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The First 3 Steps in Acquiring Medicare Supplement Insurance Coverage in Florida


Introduction

If you are to turn 65 within the next year or two, it's time to learn about your Medicare supplement insurance plan options.  A quality Medicare supplement plan is as important a piece as any, when it comes to achieving financial stability in retirement.

Let's go over the basics of Medicare supplement coverage and break down 3 tips to acquiring this insurance necessity in the state of Florida. 


What is Medicare Supplement Coverage (Medigap)?

Before you make the leap to acquiring a Medicare supplement plan, it's important to know what this coverage is and what it could mean for you and your family.  Simply put, Medicare supplement coverage is insurance for medical circumstances that are not covered by Medicare.  While Medicare coverage is quite extensive, it does not cover everything.  If you have the misfortune of suffering a medical incident that requires surgery, or a hospital stay, medical bills can mount rather quickly.  Most people are surprised at the costs associated with even the most modest of medical procedures.  A quality Medicare Supplement plan can be a financial lifesaver.

Medicare Supplement plans (also known as Medigap plans), are offered through private companies.  Keep in mind that Medigap plans are not the same as Medicare Advantage Plans. (For the pros and cons of Medicare Advantage plans, click here.)

Medigap coverage can only be used for one thing: circumstances where traditional Part A and Part B of Medicare does not provide coverage.

In total, there are ten Medigap plan styles that consumers may consider.  We'll discuss these plans in more depth so that you can make the decision that's right for you.

Good to know:  Just because your doctor writes you a prescription doesn't mean you can fill it.  Expensive medications for treatment of certain cancers, diabetes, liver disease, and a host of other maladies can cost patients tens to hundreds of thousands of dollars if the insurer does not cover the drugs.  But even if the drugs are covered, insurers have been known to try to stall, just to see if the patient will come up with the money to pay for the drugs rather than wait on the insurer's approval.  What can we say?  It happens.


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Holy Cross Hospital
4725 N Federal Hwy
Fort Lauderdale, FL 33308
Telephone: 954-771-8000
Plus Code: 5VPJ+V2 Fort Lauderdale, Florida
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Who is Eligible for Medicare Supplement Coverage in Florida?


To be eligible for a Medigap plan in the state of Florida, you must meet certain requirements.  Let's take a look at the conditions consumers must satisfy in order to be eligible to apply for Medigap insurance.

For starters, you must be enrolled in Medicare Part A and Part B.  If you are not enrolled in Both Part A and Part B of Original Medicare, you will not be able to purchase a Medicare supplement plan.
Secondly, in almost every case, you need to be age 65 or older to be eligible for Medigap insurance.  The state of Florida requires Medigap insurance companies to provide at least one type of supplemental insurance to individuals who, through specific disabilities, are eligible for early Medicare.



There are a few insurance circumstances in which you cannot be covered by a Medicare supplement plan:

  • Medicare Advantage Plans  If you are covered by a Medicare HMO, PPO, or Private Fee-for-Service Advantage Plan, you are not eligible for Medigap insurance.
  • Medicaid  You cannot augment your Medicaid coverage with a Medicare supplement plan.
  • Veterans' Benefits  Like Medicaid, Veterans' benefit coverage cannot be supplemented by a Medigap plan.

If you have a Medicare Prescription Drug Plan, you will still need Original Medicare to be eligible for a Medicare supplement plan.  Medicare Prescription Drug plans, and Medicare Supplement plans are two distinctly separate coverages.  The benefits do not overlap.  Since 2006, Medigap has been barred from covering the cost of prescription drugs.

Good to know:  If there is a deadline associated with your health insurance purchase, be sure you know exactly when it is.  Make specific note of the timeline for enrollment, and give yourself plenty of time to research your plan choices before the deadline arrives.  Let's face it.  It's easy to put off a purchase such as health insurance - largely because there is no immediate impact if you delay.  So, commit to finishing the task early.  You don't want to be scrambling for answers at the last minute.


How Does Medigap Work in the State of Florida?

If you meet the eligibility requirements for Medigap insurance in Florida, you may be wondering how exactly Medigap insurance works.  Is the payment rolled up into one bulk Medicare cost, or will you be forced to pay two different premiums?  Additionally, does Medigap insurance offer spousal coverage, or is it just for one person?

Let's take a look at these questions and break down the answers.  Because Medigap plans work differently than Original Medicare, it's important you understand the differences between the two plans.

If you enroll in a Medigap plan, you will need to pay an additional premium on top of your existing Part B premium.  This premium will be paid on a monthly basis.  These plans cover only one individual.  If you are seeking supplement coverage for both you and your spouse, each member must apply for his or her own policy.

Medigap coverage is purchased through private insurance companies.  You'll find that different insurance companies have different premium structures (and therefore different prices) when it comes to their Medigap plans.

If you suffer a medical incident, you can expect Medicare to cover any medical costs according to the Medicare coverage plan benefits.  Your Medigap insurance is designed to help cover expenses not covered in your Original Medicare plan.

As long as you continue to pay your monthly Medicare supplement premiums, you are never in danger of losing your coverage.  Because Medigap is guaranteed-renewable, you can keep your coverage even if you fall ill or have a downward turn in your health.


Steps to Finding the Right Medicare Supplement Plan

Finding the right Medigap plan for your situation doesn't have to be difficult.  Though it can be overwhelming at first, by following the steps below, you should be able to painlessly find an ideal plan. 

  • Step #1: Research Medicare Supplement plan styles.

First, you'll need to research the different Medicare Supplement plans available.  Currently, there are ten different supplement plans available: A – N.


Medicare Supplement Plan Comparison

Benefits Medicare Supplement Plans
  A B C D F* G K L M N
                     
Medicare Part A Deductible No 100% 100% 100% 100% 100% 50% 75% 50% 100%
Medicare Part B Deductible No No 100% No 100% No No No No No
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%**
First three pints of blood 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part A hospice coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled Nursing Facility (SNF) coinsurance No No 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part B Excess Charges No No No No 100% 100% No No No No
Foreign Travel Emergency (Up to Plan Limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-Pocket Limit*** None None None None None None $5,240 $2,620 None None

*Plan F is also has a high-deductible option.  The F high deductible plan pays for all Medicare-covered expenses after you meet a $2240 annual deductible.
**Office copay exceptions: Some office visits may require a copayment of up to $20.  Emergency room visits may require a copayment of up to $50.
***Plan pays 100% of covered Medicare costs for the remainder of the calendar year once the out-of-Pocket limit is reached.



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South Bay Hospital
4016 Sun City Center Blvd
Sun City Center, FL 33573
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  • Step #2:  Research plan pricing

Once you've chosen the plan type that fits your needs, you should begin looking at insurance companies that offer that plan.  Though this may sound complicated, the good news is that the state of Florida has made it exceptionally easy to find Medigap insurers in your area.  Let's take a look at a detailed step-by-step process to finding insurers near you. 

  • Go to the Official Site of the Florida Office of Insurance Regulation

First, you'll want to access the website of the official Florida Office of Insurance Regulation.  Here, you can find a wealth of information pertaining to a variety of different insurance types as they apply in the state of Florida.  Use this resource for official in-depth information regarding a variety of different insurance types.
This user-friendly site does more than provide general information.  You can also use it to find insurance providers in your local area.  Those looking for Medigap coverage can even see a list of providers, which plans they carry, average premiums, contact information, and even a rating class for each carrier. 

  • Click on "Rate Comparison Tools"

To access this information, find a tab labeled "Rate Comparison Tools" on the Florida Office of Insurance Regulation site homepage.  This tab will be located in a square box in the body section of the homepage. 

  • Click on "Medicare Supplement"

After clicking on this tab, you will be redirected to another page.  This page explains the different online rate comparison tools offered by the office.  Scroll down until you see a box labeled "Medicare Supplement. "

  • Select Your County

By clicking on this box, you will be redirected to a screen that will allow you to search Medigap insurance providers in your county.  
You should be prompted with a map of Florida labeled with its different counties.  Search the map and find your county and click on it to proceed to the next step.
For example, if you live in Polk County, select the portion of the map labeled "Polk. "

  • Enter Your Information

Once you've selected your county, you will be redirected to another webpage.  Here, you will be prompted to enter specific information regarding yourself and the Medigap plan you're looking for.
You'll need to enter your:

  • Age
  • Gender
  • Smoker/Non-Smoker Status
  • Insurance Type (Select or Standard)
  • Zip Code
  • Plan of Your Choice (A – N)*

*You also have the option to select "all plans" to see a full list of plans provided in your area.
Once you click "search," you'll be redirected to another, final page where you'll see a full list of insurance providers in your area.
It's here that you can find information regarding which insurance carriers include which plans, as well as annual premiums and contact information.
Be sure to review this information carefully Before proceeding to the next step. 

Good to know:  High-deductible plans come at a cost: You'll pay less each month in terms of premiums, but if you do have to use any medical services, you'll pay out of pocket for longer thanks to that high deductible.  Still, if you're looking to lower your monthly costs and you're someone who doesn't frequent the doctor often, high-deductible plans are a valid option.


  • Step #3:  Contact Insurance Companies in Your Area

Don't be afraid to make some phone calls.  The Florida Office of Insurance Regulation provides a contact phone number for every insurance company that offers Medicare supplement plans.  Be sure ask as many questions as you need in order to feel comfortable about selecting a plan.


The Bottom Line


Educating yourself on the Medicare Supplement options that are available to you will substantially increase your chances of purchasing the ideal plan for your needs.

Newplanoptions.com is here to help.  Our insurance professionals have years of experience helping consumers find the right plan for their needs and budget.  call now.

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Lee Memorial Hospital
2776 Cleveland Ave
Fort Myers, FL 33901
Telephone: (239) 343-2000
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5 Important Steps For Getting Health Insurance In Florida.
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