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Medicare in Florida

The saltwater and sunshine keeps people feeling young, but the right plan for Medicare in Florida keeps older Americans confident and healthy

Reviewed by: Cassandra Parker, Licensed Insurance Agent. Written by: Andrew Hall.

Key Takeaways

  • Medicare in Florida is not free, but you may have options to help with costs like copays A copayment is the fixed amount you pay directly to your provider for medical services or prescription drugs covered in your plan. For example: If your plan includes a copayment of $20 for office visits, you'll pay $20 to your doctor whenever you have an appointment. and prescription costs.

  • While Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plans in Florida may have a provider network for preventive servicesPreventive care is medical care that aims to prevent serious diseases and injuries. These include immunizations, physicals, screenings, and more., these plans are required to cover emergency and urgent care anywhere in the U.S.

  • Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). (Part A and Part B) is a public insurance plan offered by the government. If you have Part A and Part B, you can choose to enroll in Medicare Advantage. It is another way to get Part AMedicare Part A, also called "hospital insurance," covers the care you receive while admitted to the hospital, skilled nursing facility, or other inpatient services. Medicare Part A is part of Original Medicare. and Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive. through a private insurance carrier.

 

Staying active is proven to help older adults stay physically and mentally healthy. Whether you choose to swim year-round, golf, or hike at Big Cypress National Park, you’ll want a health partner as active as you.

GoHealth insurance agents are licensed for Medicare in FL, and they can help you find a Medicare plan to cover your lifestyle while providing helpful advice along the way.

Is there Medicare in Florida?

Medicare in Florida is available to all legal U.S. citizens ages 65 and older. Some younger adults living with disabilities, ESRD, or Lou Gehrig’s disease may be eligible for Medicare before 65. Medicare Advantage plans are available in Florida but vary by carrier and location. When the time comes to compare Medicare in Florida, your Medicare costs and coverage options may depend on your location. A licensed insurance agent can help make comparing plans simple.

Is Medicare free in Florida?

If you’re age 65 and have contributed Medicare and Social Security payroll taxes for at least 10 years, your Part A plan has a no-cost premium. All Medicare Part B plans require the beneficiaries to pay a monthly premium. Some people with low income may qualify for both Medicare and Medicaid programs that help pay for some or all of their Medicare premium.

How much does Medicare cost in Florida?

The cost of Medicare in Florida begins with your Part B premium. Your Part B premium is based on income. Other factors like additional coverage, your plan, or whether you paid Medicare and Social Security payroll taxes can increase your monthly premiums due each month.

Plan for Medicare costs in Florida

When you plan long term for Medicare costs, consider that premiums can increase (or decrease) from year to year. Here’s an example of low to high premiums over a three-year period (2019 to 2021). The Centers for Medicare and Medicaid Services (CMS) publishes updated premium costs each year.

Part B Premium by Year

  • 2021:  $148.50 to $504.90
  • 2020: $144.60 to $491.60
  • 2019: $135.50 to $406.50

How do I apply for Medicare in Florida?

You can apply for Medicare in Florida online, by phone, or in person at a Social Security office. A GoHealth licensed insurance agent can help you compare Medicare Advantage plans and enroll in FL.

  • Get in touch with GoHealth
  • Apply for Medicare in FL online with Social Security Administration
  • Apply for Medicare in Florida over the phone by calling Social Security at 1-800-772-1213 (TTY: 1-800-325-0778)
  • Find a local Social Security office and apply in person

When do I get started?

If you are enrolled in Social Security and receiving benefits at 65, you will automatically be enrolled in Part A and Part B. You will receive your Medicare ID card in the mail before your 65 birthday.

If you need to enroll in Medicare for the first time, you have an initial enrollment period that lasts seven months and begins three months before your 65 birthday.

What are the best Medicare Advantage plans in Florida?

To find the best Medicare Advantage plan in FL, consider your health needs and find a plan that meets your needs. You may begin by researching five star rated Medicare Advantage plans, but a five star rating is not a guarantee that the plan is the best for your needs. Comparing benefits can be tricky, so can finding the “best” plan. Let a licensed GoHealth insurance agent help you compare all the Medicare Advantage plans near you in FL to find a plan that best matches your needs.

What are the advantages and disadvantages of Medicare Advantage plans?

Medicare Advantage plans usually include Part D, offer extra Medicare benefits and lower out of pocket costs than Original Medicare. But specific provider networks can be a disadvantage if your provider is not included. If you need out of network care, your costs may be higher.

Overall, if you don’t receive medical care away from home and your provider is in your network, a Medicare Advantage plan may have many more advantages than disadvantages. Also, keep in mind that Medicare Advantage plans will cover emergency and urgent care anywhere in the U.S.

Options for Medicare Advantage Plans in Florida

There are many private insurance companies that sell Medicare Advantage plans. The availability of Medicare Advantage Plans in FL can vary county-by-county. Contact GoHealth for more information.

Medicare in FL by the numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 4,257,270 people are enrolled in Medicare in Florida. The total number of beneficiaries enrolled in Medicare Advantage in Florida is 2,056,734. The previous year, 1,922,951 enrolled in Medicare Advantage. Medicare Advantage participation in Florida went from 46.35% to 48.31% year over year. If you’d like to dive deeper into how Medicare in Florida breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Florida
4,257,270
Beneficiaries with Part A & Part B
2,056,734
Medicare Advantage Beneficiaries
48.31%
Medicare Advantage Participation Rate
54.62%
% Female
45.38%
% Male
1.07
Average HCC Score
$11,562.29
Actual Per Capita Costs
15.15%
% Eligible for Medicaid
31.80%
% of Beneficiaries with an Emergency Department Visit
18.91%
Hospital Readmission Rate
81.20%
% Non-Hispanic White
7.28%
% African American
7.79%
% Hispanic
3.74%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Florida Medicare Resources & Contacts

Beneficiaries spend an average of $11,562.29 each year on Medicare in Florida. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Florida-based resources, like these, may be able to help:

Florida Department of Consumer Services

1-877-MY-FL-CFO (1-877-693-5236)
Monday to Friday (8 a.m. to 5 p.m. EST)

www.myfloridacfo.com/division/consumers/

What Should I know about the Florida Department of Consumer Services?
File a complaint, ask questions and get needed info about your health insurance.

Florida Medicaid Managed Care (Medicaid)

1-877-711-3662 or Text 357662
Monday to Thursday (8 a.m. to 8 p.m. EST) Friday (8 a.m. to 7 p.m. EST)
TDD: 1-866-467-4970

www.flmedicaidmanagedcare.com

What Should I know about Medi-Cal?
State-backed health insurance for low-income adults, families and children

Florida Department of Health and Human Services

1-850-245-4444 (general questions) or 24/7 COVID-19 Center 1-866-779-6121

www.floridahealth.gov

What Should I know about the California Department of Health and Human Services?
CDHHS provides access to California’s public health, aging and health care resources

Florida Department of Veterans Affairs (FDVA)

Largo, FL: 1-727-518-3202
Bay Pines, FL: 1-727-319-7440
Tallahassee, FL: 1-850-487-1533

www.floridavets.org

<strong>What Should I know about FDVA?</strong>
Many veteran services, including information to get the most of your benefits

Nationwide Resources

Speak with an insurance agent that is licensed in Florida about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in FL, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

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New to Medicare Guide

Helpful information to get you started with enrolling in Medicare.

Medicare Beneficiary Guide

For those currently enrolled in Medicare.

Medicare Plans Guide

Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

For individuals with a qualifying income status.

A Caregiver’s Guide

For those helping a loved one with Medicare.