Medicare in Florida

Medicare Advantage enrollment is available when a person is initially eligible for Medicare, but there’s also an annual enrollment window each fall called the Annual Election Period (AEP) (October 15 – December 7) when Medicare beneficiaries can select a different Medicare Advantage plan, or switch between Medicare Advantage and Original Medicare.

There is also a Medicare Advantage open enrollment period (January 1 to March 31) during which people who are already enrolled in Medicare Advantage plans can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

By May 2023, nearly 55% of all Florida residents with Medicare were enrolled in private Medicare Advantage plans. ³ The growth in Medicare Advantage enrollment in Florida is in keeping with the general nationwide trend towards Medicare Advantage enrollment; enrollment had grown to approximately 48% of all Medicare beneficiaries nationwide as of mid-2023.⁵ But Florida is among a majority of states where Medicare Advantage coverage accounts for over half of the total Medicare population.³

Medicare Advantage service areas are defined/available on a county-by-county basis, and the number of plans available in a given county can vary greatly across a single state. In Florida, residents in some counties can choose from more than 65 different Medicare Advantage plans in 2023, while residents of other counties only have fewer than 20 options.²

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that people would otherwise incur if they only had Original Medicare on its own.

The Florida Office of Insurance Regulation (FLOIR) has a very user-friendly website people can use to compare premiums for Medigap plans available in each county in the state. As of 2021, an AHIP report indicated that there were 925,872 Florida Medicare beneficiaries with Medigap coverage. ⁸

Medigap plans are standardized under federal rules, and people are granted a six-month window, when they turn 65 and enroll in Original Medicare, during which coverage is guaranteed issue for Medigap plans. Federal rules do not, however, guarantee access to a Medigap plan if you’re under 65 and eligible for Medicare as a result of a disability.

But Florida is among the majority of the states that have adopted rules to ensure at least some access to Medigap plans for people under age 65 who are eligible for Medicare in Florida. Since 2009, Florida residents under age 65 are granted a six-month window (starting when they’re enrolled in Medicare Part B) during which coverage under a Medigap plan is guaranteed-issue. The premiums are typically higher for enrollees under age 65, although they are given another enrollment window when they turn 65, so they can then switch to lower-cost Medigap coverage at that point.

Original Medicare does not cover outpatient prescription drugs. But Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Medicare Part D plan.

As of May 2023, there were about 1.4 million Florida Medicare beneficiaries who were enrolled in stand-alone Medicare Part D prescription drug plans.³ But over 2.6 million Medicare beneficiaries in Florida had Part D coverage integrated with a Medicare Advantage plan.³

The number of people with stand-alone Medicare Part D coverage in Florida has declined in recent years,⁹ while the number of people with Medicare Part D prescription drug coverage as part of a Medicare Advantage plan had increased significantly.³ (Total enrollment in Medicare increases each month, so overall growth in Medicare Part D enrollment reflects this, despite the shifting from stand-alone Medicare Part D plans to Medicare Advantage plans that include prescription drug coverage).

For 2023 coverage, there are 23 stand-alone Medicare Part D plans available in Florida, with premiums starting at $8.40 per month.¹⁰ Medicare Part D enrollment is available during the same fall enrollment window (October 15 – December 7) that applies to Medicare Advantage plans.

Many Medicare beneficiaries receive financial assistance through Medicaid with the cost of Medicare premiums, prescription drug expenses, and services not covered by Medicare – such as long-term care.

Our guide to financial assistance for Medicare enrollees in Florida includes overviews of these benefits, including Medicare Savings Programs, long-term care coverage, and eligibility guidelines for assistance.

These resources provide free assistance and information about Medicare beneficiaries in Florida:

• Contact SHINE, Florida’s health insurance assistance program for seniors, with questions about Medicare eligibility in Florida or Medicare enrollment in Florida. Visit the SHINE website or call 1-800-963-5337.
• Visit the Medicare Rights Center. This website provides helpful information geared to Medicare beneficiaries, caregivers, and professionals.
• Contact the Florida Office of Insurance Regulation for questions or complaints about agents and brokers who sell Medicare plans, as well as Medigap plans (these are mostly regulated by the state, whereas Medicare Part D and Medicare Advantage plans are mostly regulated at the federal level).