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  • Writer's pictureJoseph Cintron

How to Choose the Best Florida Medicare Advantage Plan?

Updated: Feb 24, 2023

Read the article below, a guide to choosing the best Florida Medicare Advantage Plan. Or, in 3 simple steps find a plan with YourMedicare:


1) Click the button below

2) Enter your zip code

3) Find a plan





Florida Medicare Advantage Plan Introduction


In this article I will explain:










Florida Medicare Advantage plan In Florida, a Medicare Advantage plan could be your best option­­-if you choose the right plan. There are different plantypes. You can choose an HMO, a PPO, or an SNP. I’ll describe exactly what that means later.


Not only are there different plan types to choose from, but in Florida, a Medicare Advantage plan is offered by many insurance companies. And Medicare Advantage companies are very competitive. I’m sure you’ve received tons of mail and seen non-stop TV ads. This can be overwhelming and get confusing.

In Florida, 627 Insurance companies offer a Medicare Advantage plan-the most out of all states. You have a lot of Medicare Advantage plan options to consider.


Because there are so many plan options in Florida a Medicare Advantage plan offers competitively rich benefits.



How much does a Florida Medicare Advantage plan cost?


In Florida, a Medicare Advantage plan may cost as low as $0 monthly. For 2023, the average monthly premium for a Florida Medicare Advantage plan is $9.411

100% of Florida residents eligible for Medicare will have access to a Medicare Advantage plan with a $0 monthly premium.



How can a Florida Medicare Advantage plan have a $0 monthly premium?

A Florida Medicare Advantage plan can have a $0 monthly plan premium because Florida has so many retirees and people that qualify for Medicare! There are currently over 4.867 million people in Florida enrolled in Medicare.


Florida ranks #2 in the Nation in total Medicare enrollment. And roughly 56% of Medicare enrollees in Florida will choose a Medicare Advantage plan. (2)


These plans are not cheap, Medicare Advantage plans are funded by the Federal government. Private insurance companies contract with the Federal Government through the Center for Medicare and Medicaid Services (CMS).


For example, may pay a private insurance company roughly $1,000 a month to manage your Medicare benefits. Because these private insurance companies receive money to manage your Medicare benefits they can offer a $0 monthly plan premium.


Private insurance companies help manage your costs by contracting with certain medical providers and establishing their own network. For example, certain doctors and hospitals may agree to accept a slightly lower payment for services.


Using care management a Medicare Advantage plan may focus on preventative care, disease management, rewarding healthy behaviors, etc. If a specific Medicare Advantage plan is able to manage costs and save more than what they receive from the Federal government they can pass those savings on to you in the form of lower copays, deductibles, and out-of-pocket costs. (3)


This means the Medicare Advantage plan may also offer you additional benefits such as prescription drug coverage, dental, vision, hearing, gym membership, etc. Additional benefits may vary by plan even within the same insurance company.3


Certain plan types tend to offer lower out-of-pocket costs. Consult with a Licensed Agent to help you find a plan with lower out-of-pocket costs, call 386-337-5582.



What type of Florida Medicare Advantage plan is the best?


It is very important to know that in Florida a Medicare Advantage plan can be very different depending on the plan contract and what county you live in.


In other words, each Medicare Advantage plan has different benefits and may have different service areas. This is very important to know before deciding which Medicare Advantage plan is best for you.


In Florida, a Medicare Advantage plan can offer very different plan benefits depending on where you live.


For this reason, it is important to consult an experienced Licensed Insurance Agent that is a Florida resident, one that is familiar with the landscape of Florida Medicare Advantage plans.


Determining what Medicare Advantage plan is the best for you is a process that takes time.


And, only you can decide what is best for you. Your family member, friend, neighbor, and insurance agent cannot tell you what is best for you.


If you decide to do business with me, I will give you my professional opinion.


I will discuss what is important for you to know and understand. My consultation is based on your individual situation and needs. Remember, everyone is different.


My professional opinion could help clarify your decision and plan choice you need to make.


If you are not ready to contact me, continue reading. And take advantage of the information here at cintronhealth.com.


Before you decide which Florida Medicare Advantage Plan is best, you need to become familiar with the different plan types.


As I mentioned before, there are different plan types. You can choose an HMO, a PPO, or an SNP. Florida Medicare Advantage Plan HMO


An HMO stands for Health Maintenance Organization. This type of plan is designed to maintain your health and save money by managing your healthcare with its network of medical providers (i.e. Doctors, Hospitals).


Typically, these plans do not allow you to see Doctors or go to Hospitals unless they have a contract with the Medicare Advantage plan. The general exception is that you can go out of the contracted network only for emergencies and urgent care.


An HMO typically saves money for the insurance company by having predictable medical costs. They know how much contracted Doctors and Hospitals will charge.


You will also typically have to choose a doctor that will act as your Primary Care Provider (PCP). Your Primary Care Provider will manage your care and you are typically required to see the PCP before being referred to a Specialist.


With an HMO, an insurance company may require prior authorization (PA) before you receive more expensive diagnostic tests and medical procedures. This can potentially delay a diagnosis and treatment.


That is why it is important to enroll with an insurance company that is well known to have satisfactory ratings of healthcare management.


In Florida, an HMO Medicare Advantage plan can typically save you the most money by keeping your out-of-pocket costs low and by offering you extra benefits. However, the trade-off is that the insurance company typically limits you to the medical providers that are contracted with that specific Medicare Advantage plan.



Questions you should ask yourself when considering an HMO Medicare Advantage Plan:


Are all my medical providers contracted with the plan? (Doctors, hospitals, pharmacies, etc.)


Are there any specialty hospitals or medical providers that I may need in the future? Are they contracted with the plan?


Am I okay with referrals? Am I okay with waiting for prior authorization before I receive medical care?


Is the HMO worth the savings?


Should I consider a plan that gives access to more doctors and hospitals even if I will pay more money?




Florida Medicare Advantage Plan

PPO


A PPO stands for a Preferred Provider Organization. Private Insurance companies contract with medical providers to establish a network.


If a medical provider is contracted with the plan they are in-network. If a medical provider is not contracted with a plan they are out-of-network. The difference between an HMO and a PPO is that a PPO allows you to go out of network. If you choose to see a medical provider that is not contracted with the plan, the plan will still pay.


With a PPO Medicare Advantage plan, the medical provider will be paid at the standard Medicare allowable amount for a covered Medicare service. In other words, you have the freedom to see any medical provider. Usually, if the medical provider knows that they will be paid according to Medicare’s usual and customary rate, they are happy to bill the Medicare Advantage plan. Sometimes you may have to pay the medical provider and get reimbursed by the PPO Medicare Advantage plan.


In Florida, a Medicare plan that is a PPO tends to have a larger network of medical providers and a larger service area.


In Florida, a Medicare Advantage plan that is a PPO may be more valuable in areas where medical providers are more spread out. If you value a larger service area and the option to have access to medical providers whether or not they are contracted with the plan-a PPO Medicare Advantage plan may be the best plan for you!


Did I mention that you do not need a referral for most services with a PPO Medicare Advantage plan? No referrals can sometimes mean less time waiting around to have access to medical care.



Questions You should ask yourself when considering a PPO Medicare Advantage Plan:


How big is the network of medical providers?


Am I willing to pay a little more to have access to more medical providers?


If I choose to see non-contracted medical providers, am I okay paying and later getting reimbursed by the insurance company?


Is there a deductible to see non-contracted medical providers?




Florida Medicare Advantage Plan SNP

An SNP stands for a Special Needs Plan. A Special Needs Plan can be an HMO Special Needs Plan (HMO-SNP) or a PPO Special Needs Plan (PPO-SNP). Again, that is why it is important to know the difference between an HMO and a PPO and how they work.


In Florida, a Medicare Advantage plan that is an SNP can have very significant cost savings. You may qualify for a Special Needs Plan (SNP) if your income is below a certain amount or if you have certain medical conditions. These SNP plans are designed to give you very significant cost savings and extra medical attention and services that not everyone will qualify for.


It is very important to speak with an experienced Licensed Agent that can pre-qualify you for one of these types of SNP plans. Call 386-337-5582 to speak with a Licensed Agent.



Questions You should ask yourself when considering an SNP Medicare Advantage Plan:


Do I need help lowering my medical expenses?


Do I have a chronic medical condition?


Are there any extra benefits in an SNP plan that I need?


How much could I potentially save with an SNP plan?


Summary

Now that you are more familiar with how a Medicare Advantage plan works in Florida; You should be able to avoid national tv ads and overwhelming marketing ads. As a resident of Florida, I can sort through and narrow down your best options depending on where you live.


Now that you have an idea about how much a Florida Medicare Advantage plan costs monthly, you should know that plans are competitive and offer rich benefits. I can send you quotes of multiple Medicare Advantage plans in Florida. I can also quickly point out the trade-offs, advantages, and disadvantages of each plan offered by multiple Insurance companies.


I shared with you questions you should ask when determining what the best plan for you is. There are more questions to consider on a case-by-case basis. When you call me, I will ask questions you should consider and give you professional advice. Call 386-337-5582 to speak with a Licensed Agent today!


Or, in 3 simple steps find a plan with yourmedicare:


1) Click the button below

2) Enter your zip code

3) Find a plan










Sources Cited


1 <https://www.cms.gov/files/document/2023-medicare-advantage-and-part-d-state-state-fact-sheets.pdf>


2 <https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2022-enrollment-update-and-key-trends/>

3 <https://innovation.cms.gov/innovation-models/vbid>









 


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