Medicare Supplement (Medigap) plans in Florida are designed to help cover health-care costs associated with Original Medicare, Part A and Part B, like copayments, coinsurance, deductibles, and other out-pocket expenses. As a Medicare beneficiary in Florida, you may have a number of Medicare Supplement plan options depending on where in Florida you live, so it may be a good idea to understand what each Medigap insurance plan covers, so you can look for a plan that works for your health and budget needs.
How Medigap plans work in Florida
What you first need to know is that there are 10 standardized Medigap plans identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with all plans of the same letter offering the same benefits. For example, if you buy a Medigap Plan G in Miami, it will have the same benefits as a Medigap Plan G in Fort Lauderdale – though policy premiums may differ. The same 10 plans are available in 47 states, including Florida, with three states – Massachusetts, Minnesota, and Wisconsin – offering different Medigap plans.
No matter which plan you wish to join, you must already be enrolled in Original Medicare, Part A and Part B, in order to enroll in Medigap in Florida (as in other states). Your Medigap Open Enrollment Period starts the first day you are both age 65 or older and enrolled in Medicare Part B. This period lasts for six months, and it’s generally the best time to join a Medigap plan. During this time, you can sign up for any Medicare Supplement plan available in your area, and not be subject to medical underwriting or restrictions for pre-existing conditions. Basically, this means that an insurance company can neither deny enrollment nor charge more for a Medigap plan. If you decide to join a Medigap policy at another time, you may be denied coverage or charged more for the insurance policy.
Additionally, remember that Medigap plans are meant to supplement rather than replace Original Medicare. You still need to keep paying your Medicare Part B premium in order to keep your health insurance coverage.
Medigap plans in Florida, as in any state, don’t include prescription drug coverage (except if you’re still enrolled in a Medigap plan that has this coverage – they’re no longer sold). If you want to receive coverage for drug expenses, you may want to enroll in a stand-alone Medicare Part D Prescription Drug Plan.
Types of Medigap plans in Florida
Here’s a quick look at what the 10 standardized Medigap plans available in Florida have to offer. Some plans may not be available everywhere in the state. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Choosing a Medigap plan in Florida
As explained earlier, Medicare Supplement plans in Florida with the same letter designation don’t vary in coverage or benefits. However, each independent insurance company that offers Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Orlando in Orange County, you may pay more or less than a resident of Fort Lauderdale in Broward County for an identical Medicare Supplement plan. Knowing the difference in costs, it may be a good idea to compare all Medicare Supplement plans available in your area, and then choose a Medigap plan in Florida based on your individual budget and health needs.
For more information about Medicare in Florida, access the following resources:
To get help choosing the Medigap plan in Florida that best suits your needs, you can: