Medicare Advantage Plans in Florida

As of 2020, over 4.6 million seniors in Florida are enrolled in the federal Medicare health insurance program in 2020. Of these, 2.2 million choose to get their benefits through a Medicare Advantage plan. Medicare Advantage is a privately issued program, often called Part C, that combines the benefits of Original Medicare Parts A and B into a single plan with one monthly premium. Part C plans offer nearly all of the same benefits as A and B, plus a few extra covered benefits, which might include vision, dental and some prescription assistance. Some plans also include coverage for additional needs such as non-emergency medical transportation and senior health sessions.

Because Medicare Advantage plans stack multiple benefits into a highly customizable single plan, their beneficiaries generally don’t need a traditional Medicare supplement. Most Part C plans also come with an annual out-of-pocket maximum, which Original Medicare does not, making this an attractive option for seniors on a fixed income. Nationally, roughly 42% of Medicare recipients have opted into Part C, in place of the Original Medicare they would otherwise be eligible for. In Florida, nearly 48% of Medicare participants have enrolled in Medicare Advantage, according to the data from 2020.

This guide gives an overview of Medicare Advantage plans in Florida. It goes over the most popular plans in the state, eligibility requirements for participation in them and what kind of benefits they offer. It also has helpful information about how to apply for a plan in the Sunshine State. 

The Top 10 Medicare Advantage Plans in Florida

Several companies 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 getting effective health coverage. In the table below, 10 of the most popular plans are shown with their associated price data. Because these companies offer multiple plans, their rates are shown as a range, rather than as a single average figure. In order to get the most useful information, we’ve added together all of the enrollment data available to develop participation numbers. The figures in this table are accurate as of April 2022, though more up-to-date information is 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