such as meals at home and transportation
- Reputable company
- Limits maximum out-of-pocket expenses
- Limited plan options based on location
- Monthly premiums on the higher side based on location
- Some plans require referrals
- Some plans require a primary care physician
Plan Options and Costs
As with all Medicare Advantage Plans, the pricing and availability of a Florida Blue Medicare Plan differ based on location.
Florida Blue offers several types of Medicare Advantage Plans to Medicare beneficiaries. While some counties offer up to 10 plans, others offer only one option.
Under HMO plans, a primary care physician coordinates your care. HMOs require referrals for specialist visits, and you must see an in-network health care provider.
Preferred Provider Organization plans cost more than HMO plans but offer more flexibility. PPO plans allow you to see an out-of-network provider, but you’ll pay more than if you stay in-network. In addition, PPOs don’t require referrals to see a specialist. SNP: Special Needs Plans provide coverage for beneficiaries with specific chronic conditions such as COPD or heart disorders. Florida Blue offers an HMO SNP for individuals who qualify for Medicare and Medicaid coverage. These plans are called HMO-D-SNPs.
BCBS offers a private fee-for-service Medicare Advantage Plan in some states. However, Florida Blue does not provide fee-for-service plans.
Regardless of which plan type you choose, you must stay enrolled in Medicare Parts A and B and pay your monthly Part B premium.
Pricing for Florida Medicare Advantage Plans varies between insurance companies and between counties. On average, Florida Medicare beneficiaries will pay $35 a month for Florida Blue Medicare Advantage. Here are a few examples of how pricing differs geographically:
- Holmes County: $52 monthly premium (1 PPO)
- St. Lucie County: $6 monthly premium (7 HMOs, 2 PPOs)
- Hernando County: $10 monthly premium (3 HMOs, 2 PPOs)
The monthly premium is not the only thing you need to consider as you evaluate Blue Cross Blue Shield Medicare Advantage Plans. You also need to understand what your out-of-pocket expenses will be. Depending on the plan, your out-of-pocket expenses can include:
What Do Blue Cross Blue Shield Medicare Plans Cover?
Florida Blue is Florida’s Blue Cross Blue Shield insurance company. It is an independent licensee of the Blue Cross and Blue Shield Association. Florida Blue offers three types of Medicare plans:
- Medicare Advantage Plans (also called Medicare Part C)
- Medicare Supplement Insurance Plans (Medigap)
- Medicare Part D Plans (prescription drug plans)
A Medicare Advantage Plan is an alternate way for seniors to receive their Original Medicare (Medicare Part A and Medicare Part B) benefits. Medicare Advantage Plans cover everything Part A (hospital services) and Part B (doctor visits) cover. Florida Blue health plans also cover preventive care, skilled facility nursing care, and mental health services.
Blue Cross Blue Shield Medicare Advantage Plans frequently cover additional services:
Vision Hearing Wellness programs such as gym memberships Over-the-counter medications Prescription drug coverage (Medicare Part D) Medical transportation
Your first opportunity to enroll in a Florida Blue Medicare Advantage Plan is when you first enroll in Original Medicare (three months before your birthday month through three months after your birthday month). After this Initial Enrollment Period, you have three other opportunities to enroll in a Florida Blue Advantage Plan:
- Open Enrollment Period (Annual Election Period): Oct. 15 to Dec. 7
- Medicare Advantage Open Enrollment Period: Jan. 1 through March 31
- Special Enrollment Period: when special circumstances occur
Florida Blue Medicare Advantage Medicare Plans Reviews and Ratings
BCBS has offered health insurance coverage since 1929. Today, the Blue Cross and Blue Shield Association offers health plans in all 50 states and Puerto Rico. Seniors trust Florida Blue Medicare and overall report a positive experience:
- 4 (PPO plans) and 4.5 (HMOs) star ratings with the Centers for Medicare & Medicaid Services
- A+ rating with the Better Business Bureau
- 4.5 rating with the National Committee of Quality Assurance
People are different, and so are health care plans. Our insurance agents can help you determine whether a Florida Blue Medicare Advantage Plan fits your health care needs and finances.