Florida is a state with much to offer. From its sunny weather and beautiful beaches to its rich seafood, Florida has something for everyone. The state’s warm climate allows for year-round outdoor activities like swimming, fishing, boating, and golfing.
The state is a great place to live, with a relatively low cost of living and no state income tax. It’s great healthcare and weather make it perfect for snowbirds and RVrs on Medicare.
Whether you are looking for a vacation destination or a place to call home, Florida has much to offer. It’s no wonder it is a first choice for many Florida snowbirds who choose to live in Florida during the winter months. Florida also sees its fair share of RVers who choose to visit Florida’s unique subtropical climate.
In the discussion below, we look at Florida Medicare Plans for both people under 65 and those 65 and older. Medicare health insurance is an important part of a better quality of life for those who are eligible.
Under 65 Florida Medicare Supplement for Disabled
There is no federal mandate requiring insurance companies offer Medicare supplement plans to Medicare beneficiaries under the age of 65. As such, if Medicare supplement insurance is available for those under 65 it will be directed through state laws.
Under 65 Medicare Eligibility
Medicare requires that person be on Social Security Disability Income for a full 24-months prior to being automatically enrolled in Medicare. Some exceptions to this rule include those with End stage Renal Disease (ESRD) or ALS.
Under 65 Florida Medicare Supplement Plans
Some states do not offer Medicare supplement plans to anyone under the age of 65. In these states, the Medicare beneficiary’s only two choices are to just keep Original Medicare without a supplement and add a Part D prescription drug plan, or apply for an Advantage plan. With an Advantage plan, Medicare beneficiaries must re-shop that plan each year during the annual open enrollment. We suggest choosing an Advantage plan that includes prescription drug coverage.
If you stay with Original Medicare, we encourage all our clients to use https://partdshopper.com/ to shop for their Part D plan.
Second Initial Enrollment Periods (IEP)
Everyone who qualifies for Medicare under the age of 65 will have a second Initial Enrollment Period during the seven month window around their 65th birthday, as if they were new to Medicare. During that second IEP, they can apply for any Medicare supplement available in their area with no health questions asked.
With all states that offer Medicare supplement plans for those under 65, the applicant must apply for the supplement within 180-days (six months) of the start of their Medicare Part B.
Under Age 65 Florida Medigap Requirements
Florida requires that insurance companies offering Medicare supplement plans to people aged 65 and over, must offer the same Medigap plans to Medicare beneficiaries under age 65***. The under age 65 Medicare supplement policy must be applied for within the first 180 calendar days of their Medicare Part B start date. Medicare supplement insurance companies do not accept applications requiring medical underwriting from those under age 65.
Some states have additional rules dictating that the under age 65 supplement policy must be priced either equal to, or some factor of, the prices offered to those age 65. Other states have no rules regarding price. In the latter case, prices offered to Medicare beneficiaries under the age of 65 may be substantially higher than the same plan at age 65.
Under 65 Medicare Supplement Health Insurance Prices
Medicare supplement insurance plans in Florida, for those under age 65, have much higher monthly premiums than the monthly cost for those age 65. There is no rule limiting monthly premiums for Medigap plans in Florida.
How Are Medicare Supplement Plans Priced?
Medicare supplement plans can be priced using one of three methods; Attained Age, Issue Age or Community Rated. The Medicare literature often leads people to believe that a person shopping for a Medicare supplement plan will be able to choose between one of these three Medigap plan payment methods. That is not typically the case. More on that below.
In addition, it is a common misconception that one Medicare supplement pricing method may offer a lower lifetime cost than another Medicare supplement pricing method. That is not true at all.
There is no pricing method that will turn a for-profit insurance company into a philanthropic organization.
Each pricing method offers the insurance company the ability to increase your premiums by simply applying to the state insurance commissioners office for a price increase. No insurance company will price a policy in such a way as to intentionally reduce profitability.
Medigap State Pricing laws
Some states have laws that require all Medicare supplement plans to be priced as Issue Age, Community Rated or either of those two methods. States without a law mandating how Medigap coverage is priced are called “Attained Age states” because that is how most Medigap policies will be priced when not mandated to use one of the other two methodologies.
As I mention in a number of videos, the most important factor that impacts your lifetime medigap plan cost is not the pricing method or which Medigap plan you decide is best for you. The most important factor is the company you choose to manage your Florida Medigap plan.
MedigapSeminars.org
That is where Medigap Seminars Insurance Agency comes in. We help you choose
the company with the best probability of maintaining a stable price over your lifetime. You can get a free price quote and personal recommendation by using our Medicare Supplement Quote Request form.
Warning: If, in an Attained Age state you find Medigap policies priced as Community Rated or Issue Age, caveat emptor. In some cases the alternative pricing is offered to mislead the consumer into believing they are getting something they are not. Please see the specific pricing method details below.
Supplement Plans in Florida are Priced “Issue Age”.
Florida is an Issue Age state. An Issue Age State is one where state law requires that all Medigap policies offered in that state are priced as Issue Age. Some Issue Age states also allow for Community Rated pricing.
All Florida Medigap policies must be priced as Issue Age.
What is Issue Age Pricing?
With an Issue Age Medigap policy you will always pay the rate designated for the age you were when first issued your policy. If you were 65 years old when you first purchased your Medigap policy you will always pay the rate charged for a 65 year old.
This does not mean your Medigap prices will never increase. If the rate for a 65 year old increases, so will the premium rate for your Florida Medicare plan. However, in an Issue Age state, with the right Medigap provider price increases should be few and far between.
If you ever change Medigap companies or cancel your Medigap policy, you will lose your Issue Age position and restart at a higher age and premium. Changing Florida Medicare supplement plans increases your average premiums over your lifetime.
One Weakness of Issue Age Plan in Florida
Choosing the right Medigap plan and provider from the start is critical in Florida as an Issue Age state. If you find you are with the wrong insurance company and wish to change plans or companies you will lose your Issue Age position. Your new Medigap plans will be priced higher for your new age.
* Medicare supplement plans C and F are not available to beneficiaries who first became eligible for Medicare on or after January 01, 2020.
** Medicare supplement plans D and G are only available to beneficiaries who were first eligible for Medicare on or after January 01, 2020.
Best Medicare Supplement Plans in Florida
In Florida, Medicare supplement plan premiums increase the further south you live. Medicare supplement plan prices in Miami, for example, are among the highest in the country. That is why the high deductible Medicare supplement plan in South Florida are so popular.
Medigap insurance companies are not required to offer all the Medigap plans available in your state. A typical Medicare provider will offer only the most popular supplement plans in Florida. If you want the best Florida Medicare plan, you will need to all available plans, please use our Medicare supplement quote request form.
High Deductible Medigap Plans in Florida
The High Deductible Medigap Plan G and High Deductible Medigap Plan F are often the best value supplement plans in Florida, especially South Florida. High Deductible Plan G has lower premiums than any of the other supplement plans in Florida, while limiting your maximum annual out of pocket costs for medical bills to lower than almost all Advantage plans.
With high deductible Medicare supplement coverage, once you meet the deductible your out of pocket expenses for Medicare bills are zero for the remainder of the year. I produced a great video on the pros and cons of high deductible Medicare supplement plans you can see here.
Because of their low premiums but high Medicare benefits relative to Advantage plans, the high deductible plan is the most popular Medigap plan in South Florida.
Medigap Plan G in Florida
Medigap Plan G is another popular Medicare supplement insurance plan in Florida. Plan G offers the most comprehensive coverage of any Medigap plans in Florida available to those who are new to Medicare.
With Medicare supplement Plan G your maximum annual out of pocket costs for medical expenses can be less than $250 a year. Inpatient hospital costs are covered at 100%, out patient out of pocket costs are near zero, and you can still see any medical provider that accepts Medicare.
Unfortunately, of all the Medigap plans in Florida, Medicare supplement Plan G has the highest average premiums.
Medigap Plan N in Florida
Like Goldilocks and the three Bears, Medigap Plan N is often the “just right” combination of Medicare coverage and price when comparing all the Medigap plans in Florida. From South Florida through the Panhandle, Plan N is the plan many Florida enrollees consider the best value.
The Medicare benefits of Plan N are close to that of Plan G, with out of pocket expenses limited to just a few hundred dollars a year. Plan N is among the Medigap plans considered to be full-coverage. Between what Medicare pays and your Plan N, your medical costs for inpatient care should be at zero, just like Plan G.
Plan N is among the most popular Medicare supplement plan choice throughout much of Florida.
Plan N in Florida, with the right insurance provider, has among the most stable prices in the U.S. Plan N also provides coverage for foreign travel emergency services (as does Plan G and the Plan G high deductible).
Which Medicare Supplement is Right for Me?
The best place to start when researching health insurance and Medicare plans in Florida is getting price quotes. Use this quote request form and we will email you prices for the Medicare plans available and recommended in your area.
I would also encourage you to watch the video on this page as it discusses in detail how to identify the best Medicare supplement plans based on your needs and budget.
Florida Medicare Advantage Plans
Medicare Part C Advantage plans are a pseudo-privatized version of Original Medicare (Medicare Part A and Part B). They are managed by a private for profit insurance provider and meant to provide you with benefits roughly equal to Original Medicare but with an annual maximum out-of-pocket limit on Medicare related services approved by the insurance company. An Advantage plan replaces your Traditional Medicare Part A and Part B.
In 2023 it was reported by Medicare that there are 3,998 different Medicare Advantage Plans in the United States. All have different benefits and costs.
Are All Advantage Plans In Florida an HMO or PPO?
While there are many different types of Advantage plans, nearly 98% of Advantage plans are structured as either a Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO).
Recently, Medicare Savings Account Advantage plan C plans have become very popular in Florida.
How Can I Learn More About Advantage Plans?
We encourage anyone considering a Medicare Part C Plan to watch two of our videos as part of their research. The first is Medicare Explained; the Secrets of Who & Why which explores the demographics of those who choose between Advantage and Medicare supplement plans.
The second is Medicare Advantage Plans Explained which details the pros and cons of Advantage Plans.
Who Should Buy an Advantage Plan in Florida?
Part C Plans are best for those on a tight budget who have no plans for travel extensively. Advantage plans have very low or no extra premiums.
Keep in mind, you must always pay your Medicare Part B monthly premium. Thus, even a zero premium plan costs at least the Medicare Part B premium.
There are zero premium Advantage Plans available in every Florida county as well as Special Needs plans for people with low income or people with select chronic illness or conditions.
When To Buy A Medicare Advantage Plan
Medicare Advantage Plans can be purchased during your Initial Enrollment, the Annual Election Period, the Annual Medicare Advantage Plan Open Enrollment or in Special Election Periods. There is never any medical underwriting or pre-existing condition exclusions.
Your Initial Enrollment Period is the seven month window around the month you turn 65. It includes the three months before your birthday month, your birthday month and the three months after your birthday.
There is one exception. If your birthday falls on the first day of a month the entire Initial Enrollment Period moves forward by one month. You can use our enrollment calculator to find your Initial Enrollment Period.
The Annual Election Period is every year between October 15 and December 07. Changes during this period take effect as of the following January 01. You can use this period to purchase or change your Advantage Plan. Or, you can go back to Original Medicare.
The Annual Medicare Advantage Open Enrollment is from January 01 through March 31. You can use this period to make one change in your Advantage Plan or go back to Original Medicare and get a Part D plan if you do.
Improve On Your Medicare Advantage Coverage
According to the Medicare Advocacy group, if the consumer wishes to match their Medicare Part C coverage to that of a Medicare supplement, you must add ancillary insurance products to your line-up.
For example, with a Medicare Advantage plan you will pay 20% of your cancer treatment up to your maximum out of pocket. You can add Cancer Protection Insurance to your portfolio and receive a tax-free lump-sum check when first diagnosed with cancer.
Or, did you know that on average a Medicare Advantage policyholder pays more for inpatient care than a person with Medicare Part A & B? You can add a hospital indemnity insurance policy to provide you the cash you may need if you have an inpatient hospital stay. Ask us for details on what is available in your area.
What You Need to Shop for a Medicare Advantage Plan
At Medigap Seminars Insurance agency we have some of the most advanced Medicare Advantage tools in the industry designed to help us match the Florida Advantage plan to your needs and situation.
Are Your Doctors In Network?
In order to shop for an Advantage Plan you will need to provide us with a list of the doctors you see regularly and note which one is your primary. That way we make certain your doctors are in-network. In addition, we will need a list of your prescriptions so we can make certain you know what your prescription cost will be for the coming year.
When we help people shop for Advantage plans we look at the health benefits, costs and network first. That is the most important part to get right.
Are Your Prescriptions Covered?
Next we look at your current prescription medications to make certain your prescriptions are covered and you do not overpay for medications.
Do You Need Extra Benefits?
Then we will also review with you the extra benefits that are offered like dental, hearing and vision coverage, fitness programs and more.
You won’t have to call up each insurance company or go from one website to another. Our software matches your situation with the plans best qualified for your needs and then ranks them for you.
To get started, contact us and let us know how we can help. Our personal guidance is free. Check out our reviews too!
Medicare Part D Prescription Drug Plans
Medicare Part D is the primary part of Medicare to cover prescription drugs. It covers prescription drugs you would normally pick up at a pharmacy or through mail order.
There are two ways you can get Medicare Part D prescription drug coverage. The first is through a plan bundled with an Advantage Plan. Most Advantage Plans come with a bundled Part D prescription drug plan.
The second method is a Stand-Alone Part D Prescription plan (PDP) that can be used when Original Medicare is your primary healthcare, like when you have a Medicare supplement.
The Part D structure and rules are the same regardless of how you purchase your plan.
Don’t make this Part D Mistake
It is important to understand that if your Medicare Advantage HMO or PPO does not come with a Part D plan, you may not purchase a stand-alone PDP plan. Doing so will cancel your Advantage plan.
When Can You Apply for Part D?
You can apply for Medicare Part D during your seven-month Initial Enrollment Period or during a Special Enrollment Period.
If you are changing from an Advantage plan back to Original Medicare you can also use the Annual Election Period (October 15 – December -7) or Advantage Plan Open Enrollment (January 01 through March 31) to apply for a Part D plan.
Medigap Seminars created https://partdshopper.com/ to help clients search for and enroll in a stand-alone Part D plan that fits your needs. All the plans available through this site are plans recommended by Matthew Claassen.
Sources:
https://www.kff.org/medicare/issue-brief/medicare-advantage-2023-spotlight-first-look/
https://medicareadvocacy.org/ma-and-selling-extra-products/
Insurance Agent Medicare supplement guides from Mutual of Omaha, Allstate, Aetna and other insurance companies.
Matthew Claassen
Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.
