There are nearly 5 million people in the state of Florida enrolled in Medicare. Medicare is a federal health insurance program for individuals aged 65 and older, as well as those under 65 with long-term disabilities. Medicare can cover various medical services, including hospitalizations, doctor visits, prescriptions, post-acute care, skilled nursing, home health care, hospice care, and preventive services.
Medicare recipients can choose between original Medicare (Part A and Part B) or Medicare Advantage plans – like an HMO or PPO – offered by private insurers.
Original Medicare users may opt for a separate Part D plan for prescription drug coverage and consider supplemental insurance.
Those choosing a Medicare Advantage plan can select from various options covering Parts A, B, and often D. This is often a popular choice for Florida seniors – in fact, according to HealthInsurance.org, the Medicare Advantage plan is more popular in Florida than they are in the entire country, with over half of Florida’s Medicare beneficiaries choosing private coverage.
The Medicare annual open enrollment period allows beneficiaries to modify their coverage.
When is Medicare Open Enrollment?
The annual Medicare Open Enrollment period is from October 15th to December 7th.
Changes made to Medicare plans during this period take effect on January 1st of the following year.
The annual open enrollment period for Medicare allows recipients to evaluate and modify their coverage options. People can switch between traditional Medicare and Medicare Advantage plans, change their Medicare Advantage plans, and elect or switch between Medicare Part D prescription drug plans.
What changes can be made during the Medicare Open Enrollment period?
During the Medicare open enrollment period, Medicare recipients can enroll in or switch between Medicare Part D prescription drug plans. However, late enrollment penalties may apply if they did not sign up initially.
During this time, traditional Medicare beneficiaries with Parts A and B can also switch to a Medicare Advantage plan with or without Part D coverage.
Similarly, people enrolled in a Medicare Advantage plan can choose a different Medicare Advantage plan or switch to traditional Medicare. Those transitioning to traditional Medicare can enroll in a Part D plan for prescription drug coverage and consider purchasing a Medicare Supplement Insurance policy (Medigap) if available.
It is advisable for Medicare beneficiaries to review their coverage annually, considering changing medical needs, locations, and plan variations that may impact costs and access to providers.
Can you change Medicare plans outside the open enrollment period?
Yes, there are instances where some Medicare beneficiaries can make changes to their coverage outside of Medicare’s open enrollment period. Below are examples of situations in which the recipient can change Medicare health plan during other parts of the year that do not require paying a late enrollment fee:
- If a Medicare recipient has a disruption in existing coverage due to a move or loss of employer-sponsored coverage, or a change in eligibility for Medicaid or other programs, or experience other life events, they may qualify for a Special Enrollment Period at any time of the year.
- Dual-eligible individuals who are enrolled in both Medicare and Medicaid, or who qualify for the Medicare Part D Extra Help program, can change their Medicare Advantage or Medicare Part D plan once per quarter.
- People who live in nursing homes and certain other facilities are able to change their Medicare Advantage or Medicare Part D coverage once per month.
- People enrolled in Medicare Advantage plans who wish to change their plans or switch to traditional Medicare coverage can do so from January 1 to March 31 each year during the Medicare Advantage Open Enrollment Period (in addition to the standard open enrollment period from October 15 to December 7).
- People who have a Medicare Advantage or Medicare Part D plan with a 5-star quality rating available in their area are able to switch into a 5-star plan between December 8 of the current year and November 30 of the following year.
When can you sign up for Medicare coverage?
A senior’s first chance to sign up for Medicare is when they turn 65, called the initial enrollment period. A senior’s initial enrollment period lasts for 7 months, starting 3 months before they turn 65, and ending 3 months after the month they turn 65.
Medicare resources
The many different Medicare plans can be confusing. One place to start is visiting Medicare.gov or calling 1-800-633-4227. Medicare.gov published an official handbook “Medicare and You” to help people determine which Medicare plan is right for them. Medicare.gov sends a hard copy of this handbook to all Medicare beneficiaries’ households at the end of September. The handbook is also available for electronic download at any time.
Another resource is the Medicare Plan Compare website, which allows people to review and compare Medicare options in their area.
In addition, seniors can contact their local State Health Insurance Assistance Programs (SHIP), which provides local assistance with the Medicare process.
Finally, Florida residents can use this tool from The Florida Office of Insurance Regulation (FLOIR) to compare premiums for Medigap plans in each county.
Next steps
Medicare can be confusing, but it is a valuable resource for many seniors, especially as they pursue senior living. While Medicare does not officially pay for assisted living, it can help cover the cost of care, prescriptions, different types of therapy, and temporary home health care in some cases. For more information about using Medicare to help pay for senior living costs, watch Florida Senior Consulting’s Medicare and Medicaid explanation video.
Florida Senior Consulting helps seniors in Florida find the perfect senior living community for them based on their needs, preferences, and budget. Visit FloridaSeniorConsulting.com or call (800) 969-7176 to learn more about the senior living process from our expert advisors.
