Health Insurance For Seniors In Florida - The Seniors' Health Insurance Needs Service Program, or SHINE, provides information and assistance through unbiased advice and clarification on Medicare and other health insurance issues. SHINE services are provided free of charge by volunteers from the Florida Department of Elder Affairs. Every day, seniors are empowered to make health insurance decisions and solve insurance problems with SHINE.
Since the program began in 1993, nearly a million seniors have received help from SHINE volunteers. The program and its volunteers have won many awards, including
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SHINE is funded by the Centers for Medicare & Medicaid Services and administered by the Florida Department of Elder Affairs. Senior Resource Alliance, Central Florida's agency on aging, supports SHINE in Brevard, Orange, Osceola and Seminole counties.
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For more information about SHINE, call the Florida Elder Helpline at 1-800-963-5337 or visit http://www.FloridaSHINE.org/ To learn more about how to volunteer with SHINE, click here.
To speak with a SHINE counselor by phone, if you live in Orange, Osceola, Seminole or Brevard counties, call the Florida Elders Helpline at 1-800-963-5337 or 407-514-1800.
SHINE also provides community education with a focus on Medicare updates, beneficiary rights and consumer protection. Volunteers speak to local groups, community organizations and staff. You can also find SHINE volunteers at community health fairs large and small, where they provide information and answer questions about Medicare and other health insurance issues. As of 2020, more than 4.6 million Florida seniors were enrolled in the federal health insurance program in 2020. Of those, 2.2 million choose to receive benefits through a Medicare Advantage plan. Medicare Advantage is a privately issued program, often called Part C, that combines the benefits of the original Medicare Parts A and B into one plan with a single monthly premium. Part C plans offer almost all the same benefits as A and B, plus a few extra covered benefits that may include vision, dental, and some prescription care. Some plans also include coverage for additional needs such as non-emergency medical transportation and senior health sessions.
Because Medicare Advantage plans combine multiple benefits into a single, highly customizable plan, their beneficiaries typically don't need a traditional Medicare supplement. Most Part C plans have an annual out-of-pocket maximum, but Original Medicare does not, making it an attractive option for seniors on fixed incomes. Nationally, about 42% of Medicare recipients chose Part C over primary care. In Florida, about 48% of Medicare enrollees enrolled in Medicare Advantage, according to 2020 data.
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This guide provides an overview of Medicare Advantage plans in Florida. It reviews the most popular plans in the state, their eligibility requirements, and the benefits they offer. It also has helpful information on how to apply for a plan in the Sunshine State.
Several companies in Florida offer Medicare Advantage plans. As a result, Medicare-eligible seniors in the state have a wide range of options for effective health care. The table below shows the 10 most popular plans with their associated cost data. Because these companies offer multiple plans, their rates are shown as a range rather than a single average. In order to obtain the most useful information, we have included all available registration data to develop participation numbers. The numbers in this table are accurate as of April 2022, although more up-to-date information is available on Medicare.gov.
Florida seniors should be careful when choosing a Medicare Advantage plan. Since these plans are offered by individual companies, they can be arranged in a variety of ways to maximize coverage. Plans are available as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and special needs plans (SNPs). Different types of plans have different rules about how to get referrals, whether you need a primary care provider, or the difference between in-network and out-of-network coverage. Below are four of the most common design types.
Medicare Advantage plans in Florida provide almost all of the same benefits as original Medicare Parts A and B, except for hospice care, which is always covered by Medicare Part A. Medicare Advantage plans also pay for preventive health screenings, doctor's x-rays, and lab tests. Services provided during an inpatient hospital stay are also covered by Medicare Advantage plans. In addition to combining monthly premium discounts, Part C plans usually offer valuable additional services. These include vision care, dental services and hearing aids.
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To enroll in a Medicare Advantage plan in Florida, seniors must meet a number of requirements. Among them is the USA. Citizenship or legal residency and enrollment in an original Medicare plan. You must also reside in the geographic area where a particular plan is offered.
As is typical for premium health insurance policies, Medicare Advantage plans have limited open enrollment periods for new enrollees. People who sign up during one of these periods cannot be canceled or charged extra for previous terms. However, if the application is submitted outside the normal window, they may be fined. Please review the list below for helpful information about enrollment periods and the window in which you can enroll for the first time or make changes to your coverage area.
Additionally, Medicare Advantage plan participants may change plans outside of enrollment periods under certain qualifying circumstances, such as moving to a new state.
Navigating the many intricacies of Medicare Advantage plan types, insurers, and specific plan options available by region can be a difficult and time-consuming task. Below are some resources we've created to help you through the process.
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First, a downloadable PDF file that you can use as a guide to help you compare plans during your research. Finally, we've listed a number of organizations where you can contact experts who can help you decide if Medicare Advantage is right for you and which plans to consider.
Florida Services for the Health Insurance Needs of the Elderly (CHEN) program is a free health counseling service administered by the Florida Department of Aging and provided by local agencies on aging. SHINE's network of volunteers provides free, unbiased information about Medicare Advantage plans, pricing and coverage options through in-person counseling sessions and workshops. Seniors who have questions about Medicare or need help choosing the best Medicare Advantage plans for their unique needs can schedule an appointment with a SHINE advisor.
The Florida Department of Elder Affairs helps protect seniors from Medicare Advantage fraud, abuse and overpayments through the Senior Medicare Patrol program. Administered in conjunction with the SHINE program, the FL-SMP is available to seniors with questions or concerns about their graduate plan. SMP staff evaluates each report made and issues requiring escalation are referred to the appropriate local, state or federal authorities. SMP volunteers also provide free Medicare fraud prevention workshops at senior centers across the state.
Seniors, family members and caregivers can contact the FL-SMP through the Florida Department of Elder Affairs at 1-800-963-5337. FL-SMP services are also available through local agencies, also known as Aging and Disability Resource Centers (ADRCs).
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Florida seniors 60 and older can schedule a free phone consultation with an approved attorney or paralegal through the state's Senior Legal Hotline. This service for low-income seniors helps seniors with legal issues related to Medicare Advantage coverage as well as other civil issues. If callers to the premium legal help line need legal services other than free phone advice, they can get the help they need by finding a free or low-cost legal service provider in their community.
The Medicare Savings Program is a government-sponsored subsidy program for low-income seniors who have difficulty affording Medicare. MSP consists of four separate programs that help seniors pay their Medicare premiums, coinsurance, copayments, and deductibles. Eligibility is based on income, resources and medical expenses.
For more information about Medicare savings programs in Florida, seniors can call the Elder Helpline at 1-800-963-5337. Seniors can also book an in-person appointment with a SHINE counselor through their local Agency on Aging.
The Senior Connection Center is an aging and disability resource center for Hardee, Hillsborough, Highland, Manatee and Polk counties. Seniors, adults with disabilities, and caregivers have access to free and low-cost services such as evidence-based health and wellness workshops and fall prevention classes. The center also hosts a local SHINE program to help seniors learn about the different Medicare options, including which Medicare Advantage plans are offered in the area. SHINE volunteers can also help with Medicare payment issues and advise seniors about financial assistance programs to reduce out-of-pocket Medicare costs.
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Seniors First is a nonprofit organization that provides community-based services to Orange County seniors age 60 and older. Services are designed to help older people stay in their own homes for as long as possible, delaying or avoiding institutionalization. Low-income seniors with Medicare Advantage may qualify for case management, personal care, and homemaker services. The organization also operates a bank of medical supplies for elderly and disabled residents
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