Florida Medicare beneficiaries who are enrolled in both Medicare Part A and Part B are eligible to enroll in a Medigap policy, also known as Medicare Supplement Insurance.
What do Medigap plans offer Florida residents?
Original Medicare, Part A and Part B, provides most Florida Medicare beneficiaries with hospital and medical benefits; however, it does not cover all health services and supplies, and it also comes with certain out-of-pocket costs, such as coinsurance, copayments, and deductibles. Medigap plans offer coverage to fill in the “gaps” that Original Medicare does not cover, whether it be in the form of out-of-pocket costs or coverage for medical care when traveling abroad.
Medigap policies help pay your part (coinsurance, copayments or deductibles) of the costs of Medicare-covered services.
What types of Medigap plans are available in the state of Florida?
Florida is one of the 47 states that offer standardized Medigap plan offerings to all eligible residents. There are ten different types of standardized Medicare Supplement plans, each denoted with a letter name (i.e. Plan N).
Generally, all Medigap plans offer Florida residents with some coverage for:
- Medicare Part A coinsurance and hospital costs up 356 days after Medicare benefits are used up
- Medicare Part B coinsurance or copayment
- Part A hospice coinsurance or copayment
- The first three pints of blood used in a medical procedure
Certain Medicare Supplement plans may also cover:
- Skilled nursing facility care coinsurance
- Medicare Part A and/or Part B deductible
- Medicare Part B excess charges
- Foreign travel emergency coverage
All plans with the same letter name have the same standard benefits associated with that plan. However, insurance companies are allowed to charge different premiums for the same Medigap plan. For example, a Medigap Plan F from one insurance company can have higher costs than a Medigap Plan F from another company, despite having the same benefits. It is important for Florida Medicare beneficiaries to comparison shop to find the best price for their needs.
Florida beneficiaries are also able to sign up for a “Medicare SELECT” version of any of the ten Medigap plans offered. Medicare SELECT policies may charge a lower premium than other Medigap plans with the same coverage; however, these plans act like managed care plans, in which beneficiaries are required to only use doctors and hospitals within its network of healthcare providers and facilities.
When can Florida residents enroll in a Medigap plan?
The best time to enroll in a Medigap policy is during the Medigap Open Enrollment Period. This is a six month period starts the first day of the month that a beneficiary is both age 65 or older and enrolled in Medicare Part B. During this time, beneficiaries are entitled to Medigap guaranteed issue rights, meaning that insurance companies cannot use medical underwriting and must cover all pre-existing health conditions. Medical underwriting is when the insurance company uses a medication condition or complication to raise the price for coverage or deny enrollment. Any Florida resident who tries to enroll in a Medigap plan after this initial six month period could be denied enrollment.