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Medicare Advantage Plans in Florida
At eMedigap Florida, we are a proponent of Medicare Advantage plans as potential solutions for Medicare beneficiaries. Here is an overview of these plans, of course feel free to contact us for assistance or if you need more information on Medicare Advantage.
A Medicare Advantage Plan (MA) is another way to get your Medicare coverage as an alternative to Original Medicare. These plans, known as “Part C” are offered by Medicare-approved companies in Florida that follow rules and requirements set by Medicare.
If you join a Medicare Advantage (MA) plan, you still will have Medicare and its protections, but you will obtain your Part A (Hospital Insurance) and Part B(Medical Insurance) from that plan. Most plans will include Part D Prescription coverage, and many will include extra benefits not offered by Medicare to include dental, vision, hearing, fitness, and over the counter products(OTC). In most cases you will need to use medical providers who are part of the company’s network as these are HMO and PPO plans. A PPO will offer you out of network coverage for Medicare providers typically at a higher out of pocket cost.
The different types of Medicare Advantage plans include:
- Health Maintenance Organization (HMO) plans that require use of the network except in emergencies or the need for urgently needed care.
- Preferred Provider Organization (PPO) plans allow for lower costs when network providers are used, and allow for out of network access to Medicare providers at a higher out of pocket cost with no referral needed.
- Private Fee for Service (PFFS) plans have special rules and are now very limited in Florida.
- HMO Point of Service (POS) plans are HMO plans that allow access to out of network providers for certain services typically at a higher out of pocket cost.
- Special Needs Plans(SNPs) are plans for special populations including Medicaid beneficiaries, residents of nursing homes, and those suffering from certain chronic conditions including heart disease and diabetes.
- Medicare Advantage cover almost all Medicare Parts A and B services. Original Medicare will still cover you for hospice care, certain new Medicare benefits, and some costs for clinical research studies.
- MA plans must follow Medicare rules – Medicare pays a fixed amount for your coverage each month to the companies offering MA plans. These companies in turn must follow rules as set by Medicare. Each MA plan can charge different out of pocket costs for the same medical service up to a Medicare imposed limit, and have different rules for how you access services.
- Who can join MA plans? You must meet these conditions:
- You must be enrolled in Medicare Parts A and B
- You reside in the plan’s service area
You can join or leave a MA plan at certain times of the year. Typically these occur when you first join Medicare, leave your current employer coverage, change your residence, or each year during the Annual Election Period(AEP) running from October 15 -December 07 each year.
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EMedigap Florida, an independent insurance agency, is not affiliated with the Center for Medicare Services (CMS) or the federal Medicare program.
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. We currently offer plans from five organizations totaling thirty two plans. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.