Florida Medicare Supplements

florida long term care insurance

Florida Medicare beneficiaries are often shocked when they find out how much they must pay out of their own pockets for hospital or doctor bills. To help fill the "gaps" in Florida Medicare coverage, some people buy private supplemental insurance known as Medigap insurance.

Florida Medicare has become a little bit more complex in the last few years. There are more options to choose and confuse.

This web site is not designed to explain all the different plans in detail. The government has a great little booklet that will do that. Although, I still think that most people will have a lot of questions after reading it.

I am going to try and give you an overview. So that after you read Medicare's pamphlet and call me, you and I can have an intelligent discussion about what your best options might be. It will also make the literature more intelligible.

I am going to assume that you already know that you qualify for Medicare if you are 65 years of age or older and have paid into the system through your payroll deductions over your working life.


What Are My Choices?

There are four parts to Medicare:

Part A

The basic free Medicare that covers hospitals stays.

Part B This part is not free. This year (2007) it cost $93.50 per month. It is more expensive if your income is over $80,000 (individual) or $160,000 (couple). You can expect Part B to continue to go up each year. Part B covers physicians, lab tests, x-rays, medical equipment and a whole lot more. Unless you are destitute or have a Part C program, be sure you sign up for Part B.
Part C Medicare Advantage programs are private health insurance companies taking over your Medicare coverage. For each person who signs up, Medicare pays the company a monthly fee. Be aware that these are private programs and you are not covered by the government's Medicare program when you are a member.
Part D   This is the part that covers prescription drugs. These plans are administered by private health insurance companies. Each company has their own program. Figuring this one out is a pain in the ...

 

 

 

 

 

 

 

Medi-Confusion!

There are all of these different parts plus 12 different MediGap plans. There is Medicare Select and I have lost count of the different Medicare Advantage plans. I bet you are as about as confused as you can get.

Since this is my website and there are no right and wrong choices, I am going to give you my opinion - for what it is worth. Here is my personal take.

To begin with, you want to always be aware that some choices cannot be reversed. Yes, you can always go back to the standard Medicare Part A and B plans. But, you cannot necessarily always get a Medigap plan. There are only certain times and circumstances that allow you to get Medigap coverage regardless of your health.

The best time to purchase a Medicare Supplement or Medigap policy is during your open enrollment. This is a period of six months from the date you turn 65 and enroll in Medicare Part B. During this window of time, regardless of your health, no company can deny, put conditions on, or discriminate in the pricing of the policy you want because of your medical history, health status or claims experience.

However, if you try to get a Medicare Supplement or Medigap policy after the designated periods for Medicare Part B enrollment, companies who sell Medigap policies have the right to review your medical records and deny you coverage.

There are exceptions. For instance, if your Medicare HMO is going out of business or leaving the area served by your plan, you may be eligible for guaranteed coverage.

But, if you do decide on a Medicare Advantage plan and decide two years down the road that you really don't like it (for any reason), you may not always be able to buy a Medigap plan.

A Medicare Advantage plan comes in a few different flavors. They can be PPO or HMO plans. You want to be damn sure you like the network. Check for the hospitals and make sure there are plenty of physicians who you like. Remember, a physician can wake up one day and say "screw it, I am not going to participate in the plan anymore".

The Medicare Advantage plans usually require no out of pocket expense and include, to varying degrees, drug coverage. If the cost of Part B and a Medigap plan are going to present a financial problem to you, then one of these plans might work for you. Again, watch the network.

If you can afford it, my personal preference is to take the standard Medicare (A and B) and buy a Medicare Supplement. You don't have to get the plan that covers the most. You just need the standard coverage that extends your eligible hospital days and takes care of the larger deductibles.

I do not like the fact that a private health insurance company is going to take money from Medicare and then try to make money on it. Someone, somewhere gets screwed, and it is usually the consumer. Stick with Medicare and get a supplement. You will not have to hunt around for doctors, worry if you are in or out of network, etc.

Since all Medicare Supplement or Medigap plans have to cover exactly the same thing (in other words a B level plan from one company is identical to a B level plan from another company), you need to find a company that has been around a long time, had a good rating, pays claims well and does not have massive increases. It may not be the cheapest to start, but in the long run it will cost less.

Call me for my recommendations. I carry a few top plans from carriers that have been in the business a long time.

If you wait until you are sick to get a Medicare Supplement or Medigap policy, your goose is cooked!

If you are going to get a plan do it now. It will never be any cheaper and there is no such thing as an insurance sale. Think of it as an early bird special. Click here now for a quote.

Making a Decision

I know that there is a lot to learn before making a decision. The Medicare website has a good guide and if you call me after reading it, I will discuss the plans with you. But, please, do not call me up and expect me to spend hours on the phone explaining the entire Medicare system. You can read the simple pamphlet and be an expert in less than an hour. To get the Medicare pamplet just click here.

You can contact us between 9 AM and 8 PM Mon - Thurs EST and on Friday until 5 PM.

Call us at 800-986-4786.

We are insurance agents that sell Medigap and Medicare Advantage Plans, as well as Long Term Care.

 

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