Medicare Advantage in Florida

Medicare Advantage, often referred to as Part C Medicare, is a privately run program offered by participating insurance companies. Medicare Advantage differs from federally operated Original Medicare in that it combines most benefits covered by Parts A and B into one plan with a single monthly payment. Although Medicare Advantage Plans don’t generally include hospice care, they often cover additional aspects above and beyond regular Medicare, such as dental, vision and hearing. Extra services may also include senior health education and wellness classes and transportation to routine medical appointments. Most plans also include some prescription drug coverage, similar to Part D Medicare.

The wide range of services available through Medicare Advantage often removes the need for supplemental provisions, while the single monthly premium may help seniors budget effectively. Unlike Original Medicare, Medicare Advantage providers set a yearly maximum amount that seniors need to pay out of their own pockets, potentially increasing the appeal for cost-conscious seniors.

Florida is home to almost 22.25 million people, with seniors aged 65 and older composing more than one-fifth of the state’s population. In 2023, almost 5 million Floridians are eligible for Medicare, up 2.86% from 2022. Of these eligible individuals, some 2.7 million people have enrolled for Medicare Advantage Plans in 2023, representing 55% of all those who could enroll. This figure has grown by 4% from 2022 when 53% of all qualifying individuals enrolled in Medicare Advantage Plans. Not only are these plans appearing to gain more popularity among Florida’s seniors, but the state has a slightly higher percentage of eligible persons actually enrolled compared with the countrywide figure of 51%.

This guide provides an in-depth scope of Medicare Advantage Plans designed for Florida residents. It explores the top favored plans available, outlines the prerequisites for eligibility and delves into the comprehensive benefits they provide. Additionally, you’ll discover valuable insights on how to initiate the application process within the Sunshine State. 

The Top 10 Medicare Advantage Plans in Florida

Several insurers in Florida offer Medicare Advantage Plans. As a result, Medicare-eligible seniors in the state have a wide range of options available to them for health coverage. The table shows 27 popular plans with their associated price data. Because these companies offer multiple options, rates are displayed as a range rather than an average figure. To present the most valuable information, we’ve added all enrollment data available to provide participation numbers. The figures in this table were accurate as of July 2023, and more up-to-date details are available online from Medicare.gov.

How Medicare Advantage Plans Work in Florida

Seniors in Florida have to be careful when picking out a Medicare Advantage plan. Because these plans are offered through private companies, they can be organized in different ways to maximize coverage. Plans are available as health maintenance organizations (HMOs), preferred provider organizations (PPOs) and special needs plans (SNPs). Different types of plan have different rules for how to get referrals, whether you need a primary care provider and the difference between in- and out-of-network coverage. The four most common plan types are listed below.

What Medicare Advantage Plans Cover in Florida

Medicare Advantage plans in Florida provide nearly all of the same benefits as Original Medicare Parts A and B, except for hospice care, which is always covered by Medicare Part A. Medicare Advantage plans also pay for preventive health screenings, X-rays ordered by a doctor and lab tests. Services delivered during an inpatient stay in the hospital also fall under the umbrella of Medicare Advantage plans. In addition to combining benefits under one monthly premium, Part C plans also typically offer valuable extra services. These include vision care, dental services and hearing aids. 

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Florida

In order to sign up for a Medicare Advantage plan in Florida, seniors have to meet a number of eligibility criteria. These include U.S. citizenship or legal residence and enrollment in an Original Medicare plan. It’s also necessary to live in a geographic area where a specific plan is offered.

As is common for senior health insurance policies, Medicare Advantage plans have limited open enrollment periods for new participants. People who enroll during one of these periods cannot be declined or charged more for pre-existing conditions. They can be charged a penalty rate, however, if the application is submitted outside of the usual window. Look over the list below for helpful information regarding enrollment periods and the windows when you can first enroll or make changes to your coverage.

• Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
• Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
• Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Florida

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources