Medicare Advantage Plans Florida 2021
Medicare Part C, or Medicare Advantage, works by providing the coverage of Medicare Part A and B. However, you are not receiving these benefits through Original Medicare. Original Medicare is a government-run healthcare program. You will be getting your coverage through an HMO or PPO Medicare Advantage plan. When you choose one of these Medicare Advantage Plans in Florida for 2021, you are getting the exact benefits you would normally get from basic Medicare while receiving added benefits that the federal program doesn’t cover. This could include prescription drug plans.
Beneficiaries that enroll in Original Medicare have the ability to sign up for Advantage plans. The extra benefits that are applied to the plan by the private insurer that provides it are dependent on the Advantage plan you enroll in and the specific zip code of where you reside.
Florida Medicare Advantage: How it Works
In Florida, as well as the rest of America, Medicare Advantage is required by the federal government to offer both Medicare Part A & B. This is the hospitalization and medical benefits that Original Medicare offers. Hospice care is an exception. There are some Advantage plans that could offer additional Benefits to Florida residents. Such benefits include Hearing, Vision, Dental, Wellness Programs, and More. You will also find it common practice for Medicare Advantage plans to offer Medicare Part D, a powerful prescription drug plan.
In order to enroll in an Advantage plan, you have to be currently enrolled in (Or eligible for) Original Medicare. Also, you must be a resident in the service area of the plan, while not having a renal disease. There are some exceptions to this.
There is an enrollment period for joining Original Medicare, which is when you first become eligible, that you should take advantage of. It begins 3 months prior to your 65th birthday, then lasts for three months afterward. This means you get a total of 7 months to enroll for Original Medicare. If you are disabled and qualify for Medicare, your period for enrollment is three months prior to the 25th month of your disability benefits to three months following. This is another 7-month window for enrollment.
There is a possibility of suffering a late-enrollment penalty if you don’t sign up during this enrollment period. This penalty could affect you for the duration of your enrollment into Medicare. Enrolling at a later date is possible during the General Enrollment Period. This period of time is from January 1st to March 31st. You will still look at a late-enrollment fee during this time. There is another period to enroll, given you are able to delay the Medicare enrollment. This is known as the Special Enrollment Period. You won’t be forced to pay the penalty.
After your enrollment into Medicare Parts A & B, you could become eligible for Advantage. You have an Initial Coverage Period that opens the window for eligibility to apply for Medicare Advantage Plans in Florida for 2021. This election period usually falls in line with the seven month enrollment period for Original Medicare.
There is also an Annual Election Period. This is a time when you can switch Advantage plans, as long as you are already enrolled in one. This time frame is from October 15th to December 7th. Once you switch plans, your new coverage won’t take effect until the 1st of January. This period of time can also be used to disenroll or enroll for the first time. Disenrollment is when you revert back to Original Medicare. There are some cases when you are able to switch Advantage Plans during the Special Election Periods. This is if you go through events that are considered life-changing. Such events include:
- Loss of Coverage
- Moving to an Area Where your Plan is No Longer Available
- Among Others
Just remember, your qualifying situations dictate the Special Election Periods.
Running from January 1st to February 14th, you have the Disenrollment Period. This is when you are able to transition from Advantage to Original Medicare Parts A & B. Also, if you transition back to Original Medicare, you are able to use this period to apply for a stand-alone prescription drug plan from Medicare. This is a great opportunity to cover the gap in the limited drug coverage offered by Original Medicare.
2021 MEDICARE ADVANTAGE
Types of Advantage Plans Available in Florida
Before you make the decision to enroll in an Advantage plan from Medicare, you will want to take the time to review the following plan types that are available in Florida. Mind you, not every insurer will offer each of these plans. The Plans Include:
HMO: You are restricted to your insurer’s network with an HMO plan. You are granted full coverage of your policy through any facility that honors your Medicare Advantage plan. However, if you travel off of your insurer’s network, you will not receive any coverage at all. This will leave you with the out-of-pocket costs that occur upon receiving healthcare services.
HMO-POS: HMO-POS (Point-of-Service) is a plan that offers you a tad more flexibility than you get with a basic HMO plan. You get a higher fee that occurs, but you are oftentimes granted the ability to go outside of your network for specified health services.
PPO: PPO (Preferred Provider Organization) is an incredibly flexible plan that is considered to be one of the more popular options. While you are inside the network, you are granted full coverage of your policy. However, should you travel outside your network, you are granted partial coverage for services received. This does come with a price tag that is greater than you would get with an HMO plan. Also, you won’t need to have referrals to receive care from a specialist.
PFFS: PFFS stands for Private fee-for-service. This plan can choose the amount that it pays for your healthcare provider, doctor, or hospital visits. It will also dictate the expense that you are left to pay out-of-pocket. Whichever provider you decide to use must accept the terms and conditions of the plan. That also means, even if they treated you once, a provider might choose not to treat you at any point in the future. There are some plans of this type that do have a network of hospitals and doctors that are contracted with this plan.
MSA: Medical Savings Account will combine a savings account with a high deductible. There will be yearly deposits into a savings account that you are able to access to help you pay for healthcare expenses prior to reaching the deductible.
SNP: In the event that you have a chronic health condition, a disabling health condition, qualify for both Medicaid and Medicare, or live inside an institution, your best choice just maybe the SNP plan type. These are tailored plans that cater to the specific needs of the beneficiary. Patients with certain disabling or chronic diseases may be able to find an SNP plan right for them.
MAPD: Medicare Advantage Prescription Drug plan will grant you prescription coverage for your medications. You are also able to purchase this separately through Part D of Medicare. The previously mentioned types may include Part D, so make sure you are paying attention to the benefits of each plan when you are comparing them.
Comparing the Available Medicare Advantage Plans in Florida for 2021
There are several things you should know about comparing plans in Florida for 2021. You need to be aware of your expenses and current medical costs. You must know what you are paying out-of-pocket for. That way, you know what to look for as far as coverage goes. Also, you have to compare the companies too. Not just their plans or prices, but their reputation and membership benefits. These are important factors in your healthcare coverage that makes your plan worth what you are paying for.
The price of these plans is not federally regulated, which means they are determined by the private insurer that provides the plan. They base the price on what they believe is the value of the plan, and every insurance company has a different determined value of each plan.
Comparing the plans is equally important to compare the price. You want to make sure you aren’t paying more for a plan that offers fewer benefits than another company. They all offer Original Medicare services, but some of them have additional benefits with the plans, and their membership benefits make a difference too.
The best way to compare Medicare Advantage plans in Florida for 2021 is to use our website. Instead of searching through several companies’ websites and calling around for quotes, you are able to utilize a helpful and easy tool to source quotes for you. This tool comes with no obligation to purchase or sign up for anything. You also get access to a team of experts able to answer any questions you may have and help you make an informed decision.