This site provides helpful information for Florida residents dealing with Medicare Parts A, B, C and D as well as links to the MyMedicare.gov and Medicare.gov sites. If you do not understand the differences between these types of insurances, the licensed agent can answer your questions. Being informed about your options and the costs they charge for their coverage and benefits is an essential task in identifying the insurance best suited to your individual circumstances. Enrolling in the wrong type of insurance can be a costly mistake.
Out of the 18,000,000 residents of Florida, approximately 18% are enrolled in Medicare according to 2010 data from the Kaiser Family Foundation. These statistics mean that Medicare is a subject of critical concern for nearly one out of five people in Florida. Most of these beneficiaries were age 75 (42%) or older while over half were women (54%) in 2010.*
Florida Medicare beneficiaries may enroll in stand-alone prescription drug plans, Medicare Advantage plans, or Medicare Supplement (Medigap) plans. However, many residents are often unclear regarding the differences among these types of plans and gravitate towards whatever plan has been marketed to them. Stand-alone Medicare prescription drug plans, sometimes referred to as PDPs, are private insurance plans approved to provide drug coverage to people enrolled in either Part A or Part B. There is no coverage for hospitalization or medical services in a stand-alone PDP, only drug coverage. Each PDP has a list of drugs that it covers. This list is known as a formulary. Medicare mandates that a formulary must cover AT LEAST two drugs from each therapeutic category approved by Medicare. Formularies also determine how much you pay for a drug covered by the PDP plan. PDPs can cover different drugs so it is vital that you confirm that your drugs are covered before enrolling in a PDP plan.
Medicare Advantage plans are private health insurance plans available to people enrolled in Parts A and B. They provide hospitalization and medical benefits and, most often, include prescription drug coverage. However, as is the case with stand alone prescription drug plans, Advantage plans with drug coverage have formularies that determine which drugs they cover and which ones they do not cover. Always confirm your drugs are covered before enrolling in a plan as some can be confusing because they offer a $0 monthly premium. Those insurance companies that offer this rate can do so because they receive a reimbursement rate from the government that enables them to remain profitable given their plan enrollees.
Medicare Supplement plans intend to cover the out-of-pocket expenses, or “gaps,” associated with Parts A & B. In every state but Massachusetts, Minnesota, and Wisconsin there are ten standard plan types from which to choose. Each of the plan types has a letter name: A through N. Each plan covers different out-of-pocket expenses with plan F having the broadest coverage. Supplement plans do not include prescription drug coverage. However, you may enroll in a stand-alone prescription drug plan alongside a Supplement plan.
According to statistics from 2010, 32% of beneficiaries in Florida were enrolled in stand-alone prescription drug plans as compared to 29% in Medicare Advantage plans with drug coverage and 27% had prescription drug coverage from another source such as an employer plan. United Healthcare’s 2010 statistics claimed that Florida had over 642,000 residents enrolled in a Medicare Supplement plan. For more general Medicare information, visit Medicare.gov or MyMedicare.gov.