The gaps in Original Medicare coverage not phase seniors who are new to Medicare, but not having coverage over those gaps can become costly over time if you aren’t protected. Medicare Advantage is a private health insurance policy which tries to protect senior citizens from these gaps. Basically, it replaces your federal Medicare benefits with a private insurance policy, as well as additional coverage options, to avoid paying out of pocket for expensive coverage gaps.
Federal Regulations for Medicare Advantage
Medicare Advantage plans are regulated by federal law and must offer you no less than the same coverage as Original Medicare. Some plans contain extra benefits which cover gaps in Medicare and provide other benefit options. Some comprehensive Medicare Advantage plans also cover Medicare Part D (prescription drugs). These are called MAPD plans.
Medicare Advantage Enrollment In Florida
Medicare Advantage is a fairly popular option for Floridians. Around 38% of Medicare-qualified seniors in the Sunshine state are currently managing their health care needs with a Medicare Advantage plan. The chart below offers enrollment statistics on the different types of Medicare Advantage plans:
|Plan Type||Enrollment Percentage|
|Local PPO Plans||13%|
|Special Needs Plans||11%|
|Regional PPO Plans||9%|
|Private Fee-For-Service Plans||5%|
|Other (Cost Plans, MSA’s, etc.)||3%|
Plan Coverage & Cost
Your smoking habits, your gender, and your Medicare enrollment status are all factors which will change the cost of your Medicare Advantage plan. A female non-smoker within her Initial Enrollment period, for example, will likely pay a lower rate. The chart below shows estimated quotes for Medicare Advantage plans near you:
Most Popular Medicare Advantage Plans in Florida
Medicare Advantage plans, like some private health insurance policies, will vary provider and location. They will also vary by their provider network limitations. An HMO plan, for example, will have a lower rate, but a more restrictive network. On the contrary, PPOs have greater choice, but it comes at a higher price.
Helpful Medicare Advantage Tips & Tricks
Doctor/Provider Network Restrictions
Depending on your Medicare Advantage plan, you may have few or many restrictions on the doctors and hospitals available to you. Also, keep in mind that restrictions on these networks can change at any time. You could have the same doctor for years, and later lose his services due to a change in your provider network. You should have a plan ready for if or when the rules change.
Drug, Vision and Dental Coverage
Unfortunately, Medicare Parts A and B have never offered coverage for dental or vision, and only in recent years has Part D prescription drug coverage become available. While Medicare Part D is an option to help you with prescription costs, few other supplement policies offer affordable access to such ancillary coverage. But with a Medicare Advantage plan, you can get some or all of these bundled into the same policy, if you want them. But they will increase your rates.
Enrollment Options & Best Time To Enroll
Remember: while it is simple for some seniors to get coverage with a Medicare Advantage policy, you have to apply within the open enrollment window to avoid any complications with getting coverage due to things like pre-existing health conditions. You may or may not be denied coverage due to maladies such as End Stage Renal Disease (ESRD). By contacting a licensed insurance agent, you can get help determining what your options are based on your circumstances. For more questions about enrollment, please visit our Medicare Advantage Enrollment Page.
- Initial Enrollment Period: The enrollment period during your first 6 months of being enrolled in Medicare.
- Annual Enrollment Period (AEP): This timeframe runs from October 15th through December 7th every year, and during this time you can change or cancel your Medicare Advantage and part D drug plan.
- Special Enrollment Period (SEP): Circumstances which happen outside of the AEP window, such as employer coverage loss or moving out of state, which may require you to find new coverage immediately.