When it comes to health insurance options, many Medicare beneficiaries are turning to a top Medicare Advantage plan in Florida. Private insurance companies sell Medicare Advantage plans, also known as Medicare Part C plans, and handle the details of claims processing and customer service.
The Centers for Medicare and Medicaid Services write the Florida Medicare Advantage plan guidelines. To be eligible for Medicare Advantage, you must pay your Medicare Part B premium. If you opt for a Medicare Advantage plan, you cannot buy additional coverage through Medicare Supplement insurance (Medigap).
Medicare Advantage offers cost-saving opportunities, flexible coverage options, and more benefits than traditional Medicare coverage.
Best Medicare Advantage Plan Types in Florida
One of the advantages of Medicare Advantage is its flexibility in coverage. Medicare beneficiaries can choose from several options.
Best network freedom: Medicare Advantage PPO
- A more extensive network of healthcare providers
- No referrals required
- Monthly premiums range from $0 to $100 per month.
- Free to go out of network but at a higher cost
Best for lowest out-of-pocket: Medicare Advantage HMO Plan
- Lower out-of-pocket cost because it uses the HMO referral network
- Frequently has no deductibles and low copays
- Premiums are generally $0 per month
Best for low income or health conditions: Medicare Advantage D-SNIP
- Eligibility based on income
- Must meet one of the designated health conditions
- Can have Medicare and Medicaid to lower out-of-pocket costs such as copays
- Total Medicare enrollment: 4.638 million
- Number enrolled in Medicare Advantage: 2.231 million
- Percentage of Medicare beneficiaries enrolled in Medicare Advantage: 48%
- Number enrolled by plan:
- Local HMO: 1,297,063
- Local PPO: 310,658
- Regional PPO: 301,746
- Total Medicare enrollment: 61.212 million
- People enrolled in Medicare Advantage: 23.467 million
- Percent of Medicare beneficiaries enrolled in Medicare Advantage: 38%
How much does Medicare Advantage cost in 2022?
What you’ll pay for a Florida Medicare Advantage plan varies by county and whether it’s a PPO or HMO. On average, here’s what Floridians can expect to pay:
- Lowest premium: $0
- Average premium: $8.28
- Average premium for MA prescription drug plans: $13.17
When can I enroll in a Medicare Advantage plan in Florida?
To join Medicare Advantage, you must meet these conditions:
- Be enrolled in Medicare Part A and Medicare Part B
- Live in the service area of the plan
- Stay current on your Part B premiums once enrolled
Initial Enrollment Period
Your Initial Enrollment Period is when you’re first eligible for Medicare benefits.
- You turn 65: A seven-month span that starts three months before your birthday month and ends three months after your birthday month
- Eligible due to disability: A seven-month span that starts three months before and ends three months after the month you’ll receive your 25th disability payment
- Eligible due to disability and you turn 65: Seven-month span that starts three months before your birthday month and ends three months after your birthday month
- You have Part A and enrolled in Part B between January 1 – March 31: April 1 to June 30
Open Enrollment Period – AKA Annual Election Period
Open enrollment runs from October 15 to December 7. During open enrollment, you can:
- Switch from Medicare Advantage to Original Medicare
- Switch from Original Medicare to Medicare Advantage
- Change Medicare Advantage plans (with or without Medicare Part D coverage)
Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. This is when you can:
- Change to another Medicare Advantage plan (with or without drug coverage)
- Change from Medicare Advantage to Original Medicare and buy a Part D plan
Special Enrollment Periods
You can still qualify for Medicare Advantage in Florida when life changes your circumstances. Following are a few of the most common situations that qualify for a Special Enrollment Period (SEP):
- You move out of the plan’s service area.
- You move within your plan’s service area but have additional plan options.
- You lose your current coverage (group, employer, or Medicaid).
- The insurance company’s contract with Medicare ends.
Our agents can review your circumstances and tell you whether an SEP applies.
5-star Special Enrollment Period
The Center for Medicare and Medicaid Services assigns a star rating to Medicare Advantage plans. Plans with a 4-star rating or higher are considered top-quality insurance plans. (Florida Blue has a 4-star rating.) If a 5-star plan comes to your service area, you can switch from your current plan to a 5-star plan between December 8 and November 30.
Special Enrollment Periods if you get “Extra Help”
If you become eligible for Medicare and Medicaid, you can enroll in, switch, or drop your Medicare Advantage plan once during the following times:
When can I make changes to my Medicare Advantage plan?
The Annual Election Period, also known as the Open Enrollment Period, is the most common time for beneficiaries to make changes to their Medicare Advantage plan. Unless you qualify for a special enrollment period, you’re locked into your plan from January 1 to December 31. The Annual Election Period runs from October 15 to December 7 and allows you to change from one plan to another based on your health care needs.
Ready to Learn More?
Medicare can be very confusing. If you need help with plan selection or more detailed information, don’t hesitate to get in touch with us for additional assistance. We are here to guide you!
Florida Medicare Resources
- Florida Elder Services
- Official Florida Medicare Pages
- CMS: Centers for Medicare and Medicaid Services
Florida Medicare Plans Statistics:
These statistics demonstrate how many people choose Medicare Advantage plans in Florida:
- Floridians with a Florida Medicare Advantage plan: 1,793,258
- The overall percentage of people on Original Medicare who choose a Medicare Advantage plan: 42%
These are the high-population Florida counties. Most of the healthcare plans for Medicare coverage purchased in Florida come from these counties, but you can compare health plans and sign up for a Medicare plan to save on out-of-pocket costs no matter what county you live in.
- Miami-Dade County, FL: 2,751,796
- Broward County, FL: 1,935,878
- Palm Beach County, FL: 1,471,150
- Hillsborough County, FL: 1,408,566
- Orange County, FL: 1,348,975