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Medicare in Florida

If you live in Florida, you have various insurance options available to you through Medicare, including Original Medicare, Part A and Part B, which together cover hospital and medical insurance. Depending on the county in which you reside, you may also have access to private Medicare options, including prescription drug coverage.

Original Medicare for Florida beneficiaries

Florida residents have access to Original Medicare, which encompasses Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).

In Florida, you’re eligible for Original Medicare, Part A and Part B, if:

  • You’re age 65 or older.
  • You’re a US citizen or permanent legal resident.
  • You receive disability benefits, have end-stage renal disease, or have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). Disabled individuals can get Medicare regardless of age, if they’re collecting disability benefits from the Social Security Administration (SSA) or the Railroad Retirement Board.

In Florida as in other states, you can apply for Medicare through the SSA. If you are applying for retirement benefits, you can enroll in Medicare at the same time. You can apply:

  • Online at the Social Security website. Individuals applying for Medicare only (as opposed to applying for SSA benefits as well) can use this application.
  • By calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778). SSA representatives can be reached Monday through Friday, from 7AM to 7PM.
  • In person at a local Social Security office. To look up office locations in Florida, click here.

As a Florida resident, you may enroll in Original Medicare, Part A and/or Part B, during the following enrollment periods:

  • Initial Enrollment Period: Your IEP begins three months before you turn 65, includes your birthday month, and ends three months after that date.
  • General Enrollment Period: If you miss your IEP, you can sign up for Medicare from January 1 to March 31 annually, and the effective date of your coverage would be July 1. However, you will probably have to pay a late-enrollment penalty in the form of higher monthly premiums because you missed your Initial Enrollment Period.
  • Special Enrollment Period: If you delayed your enrollment in Medicare Part A and/or Medicare Part B because you had coverage through an employer, you may sign up for Medicare during a Special Enrollment Period, when your employee coverage ends. You generally won’t have to pay a late-enrollment penalty if you sign up for Original Medicare during a Special Enrollment Period.

For Florida residents, as for those living in other states, enrollment in Medicare Part A is free of charge if you worked long enough to collect Social Security benefits. . Medicare Part A coverage in Florida includes, but is not limited to, the following health services:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Home health services

Medicare beneficiaries in Florida are also eligible for Medicare Part B, which has a standard monthly premium. Medicare beneficiaries in Florida with a higher annual income may have to pay a higher premium. Under Medicare Part B, Florida residents receive, among others benefits, the following services and supplies:

  • Outpatient doctor visits
  • Outpatient hospital services (such as outpatient surgery)
  • Laboratory services
  • Radiological services (such as x-ray)
  • Ambulance services
  • Durable medical equipment
  • Mental health services
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

Medicare private insurance in Florida

Medicare beneficiaries in Florida can elect to receive their Medicare benefits through Medicare Advantage (Medicare Part C), which is private insurance. The government requires Medicare Advantage to offer at least the same coverage as Original Medicare, Part A and Part B. Some Medicare Advantage plans also offer extra coverage not available under Original Medicare, like dental benefits, for example, or vision if you require eyeglasses or contact lenses, so be sure to compare all Medicare Advantage plans available in Florida and choose the one that includes the benefits you need. Read more about Medicare Advantage plans in Florida.

Other options for Medicare beneficiaries in Florida include Medicare Advantage Prescription Drug plans, which combine health and prescription drug coverage into one single plan. However, even those who join a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium in order to keep their health insurance coverage.

Florida residents eligible for Original Medicare, Part A and Part B, may also enroll in a Medicare Part D stand-alone prescription drug plan. Costs for Medicare Part D in Florida vary, but they generally depend on the type of coverage chosen. Find out about Medicare Part D plans in Florida.

Those concerned about the out-of-pocket expenses associated with Original Medicare, like coinsurance, copayments, and deductibles, can get financial help by enrolling in a Medigap plan, also referred to as a Medicare Supplement plan. Medigap plans may also offer travel benefits, providing health insurance when you’re out of the United States. Get more information about Medigap plans in Florida.

Medicare beneficiaries in Florida have access to various private health plans, depending on the county in which they live. For example, a resident of Miami in Dade County may have different Medicare plan offerings than a resident of Orlando in Orange County. Considering the various Medicare insurance plans available in Florida, it’s important to customize your search for plans based on your own health and prescription needs.

Florida resources for Medicare beneficiaries

There are a number of resources designed to help Medicare beneficiaries in Florida with Medicare-related issues and concerns. Here are some of the resources that may be helpful to you: