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Medicare Summary for Florida

Medicare is a nationwide health insurance program designed for senior citizens, as well as people with disabilities and certain qualifying health conditions. Medicare comes in four parts, A through D. Parts A and B are standardized, but some aspects of Parts C (Medicare Advantage) and D can change, depending on where you live and from which company you purchase your plan. Medicare Advantage and Part D Medicare are available from approved vendors according to service areas in the Sunshine State.

  1. Parts A and B

    • In Florida, you can purchase original Medicare, Parts A and B, from either the federal government or as part of a Medicare Advantage policy bought from a private insurance company. Both versions of Parts A and B must offer the same benefits, except for hospice care. Hospice services are always covered under original Medicare, even if you have Medicare Advantage. Part A covers inpatient services and home health care while Part B offers outpatient hospital care, preventive services, vaccinations and health screenings. if you get Part A from the government, it is will be premium-free if you have paid Medicare taxes for at least 10 years; however, you will have to pay a premium for Part B, which is optional coverage.

    Medicare Advantage

    • Florida Medicare Advantage plans may or may not have monthly premiums, but you must have both Parts A and B to join. These plans offer the same benefits as Parts A and B but usually contain a few extras, such as vision, dental or hearing. Many Florida Medicare Advantage plans provide prescription drug coverage as well. If you get medication benefits through Medicare Advantage, you do not need to purchase a separate Part D prescription drug plan.

    Types of Medicare Advantage Plans

    • Florida allows the sale of four kinds of Medicare Advantage Plans: HMO (health maintenance organization), PPO (preferred provider organization), PFFS (private fee-for-service) and MSA (medical savings account). Private fee-for-service plans offer traditional health insurance where you can go to any doctor who accepts your plan. Both HMOs and PPOs entail getting your non-emergency services from providers that are part of your insurance company's network. HMOs will require you to get a referral before seeing a specialist. PPOs generally allow you to go outside the network in exchange for higher fees. MSAs are high-deductible policies that can be used in combination with a health savings account. Medicare makes deposits into your account, which you then use to pay for deductibles, services and co-pays.

    Part D

    • Many Florida Medicare Advantage plans come with prescription drug benefits. As of 2011, the following plans require no annual deductible for prescription drugs: Any, Any, Any Gold plan, Humana Gold Plus, WellCare Value, Medicare Masterpiece, Citrus Total, CareOne and AARP MedicareComplete Choice. If you have original Medicare, you can purchase stand-alone Part D plans. Premiums in 2011 for the stand-alone Part D plans ranged from $14.80 to $110.70 per month.

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