Medicare Coverage Overview for Florida

The federal Medicare program provides health insurance coverage to eligible United States citizens and permanent legal residents who are age 65 or older, or under 65 with certain medical disabilities or illnesses, including those in Florida.

According to the Centers for Medicare & Medicaid Services (CMS), there were 3,968,885 total beneficiaries enrolled in the Medicare program in Florida in 2015. Of this total, there were 1,601,277 residents enrolled in a Medicare Advantage plan, through which they are guaranteed the same coverage as provided through Original Medicare, Part A and Part B (except hospice care, which is still covered under Part A). Also in 2015, 1,401,435 Florida residents received their Medicare prescription drug coverage through a stand-alone Medicare Part D Prescription Drug Plan (PDP), while 1,518,812 received coverage for both their medications and Original Medicare benefits through a Medicare Advantage Prescription Drug plan (MAPD).

The government-sponsored program known as Original Medicare refers to Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).

There are many Medicare plan options in Florida, listed in the table below. Each plan type comes with different out-of-pocket costs, coverage of health services, and additional benefits. Medicare beneficiaries in Florida may want to compare all available plans in their county with their health and prescription drug needs in mind.

Here are some Medicare plan options that may be available in your part of Florida.

Medicare Insurance Plan Type Description
Medicare Advantage plan Offered by private insurance companies that contract with Medicare, Medicare Advantage plans provide Medicare Part A and Part B benefits (except for hospice care, which Part A still covers). Medicare Advantage plans often include additional benefits, such as routine vision or hearing care. Many plans include prescription drug coverage; these are sometimes referred to as Medicare Advantage Prescription Drug plans.
Medicare Prescription Drug Plan Under Medicare Part D, private health insurance companies that contract with Medicare offer stand-alone Medicare Prescription Drug Plans. These plans are designed to work alongside your Original Medicare coverage. Each plan maintains its own formulary (list of covered medications). The formulary may change at any time. You will receive notice from your plan when necessary.

Another choice you may have if you’re enrolled in Original Medicare is a Medicare Supplement plan. Also known as Medigap, these plans are also offered by private insurance companies and can help you pay your out-of-pocket costs for services covered under Original Medicare.

Medicare dual-eligible beneficiaries in Florida

Florida residents who are enrolled in both the Medicare and Medicaid programs are also known as “dual-eligible,” and may be qualified to participate in programs that assist with out-of-pocket Medicare costs.

The Medicare “Extra Help,” or “Low Income Subsidy” (LIS) program, is one program you might qualify for if you’re a dual-eligible beneficiary. Qualifying individuals may receive help with prescription drug costs and even Medicare Prescription Drug Plan premiums if their income falls under a certain threshold. If you’re interested in finding out whether you qualify to receive assistance with your Medicare out-of-pocket costs, contact Florida’s State Health Insurance Assistance (SHIP) agency, called FloridaShine.

You can start comparing plans at your convenience; just enter your zip code in the box on this page.

To learn about Medicare plans you may be eligible for, you can:

  • Contact the Medicare plan directly.
  • Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
  • Contact a licensed insurance agency such as Medicare Consumer Guide’s parent company, eHealth.
    • Call eHealth's licensed insurance agents at 888-391-2659, TTY users 711. We are available Mon - Fri, 8am - 8pm ET. You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.
    • Or enter your zip code where requested on this page to see quote.

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