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Best Medicare Advantage Plans in Florida 2020

If you’re enrolled in Medicare Part A and Medicare Part B or if you will be doing so in the near future, it’s time to start learning more about some of the best Medicare Advantage plans in Florida for 2020. Medicare Advantage plans in Florida, like Medicare Supplement plans, allow you to enjoy more benefits from your Original Medicare coverage. However, there are some key differences between these two options, so you’ll definitely want to learn more about Medicare Advantage plans, which are also known as Medicare Part C so that you can decide if it’s the best option for you.

Overview of Medicare Advantage Plans in Florida for 2020

With Medicare Supplement insurance, plans are the same from company to company. Medicare Supplement insurance also works with Original Medicare (Medicare Part A and Part B) to fill in gaps in coverage, such as copayments (copays), deductibles and coinsurance.

Medicare Advantage plans are a little different. Instead of working with Original Medicare (Medicare Part A and Part B), they work as a replacement for Original Medicare. They are more similar to health insurance policies that you might have had in the past, but many Medicare Advantage plan options include extra perks.

We’re here to help you learn more about your options for a Medicare Advantage plan in Florida. Once you decide if it’s the best option for you, we can help you find affordable pricing on the best plan for your needs.

Best Medicare Advantage Plans in Florida: When Can You Enroll?

You can only enroll in a Medicare Advantage plan in Florida during certain periods. These are the times when you’ll have the opportunity to sign up for a Medicare Advantage plan:

  • Medicare Initial Coverage Election Period ICEP: When you first become eligible for Medicare and enrolled in Medicare Part A and Part B, you will have an opportunity to sign up for a Medicare Advantage plan. It’s a good idea to sign up during this Medicare Advantage Enrollment Period so that you can enjoy these benefits immediately.
  • Medicare Annual Election Period AEP: Each year from October 15 to December 7, beneficiaries have the opportunity to sign up for, disenroll or change their Medicare Advantage policy.
  • Medicare Advantage Disenrollment Period MADP: At one time, this was the time when beneficiaries could disenroll from a Medicare Advantage plan. It was designed for those who wanted to go back to Original Medicare (Medicare Part A and Part B), but it has been discontinued now in lieu of the MA OEP.
  • Medicare Advantage Open Enrollment Period MA OEP: This period starts on January 1 and ends on March 31st of each year. It gives you another opportunity to change your MA policy.
  • Medicare Special Election Periods SEP: If you need to shop for a policy outside of a standard Medicare Enrollment Period, you may have the opportunity to do so. If you have lost your Medicaid coverage after once being dual-eligible, for example, an SEP will be triggered. If your insurance company does not complete its Medicare contract renewal, you’ll have an option to shop for another policy. Moving, losing employer-sponsored coverage and more can trigger an SEP, too.

Best Types of Medicare Advantage Plans in Florida

Before you sign up for a replacement plan for Medicare Part A and Medicare Part B, you’ll need to know about your different policy options. This is a simple breakdown of the different types of policies that you can choose from. In addition to taking the time to compare coverage between these different types of plans, you’ll probably want to compare rates, too.

PPO Preferred Provider Organization Plans (PPO) in Florida

  • Has networks
  • Beneficiaries can go to the doctor or hospital outside of their insurance company’s network, but out-of-pocket costs will be higher for them
  • You do not have to worry about referrals

HMO Health Maintenance Organization Plans (HMO) in Florida

  • Often has the lowest monthly premiums of all of the Medicare Part C options in Florida. Many insurance companies even have $0 premium options.
  • Your insurance company will not pay for you to see providers outside of their network service area, except in emergency situations
  • You must ask your primary care doctor (PCP) for referrals

Private Fee-for-Service PFFS in Florida

  • How much you pay and how much the insurance company pays is determined by the plan
  • You do not have to worry about network restrictions

Special Needs Plans SNPs in Florida

  • People with end-stage renal disease ESRD or other chronic health conditions or institutional conditions can sign up for these policies
  • Insurance companies are required to include Medicare Part D prescription drug plans in Special Needs Plans

Enrollment Figures for Florida Medicare Advantage Plans

  • The five largest counties in Florida are Miami-Dade, Broward, Palm Beach, Hillsborough, and Orange.
  • There were 4,515,510 Medicare beneficiaries in Florida in 2018.
  • 1,922,172 of Medicare beneficiaries in Florida were enrolled in Medicare Advantage in 2018.

How do Medicare Advantage Plans in Florida Cover Prescription Drugs?

Not all Medicare Advantage plans include prescription drug coverage. However, many of these plans do include Medicare Advantage prescription drug plans. In these situations, the prescription drug coverage is already included in the rates, and you don’t have to buy a separate stand-alone plan.

Take a look at the formulary for each plan to determine if your medication is covered. You can also take a look at the prescription drug tiers to get an idea of how much you will have to pay for your medication.

A Basic Star Rating Guide for Medicare Part C Plans in Florida for 2020

Medicare has already approved a small payment increase for Medicare Advantage plans for 2020. This should help assure plenty of competition for members. Here are a few changes for 2020:

  • Starting in 2020, insurance companies that provide Medicare Advantage plans will be able to add some supplemental non-health related benefits to certain beneficiaries, such as providing help with making structural changes to the home when needed. This is designed to help those who might need help with widening doorways or installing ramps for their homes.
  • The Centers for Medicare and Medicaid Services approved a 2.53% payment increase to Medicare insures that offer Advantage plans.

Most of you will only be able to change your Medicare Part C plan in Florida once a year. So it’s a good idea to make sure you can still find your doctors and prescriptions on any plan you decide to commit to for the next 12 months.

Medicare assigns a 5-star rating very rarely; however, most insurers want a star rating with at least 4 stars to gain incentives.

It might help to consider some of the insurers that will provide Medicare Advantage Plans in Florida:

  • Aetna: This insurer hasn’t attracted a significant share of the Florida market, but some of their HMO plans have high star ratings
  • Humana: Humana has a 40-percent market share.
  • Optimum: Optimum offers their Gold, Emerald, and Diamond plans in some Florida counties. The company’s regular and special needs, or SNP, HMOs have earned 5-star ratings from Medicare on their Medicare Advantage plans.
  • Florida Blue Medicare:  Florida Blue, formerly known as Blue Cross Blue Shield of Florida, has been a leader in the Florida market.

Your location within Florida might limit your Medicare Advantage plan choices. For instance, residents of these bigger cities will enjoy more plans and larger provider networks than residents of more out-of-the-way places:

  • Jacksonville, FL: 868,031
  • Miami, FL: 441,003
  • Tampa, FL: 369,075
  • Orlando, FL: 270,934

Network Restrictions for Medicare Advantage Plan in Florida for 2020?

Before you become a beneficiary of one of these policies, you might want to find out more about in-network providers and the doctors and hospitals that you can go to for care. This is a quick guide to help you understand any restrictions that might be in place.

  • In-Network vs. Out-of-Network Within Coverage Area: HMO Medicare Advantage plans and PPO Medicare Advantage plans in Florida both cover out-of-network care in emergency situations. An HMO will not pay for out-of-network care in other situations, while a PPO will. If you use an out-of-network provider with a PPO, though, your out-of-pocket expenses will be higher.
  • Traveling With Plan: Once again, with both health maintenance organization HMO plans or preferred provider organization PPO plans, emergency care is covered, even outside of your provider network. With a PPO, you can use your policy to see health care providers even for non-emergency situations when you’re traveling.
  • Moving Across State Lines: Since Medicare Part A and Part B is the same in each state, you might think that this is the case with Medicare Part C, too. However, you will need to change policies when you move to another state.

Added Benefits of Medicare Advantage Plan in Florida in 2020

Depending on which of the health plans you choose, you might be able to enjoy these perks and more as a beneficiary of a Medicare plan:

  • Hearing care, routine vision, and dental care
  • Wellness programs
  • Silver Sneakers or other similar gym membership
  • Recommendations for diet and nutrition
  • Allowance for over-the-counter medication costs
  • Healthy living seminars and classes
  • Transportation to and from healthcare appointments
  • Payment of some or all of the Medicare Part B premium

Florida Medicare Resources

You can make use of these helpful resources if you need more information or extra help in the State of Florida:

You can also call and talk to one of our licensed insurance agents about Medicare Advantage plans in Florida, Medigap, Medicare prescription drug plans and more. We’ll share a complete description of benefits about your options and will help you find a plan with a top star rating, all while keeping your budget in mind. Don’t hesitate to contact us for help today.