How Does Florida Medicare Work?

The Ins and Outs of Medicare

How Does Florida Medicare Work?

The Ins and Outs of Medicare

Eligible for Medicare, but not sure how Medicare enrollment works? Florida residents — if you’re wondering how Florida Medicare works for your medical insurance, you’re not alone! The Medicare program, especially Medicare in Florida, may be confusing and complex to fully grasp for Medicare beneficiaries, making it difficult for individuals to know whether or not they have selected the right amount of coverage for their needs. It’s vital to be properly insured to protect both your health insurance needs and your finances, so your Medicare coverage shouldn’t be left to chance.


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The Parts of Medicare

For Medicare beneficiaries, known as Original Medicare or Traditional Medicare, consists of two Parts, Medicare Part A and Medicare Part B. If you are enrolled in Medicare Part A, it will cover hospital insurance, medicare inpatient care, which includes care received when staying in a nursing home, a hospital, and sometimes at home. Also, it covers blood transfusions (the first three pints) and hospice services. It does not, however, cover long-term care, such as an extended stay in a nursing home. Here’s a simplified look at what Part A can cover:

  • Hospital Insurance

  • Inpatient Hospital Care

  • Skilled Nursing Facilities Care

  • Medicare covers your room, board, and certain services provided in a skilled nursing facility.

  • Hospice Care

  • Hospice care is covered for as long as your provider certifies it is necessary. 

Medicare Part B is different from Part A in that it provides medicare benefits like medically critical supplies and services required for the treatment or diagnosis of your health state, including outpatient services provided in a hospital, clinic, doctor’s office, or any health facility. While Medicare Part A covers hospital insurance, being enrolled in Medicare Part B provides additional Medicare benefits medical insurance in part A might not cover. Medicare part B coverage also helps cover preventive services to help detect illness or avoid them at an earlier stage. Here are some of the examples of outpatient medical coverage that Medicare Part B offers:

  • Doctor office visits

  • Diagnostic imaging and lab testing

  • Ambulance rides and surgeries

  • Chemotherapy and radiation

  • Preventive care (screenings, shots or vaccines, and yearly “wellness” visits)

  • Extensive dialysis care

Medicare Enrollment For Florida Medicare Benefits

Generally, Medicare enrollees only need to enroll for Medicare benefits (Medicare Part A & Medicare Part B) once. Each year, you will be able to choose the method in which you get your health coverage (such as adding prescription coverage, or switching plans). Medicare recipients coverage is different from private insurance — there aren’t any plans for couples or families, which means you and your spouse have other health insurance and completely separate policies.

Initial enrollment periods for medicare (Part A and/or B) happens automatically if you are turning 65 and already receiving Social Security benefits or will start collecting retirement at age 65. 

You will need to sign up for Medicare Part B at the time that you apply for retirement benefits, and Medicare Part A enrollment occurs automatically if you are eligible for Social Security retirement. A Medicare card will be mailed out about three months before your 65th birthday.

Original Medicare

Original Medicare coverage plans covers most, but not all of the costs for approved health care services and supplies. After your deductible is met, you pay your share of costs for services and supplies as you get them. Yikes, you just noticed that you’re responsible for 20% of the costs! We take pride in finding you the specific plan that covers the remaining 20% at little to zero cost to you!

How Medicare in Florida Works with Your Florida Medicare Advantage Plan

Your Medicare Advantage Plan bundles your Part A, Part B, and usually Part D prescription drug coverage (Medicare prescription drug coverage) into one plan. Your Medicare Advantage plan may offer some extra benefits to health insurance that Original Medicare doesn’t cover — like vision, hearing, and dental services. The great “advantage” to this Medicare Advantage plan is that a Medicare Advantage plan could have $0 monthly premiums or may help pay all of your Part B premium. It’s important to note that you must have both Part A and Part B to join a Florida Medicare Advantage Plan.

A Medicare Advantage plan, also known as Medicare part C s a private, Medicare-approved health insurance plan designed for Florida Medicare beneficiaries who need Medicare coverage and are registered in both Parts A & B (Original Medicare). Your Medicare Advantage plan combines coverage for doctor visits, hospital care, and other medical services like Medicare prescription drug plans in one plan.

Medicare Supplement Plans

Medicare Supplement Insurance, also known as Medigap, covers the “gaps” in Medicare coverage to eliminate healthcare expenses like copayments, coinsurance, and deductibles. If you’re insured under Medicare Part A and Part B and are frustrated with having to cover part of the cost of your medical care — then Medigap would be an excellent option for you!

Prescription Drug Coverage And Medicare Supplement Insurance

Looking for prescription drug coverage or Medicare Supplement insurance? Give us a call. We work with private insurance companies and the health insurance Marketplace to provide Medicare beneficiaries with Medicare advantage plans, prescription drug coverage or prescription drug plans, along with Medicare supplement insurance. Your health care is important and we can help determine whether you qualify for Medicare savings program or Medicaid services.

Eligible for Medicare in Florida? Let’s get you covered today!

If you’re a Florida residents qualified medicare beneficiary and are eligible for medicare or if you are already receiving coverage and need a Medicare advantage plan to bundle everything, give us a call.We have been serving health insurance, private insurance, and Florida medicare beneficiaries who need to be enrolled in medicare or a Medicare advantage plan for over twenty years. We’re proud to be one of the top medicare resources in Florida, providing those who are enrolled in Medicare or a Medicare advantage plan quality prescription drug plans to Florida Medicare beneficiaries. Eligible for medicare or have questions about your Medicare Drug plan or Medicare enrollment? Give us a call.

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