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Medicare Advantage Plans in Florida

If you wish you had more or different benefits than Medicare Part A and Part B provide, consider Medicare Advantage plans in Florida. These plans offer a variety of other benefits that you won’t get with the standard Medicare plans.

The Benefits of Medicare Advantage Plans in Florida

Unlike standard Medicare plans, Medicare Advantage plans offer:

  • Prescription Benefits
  • Vision Benefits
  • Wellness Benefits
  • Dental Benefits

Just like any other insurance plan, the coverage varies by insurance company. Some plans offer all of the above benefits. Others offer only one or two. Before you shop for your Medicare Advantage plan, consider what you need. Do you wear glasses? If so, you may want vision benefits. If you don’t, dental or wellness benefits may be of more concern to you.

Prescription Benefits on Medicare Advantage

If you have standard Medicare Part A and Part B, you can buy a separate prescription plan. It’s called Medicare Part D. You buy the plan from an independent insurance agent, just like you do with Medicare Advantage. But it’s a separate policy.

Medicare Advantage plans in Florida include prescription benefits if you choose the right plan. This means one premium each month and coverage all from one plan. Some beneficiaries prefer this as it’s less confusing. Some Medicare Advantage plans also offer better prescription benefits than Medicare Part D plans.

If you currently take medication, check each plan’s formulary list to make sure your medications are on it. If they aren’t, paying for the plan won’t benefit you. If you don’t take medication now, consider the broadest plan that offers coverage for both generic and name-brand medications.

The Types of Medicare Advantage Plans in Florida

You have four plans to choose from:

  • HMO — You choose one doctor for this plan. This doctor becomes your medical home. You see this doctor for everything. If you need to see a specialist, you need a referral from your primary doctor first. If you go without a referral, the insurance company may deny your claim.
  • PPO — This is the Preferred Provider Organization. You can choose from a network of doctors. As long as you stay within the network, you will pay the contracted rate with your insurance. If you go outside of your network, your insurance will cover a smaller part of the bill. You also don’t have the advantage of paying the contracted rates. You don’t need a referral to see specialists with this plan.
  • Private For-Fee-Service — The PFFS plan is a private plan with your insurance company. Medicare gives the insurance company a set fee each month. The insurance company then decides what you pay for your medical services. The provider must agree to the amount the insurance company will pay. If it won’t, you have to find a different provider.
  • Special Needs Plan — The SNP offers coverage to chronically ill, permanently injured, and very-low-income beneficiaries. The plan caters to your specific illness or issue.

The Cost of Medicare Advantage Plans in Florida

Each Medicare Advantage plan has a different cost. You are free to shop around to find the plan that provides the coverage you need and prices you can afford. The most common things to look for when comparing pricing include:

  • Premiums — You’ll pay your Medicare Part B premium plus potentially an extra premium for the Advantage plan. Not all plans have the extra premium, so make sure you read the fine print.
  • Deductibles — If the plan has a deductible, you must meet that first before the insurance will cover anything. Make sure you can afford it.
  • Co-Pays — If you have a co-pay, you pay this amount every time you see the doctor. Most medical providers require the co-pay at the time of the visit.
  • Co-Insurance — You may owe a percentage of the total cost of the service. Your co-pay may be 20 percent or more. This goes into effect after you meet your deductible.

Before you choose one of the Medicare Advantage plans in Florida, consider your needs. Do you want coverage every time you go in for a physical or wellness check? Then, you’ll want an Advantage plan that offers wellness benefits. Do you need vision or dental coverage? You may need a different plan, then. Look at all your options, compare the costs, and choose the plan that suits you today. You can change your plan during the open enrollment period each year, which gives you a chance to change your coverage as your health needs change.

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