If you’re nearing your 65th birthday, you probably have Medicare on your mind. As a Florida resident, you may automatically be enrolled in Medicare Part A and Part B in the months surrounding your birthday. Or, you might need to enroll yourself online or over the phone.
Many Florida residents have questions about Medicare in Florida and how it works. Does Florida have Medicare? How does Medicare work in Florida? Who qualifies?
This page will help answer all of your questions about Medicare Floridia requirements.
Medicare is a federal insurance program that covers seniors and certain disabled Americans in all 50 states. There aren’t that many differences in coverage by state, but we still find many location-specific Medicare questions.
There are several parts of Medicare and each provides a specific type of health insurance coverage. Together, Medicare Part A and B are known as Original Medicare.
The parts of Medicare include:
Medicare enrollment goes through the Social Security office, so you can contact your local office if you have questions about your coverage.
Medicare Advantage is a replacement for Original Medicare that provides both hospital and medical coverage, along with additional benefits.
For instance, you will usually get prescription drug coverage with your Medicare Advantage plan, and you may also get vision, dental, and discounts on fitness programs.
The difference between Medicare Advantage in Florida versus other states is that the prices and medical networks will be different. Because Medicare Advantage is offered by private Florida health insurance carriers, you’ll have provider networks local to your area and pricing may vary as well.
The good news is that the Medicare eligibility requirements in Florida are the same as they are in other states because this is a federal program administered by the national government.
Do I qualify for Medicare in Florida? That’s a common question, especially if you plan to retire early and haven’t yet reached 65 years of age.
To qualify for Medicare, you need to be a U.S. citizen or permanent resident who has lived in the country for at least five years. Also, one of the following must apply:
To qualify for Medicare, you generally need to be 65 or older. The enrollment period begins three months before your birthday month, and coverage can begin as early as the first day of the month you turn 65.
If you’re under 65 and receiving disability payments, you are eligible for Medicare after you’ve been receiving those benefits for two years.
For those with end-stage renal disease, Medicare begins on the first day of your fourth month of dialysis treatments. If you have ALS, you can enroll in Medicare on the first day you receive a disability payment from Social Security or the Railroad Retirement Board.
Applying for Medicare is easy. In most cases, if you’re receiving Social Security benefits or payments from the Railroad Retirement Board, you’ll be enrolled automatically and coverage will begin on the first day of the month you turn 65.
In some cases, such as if you’re still working when you’re 65, you’ll have to enroll yourself. There are several ways to enroll:
Contact your local Social Security office Call 1-800-772-1213 to enroll over the phone If you retired from a railroad, call the Railroad Retirement Board at 1-877-772-5772 Sign up for Part A online at www.socialsecurity.gov and Part B using Form CMS-40B
You’ll need to enroll during the initial enrollment period, which starts three months before your 65th birthday and lasts for seven months.
Is Medicare free? It may be, in part. For many people who have a full-time work history, Medicare Part A will be premium-free. However, everyone has to pay a monthly premium for Medicare Part B.
If you can’t afford your Medicare Part B premium, you may be able to get assistance from a Medicare Savings Program. These programs also help with deductibles, coinsurance, and copayments that you might owe.
Medicare Part B has a standard premium that is the same for almost everyone. You might pay more if you have a late-enrollment penalty or a higher income, or less if you have an assistance program.
The best Medicare Advantage plan in Florida depends on your specific needs. Some plans do not cost any additional monthly premium above your current Part B premium. Others will cost a bit more. You should also take into account whether your preferred doctors and specialists are within the medical network.
Different plans will offer different deductibles, copayments, and coinsurance. You’ll want to carefully balance your monthly premium with your out-of-pocket costs, especially if you have significant medical needs.
Are you wondering, “How do I apply for Medicare Advantage in Florida?” You can apply online using a comparison tool, or you can contact a health insurance provider directly online or over the phone. They can review your needs and tell you about the plans they offer.
Medicare Supplement Plans, also known as Medigap, are another way to reduce your out-of-pocket costs. With Medigap, you stay on Original Medicare, but you get help with your copayments, coinsurance, and deductibles.
Medicare Supplement Plans are standardized and are lettered A - N. Different letter plans offer different benefits. When buying Medigap from an insurer, each policy with the same letter will be the same no matter which company offers it. Price may differ.
Keep in mind that Medigap does not provide prescription drug coverage or other benefits — it simply helps you better afford your out-of-pocket costs. Medigap also involves medical underwriting, which means that your age and health status will be factored into your eligibility and premium.
Medicare Part D is a way to add prescription drug coverage to Original Medicare. This is a standardized coverage that does not vary from state to state.
If you choose to get a Medicare Advantage plan instead of Original Medicare, you will have access to a variety of prescription drug plans depending on the Advantage plan you choose. You’ll want to check the formulary list to ensure that the drugs you need are covered.
Prescription drug plans also vary when it comes to copayments and which pharmacies are included. Before you choose an Advantage plan, be sure your pharmacy is on the list and that you can afford the out-of-pocket costs.
Medicare Supplement Plan F is a popular choice among Florida seniors. No matter who offers Plan F, the coverages will be the same. The only difference will be how much the insurer charges.
Plan F helps with every category of costs, from Part A coinsurance to a skilled nursing facility. You can also get help with both Part A and Part B deductibles, which not every plan offers. If you need a significant amount of medical care, Medicare Supplement Plan F provides the most assistance.
If you qualify for both Medicare and Medicaid, you can enroll in both simultaneously. If you qualify for Medicaid you will probably also be in a Medicare Savings Program, which will help with your Part B premium and other costs.
Medicaid also helps with care coordination and provides secondary insurance for things not covered by Medicare. If you have questions about either program, contact the appropriate office in your state.
Are you interested in finding Medicare in Florida that works for you? We’re here to help. You can call or visit our website to talk to a licensed insurance agent to find and compare plans.