February 26th 2024
By Ari Parker
While there are highly-rated plans, the best Medicare Advantage plan in Florida for you depends on your unique health, lifestyle, and financial situation. Explore more in this article.
Medicare Advantage plans are the most commonly chosen type of coverage for Medicare beneficiaries in Florida. In fact, Floridians favor Medicare Advantage plans over Original Medicare more than most other states in America.
Given the popularity of Medicare Advantage policies in the Sunshine state, you may be wondering what the best Florida Medicare Advantage plan is. While there are highly-rated plans and health insurance providers that people prefer, there is no single “best” plan for everyone. Choosing the plan for you requires a careful assessment of your healthcare needs.
We’ll discuss top-rated Medicare Advantage plans in Florida and what options you have available to you in the state—but the best Medicare Advantage plan for you may be different from your neighbor’s.
The best Medicare Advantage plan in Florida will vary based on your individual healthcare needs. Before picking a plan, it’s a good idea to think about what services, providers, and prescription drugs you need covered.
Popular, high-rated plans in Florida come from Devoted Health, Humana, and Leon Health Plans. Highly-rated plans change on a yearly basis based on Medicare star ratings.
There are two main options for Medicare insurance coverage: Original Medicare and Medicare Advantage. Also called Part C, Medicare Advantage plans generally cover more services than Original Medicare. These plans can include benefits such as routine dental, vision, and hearing services.
One of the big differences between Original Medicare and Medicare Advantage is that Medicare Advantage plans are offered by private insurance companies, while Original Medicare is run by the federal government. For this reason, Medicare Advantage plans have much more variance, including how out-of-pocket costs and prior authorization requirements work. Learn about the pros and cons of both Original Medicare and Medicare Advantage.
While the specific coverage details of Medicare Advantage plans vary from one plan to another, all plans are required to cover the same services that Original Medicare covers. This includes outpatient services and hospital care.
In addition to standard medical care, Medicare Advantage plans can also provide additional benefits, like:
Routine vision, dental, and hearing services
Transportation benefits
Prescription drug coverage
If you’re eligible, you may want to opt for a Special Needs Plan, a kind of Medicare Advantage plan that includes benefits tailored to specific populations: those with low-incomes, with chronic conditions, or who need institutional care. For example, a Dual Eligible Special Needs Plan (D-SNP) helps meet the needs of people who qualify for both Medicare and Medicaid. D-SNPs come with extra benefits like reduced out-of-pocket costs and financial assistance for day-to-day expenses (such as food and rent).
There are 394 Medicare Advantage plans in Florida.
$10.38 is the average monthly premium for a Florida Medicare Advantage plan.
There are 24 insurance providers offering Medicare Advantage plans in Florida, including Aetna Medicare, UnitedHealthCare, Cigna, and Humana.
Each year the Centers for Medicare and Medicaid (CMS) evaluates the quality of Medicare Advantage and Part D plans. CMS judges these plans through Medicare star ratings, a system that rates plans from 1-5 stars, with a five-star plan being the highest quality plan. These ratings help beneficiaries compare Medicare Advantage plan options. You can see what 2024 Florida Medicare Advantage carriers received the highest scores below.
In Florida, CMS gave 5 stars to plans offered by:
Devoted Health
Humana
Leon Health Plans
Optimum HealthCare
Simply HealthCare Plans
UnitedHealthCare
And CMS gave 4.5 stars to certain plans offered by:
BayCare Health Plans
Capital Health Plan
Cigna
Freedom Health
HealthSun Health Plans
Humana
UnitedHealthCare
Keep in mind that the Medicare star ratings have certain limitations. These Medicare Advantage plans may have the highest ratings in Florida overall, but they don’t factor in healthcare benefits that could be important to you. For example, if you have diabetes, you may want a plan that has comprehensive drug coverage and low out-of-pocket costs for regular doctor visits.
When picking the best Medicare Advantage plan in Florida for you, think about what you need for your health and budget. Consider the following factors.
Pay attention to how much you’ll have to pay with a Medicare Advantage plan. Many people get excited about the zero-dollar premium that comes with many Medicare Advantage plans. We also get a lot of phone calls about the Medicare premium give back benefit, which gives you a portion of your Part B benefit premium back. These perks won’t matter though if you have to pay more for the services and prescriptions you need. It’s important to be mindful of what your plan covers and the out-of-pocket costs you’ll owe for covered services.
Medicare Advantage plans fortunately do have maximum out-of-pocket costs. Once you reach this limit, you won't need to pay for covered services for the rest of the year. If you spend a lot on healthcare, choose a plan with a lower maximum out-of-pocket cost. Alternatively, you might want to explore staying on Original Medicare and adding a Medigap plan for additional coverage. Read more about choosing between Medicare Advantage and Medigap plans.
Before reviewing coverage options, make a list of all the services you need coverage for each year. This is particularly important for people who have a condition that requires more care. Consider additional benefits you may need, like prescription drugs, specialists, fitness programs, and dental services. Keep in mind that, with Medicare Advantage plans, many services require prior authorization. If denied prior authorization, you'll be responsible for paying the full cost of the service.
Drug coverage is an important part of your healthcare plan. Most Medicare Advantage plans include prescription drug (Part D) coverage. Make a list of the drugs you need covered and make sure that your medications are covered by the plan you choose. If you need help determining a specific prescription’s coverage, we can help!
Understanding the limitations of Medicare Advantage plans can save you from healthcare headaches in the future. Medicare Advantage plans limit the providers you can see in two ways:
In-network restrictions: Medicare Advantage plans have unique networks of covered doctors. It’s generally best to stay in your plan’s network, but if you go out-of-network, coverage will depend on your plan type. HMOs and PPOs handle coverage for out-of-network doctors differently. PPOs provide lesser coverage for out-of-network providers while HMOs don’t provide any coverage.
Referrals for specialists: You’ll need a referral to see a specialist, which may delay your access to necessary care.
Both of these factors can affect your access to care. On the other hand, Original Medicare provides access to a large number of providers without requiring referrals.
Choosing the right Medicare Advantage plan in Florida depends on your unique health and financial situation. Those that are new to Medicare can pick a Medicare Advantage plan during the Initial Coverage Election Period. Current Medicare beneficiaries can switch to a Medicare Advantage plan during the Medicare Open Enrollment Period. For support and reassurance in picking the best plan for your needs, you can talk to a Chapter Medicare Advisor. Call us at 855-900-2427 or schedule a time to talk for free advice tailored to your needs.
