ORIGINAL MEDICAREMedicare Supplement Plans in Florida
Medicare Supplements are insurance policies sold by private insurance companies. They’re also known as Florida Medigap plans.
Charles went out on the boat one day and ended up falling. Once he got back to land, he went to the hospital to get checked out. This is where Part A coverage kicks in. However, there is a deductible Charles must meet first, which is $1,364 in 2019.
This deductible is per benefit period, meaning he may end up paying it more than once within a year if he gets hurt again.
If Charles had a Medicare Supplement plan, his Part A deductible is covered, each time.
Let’s say he ends up going to his primary physician for follow up tests, this is where Part B kicks in. Part B only covers 80% of his medical costs at the doctors’ office, billing the remaining 20% to him.
The Part B deductible is $185 in 2019. With a Medigap plan, that 20% will be billed to the carrier vs Charles, the beneficiary.
Florida Medicare Supplement Plans Eligibility
To sign up for a Florida Medigap insurance plan, you must be at least 65 and enrolled in Medicare Part B. Medicare Supplements are not available to people with Medicare Advantage plans.
Unless you are still covered by an employer or union-sponsored health insurance plan, you will pay a late enrollment penalty if you do not enroll in Part B as soon as you are eligible – during a seven-month Initial Enrollment Period (IEP) around your 65th birthday.
You can still sign up after your IEP ends, but a penalty will be added to your insurance premium every month. And the longer you wait, the higher the penalty will be.
If you have employer or union coverage, you will avoid the penalty if you enroll promptly after that coverage ends. Especially since voluntary loss of coverage still qualifies you for Guarantee Issue rights.
Medicare Supplement Plans for Disabled Under 65 in Florida
You are automatically enrolled in Medicare Parts A and B if you have been on Social Security Disability or receiving certain Railroad Retirement Benefits for 24 months.
In Florida, you are also eligible to sign up for any Medicare Supplement insurance plan. Keep in mind, your premium will be different than it would be for someone over 65.
How to Enroll in Medicare Supplements in Florida in 2019
Beneficiaries get the best rate on Medigap policies by signing up during their Open Enrollment Period (OEP). This begins on the first day of the first month you are 65 and signed up for Medicare Part B, and extends for six months.
If you are turning 65, you can arrange to have your Medigap policy and your Part B coverage take effect at the same time.
The advantage of signing up during your OEP is that insurance companies have to issue you a policy. They also can’t charge you extra just because you have a pre-existing condition. This is known as a Guaranteed Issue (GI) right.
Beneficiaries can also have guaranteed issue rights for two months after the termination of employer-sponsored health insurance.
If you buy a plan at any other time, you may have a hard time finding coverage. You may have to pay more because of your individual circumstances.
Premiums for Medigap Insurance Plans in Florida
Insurance companies charge a premium each month for Medigap plans. These premiums can vary from one insurance company to another, and they also depend on your age, sex, and location.
If you live in Miami, you may pay a different rate than your cousin in Orlando or Clearwater.
Your rate will also depend on the pricing method your insurance company uses.
There are three:
- Community-rated pricing means everyone pays the same amount, no matter how old they are
- Issue-age-rated pricing means your premium amounts depend on how old you were when your policy was first issued.
- Attained-age-rated pricing means your premium will go up as you get older.
The good news is, Florida is an Issue Age Rated state. Also known as “Entry Age Rated”, this rating method is preferable because your premium will not increase as you age.
Best Medicare Supplemental Plans in Florida
The best Medicare Supplement insurance plans are Plan F, Plan G, and Plan N.
- Plan F: This plan is considered the most comprehensive Medigap insurance plan. This is because it has the most benefits. It even has a high deductible version that has a lower premium, but still gives you the same benefits.
- Plan G: This plan is the second most popular option. It covers almost all the additional benefit options and costs a little less than Plan F. The only benefit it doesn’t cover is your Part B deductible, which is $183.
- Plan N: This plan is considered a cost-sharing plan. It requires a small co-payment for some office visits and emergency room visits.
Florida Medicare Advantage Plans
Medicare Advantage Plans replace Parts A & B.
Some beneficiaries enroll in Advantage plans instead of Medigap plans because the premiums are cheaper. However, over time beneficiaries end up paying more out of pocket costs.
We find that most beneficiaries that opted to enroll in Advantage Plans end up switching back to Original Medicare during the Medicare Advantage Dis-enrollment Period, or MADP.
This is due to the unexpected high out of pocket costs and network limitations Advantage plans come with.
Part D
Since Original Medicare and Medigap plans don’t include drug coverage, most Floridians choose to enroll in Part D.
PDP Plans work with Original Medicare and Medicare Supplement plans. Ideally, the perfect benefits package includes Original Medicare Parts A & B, Medigap, and a Part D drug plan.
Florida Medicare Frequently Asked Questions
Does Medicare pay for assisted living in Florida
No, it does not pay for assisted living. However, it does pay for a limited stay in a skilled nursing facility after a hospital stay. The stay must be at least three days.
Does Medicare cover home health care in Florida
Yes, but you must be under the care of a doctor, be homebound, need speech therapy or skilled nursing care. Also, please note that “home” can be assisted living, a house, an apartment or adult family care housing.
Does Medicare cover dentures in Florida
No, it does not cover routine dental care, and therefore it will not pay for dentures.
However, you may supplement your Medicare coverage with a standalone dental insurance policy. Keep in mind, some of these policies do provide denture coverage.
Florida Medicare Resources
A great resource for Florida seniors regarding Original Medicare questions is the Florida Department of Elder Affairs. For supplemental policies in Florida, contact one of our agents today.
Florida Medicare Supplement Plan Quotes
To apply for Florida Medigap insurance, Advantage or Prescription Drug Plans online, simply complete our rate form.
We’ll take your specific information and compare rates with the top carriers in your area.
Our services are 100% free, we’re here to help you understand the Medicare maze. You can also give us a call directly at the number above to speak to an agent now.
We’re located in Clearwater, Florida. Our agents know Florida Medigap insurance. You can trust that they will find you the best plan that fits your healthcare needs.
