New to Medicare; Quickly & Easily Get The Answers You Need
New to Medicare; Quickly & Easily Get The Answers You Need
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Getting Started With Medicare
The Medicare Roadmap
Learn about your Medicare plan options.
Decide on a plan type (Medicare Advantage or Medicare Supplement).
Enroll online with Florida Medicare Advantage.com, or call 772.276.6669.
You worked and paid taxes all your life, and now you’re eligible for Medicare. Congratulations on making it this far! However, health insurance as you know it has just changed completely. In your quest to understand your options, you may find that Medicare can be quite confusing. Rest assured, however, that Florida Medicare Advantage advisors are quite knowledgeable when it comes to your Medicare options. Try not to get overwhelmed as you attempt to figure out how Medicare works, or the best plan for you. Just contact us for a friendly, no-pressure conversation about your needs. Now lets get to it!
The following is a summary of Medicare’s basic programs. Speak with a licensed agent for specifics, or unique situations.
The Basics of Medicare
Medicare has two main parts, Part A and Part B. Part A pays for your hospital expenses, while Part B pays for your doctor’s bills. In addition, there is also a Part D that addresses your prescription needs. These are very basic definitions, of course.
When You Become Eligible For Medicare
Your Medicare eligibility begins when you turn 65, have been on Social Security disability for 24 months, have ALS (Lou Gehrig’s disease), or have End Stage Renal Disease.
Medicare is the federal health insurance program primarily for:
- Adults age 65 and older
- Some people under 65 with qualifying disabilities
- Individuals with End-Stage Renal Disease (ESRD)
- Individuals with ALS
Most people qualify for premium-free Medicare Part A because they or their spouse paid Medicare taxes while working.
What Original Medicare Covers
There are four basic parts to Medicare; Parts A, B, C, and D. Parts A and B are original Medicare, amd parts C and D are Medicare Advantage.
Medicare Part A
Medicare Part A covers (2026):
Inpatient hospital care – $1736 deductible per benefit period of 60 days, plus $434/day for days 61-90
Skilled nursing facility care – $217 per day for days 21-100
Hospice
Limited home health services
Medicare Part B
This is primarily you doctor coverage. Medicare covers 80% and you are responsible for the remaining 20%. There is also an annual deductible for Part B medical services ($283 in 2026).
Part B Medical coverage including:
Primary care
Specialists
Preventive care
Outpatient surgery
Lab work
Durable medical equipment
How Medicare Advantage Compares to Medicare Supplements
Medicare Advantage
- Private plan offered by an insurance company
- Usually includes Part D drug coverage
- Often offers a $0 monthly premium
- Generally utilizes provider networks
- Has copays on many services
- Many offer extra benefits not available on original Medicare
Medicare Supplement
- Works in coordination with Original Medicare
- Must purchase Part D drug plan separately
- Will have a monthly premium that generally increases annually
- Generally accepted anywhere without referral or authorization
When to Enroll in Medicare
You will be automatically enrolled in Medicare when you elect to take Social Security, or when you request it from the Social Security Administration. In most cases, you will want to enroll in both Medicare Parts A and B. This is very important, as you will not be able to get a health plan without both parts.
For most people, your Medicare enrollment period begins three months before your 65th birth month, and lasts until three months after your birth month.
How to Avoid Lifetime Penalties
There is a lifetime penalty if you delay enrollment in a Part D prescription drug plan. This penalty may not apply if you have creditable coverage elsewhere (employer, VA, Tricare, etc). The Part D penalty amount increases every month you do not have creditable coverage, and will be assessed for the remainder of your lifetime.
Part D prescription plans are readily available and generally inexpensive. Speak with a trusted advisor ensure you are covered properly.
How to Compare Plans And Enroll
Should You Choose a Supplement or an Advantage Plan?
Enrolling in a Medicare plan is easy; choosing the right one for you is the hard part. When deciding to go with a Medicare Supplement or an Advantage plan, you should consider several factors about your circumstances.
The best plan for you will depend on:
- Budget
- Preferred doctors
- Prescriptions
- Travel habits
Medicare Advantage plans have provider networks, so if you spend a lot of time outside of your coverage area (the area surrounding your home, generally speaking), then you will be limited to emergency and urgent care coverage. The Medicare supplement will not have this limitation.
The short answer is that the Medicare supplement will be easier to use, but more costly in terms of monthly premiums and extra benefits. If freedom of use is the most important factor to you, choose a supplement plan. Should you not want to pay the $200+ for a supplement plan, and are comfortable using a network, you may enjoy an advantage plan. There isn’t a “best” option for everyone, and your personal needs and preferences will dictate your choice.
When you can enroll in a plan
You can enroll in a Medicare plan during specific dates throughout the year. These times are known as enrollment periods, and there are five basic types. See the chart below to see which enrollment period applies to you.
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Ways to Use Your Medicare
One of the first decisions you’ll need to make is whether you will use original Medicare in conjunction with a Medicare supplement, or a Medicare Advantage plan. How you use your Medicare benefits will depend-on your personal needs, as there is not a one-size-fits-all plan. View the brief description of each plan type below to help you decide which Medicare plan is right for you.
NOTE to VA eligibles: VA coverage alone will typically leave gaps in your coverage, potentially exposing you to unexpected financial costs if you require emergency care outside the VA hospital. There are Medicare Advantage plans specifically for those with VA benefits. Be sure to speak with an advisor to take advantage of this program. Click here to read what the VA says about using them as your sole coverage (pay particular attention to the question “should I give-up my private health insurance…”).
Medicare Supplements
Medicare supplements, sometimes referred to as medigap plans work in conjunction with Medicare Parts A and B, and “fill-in the gaps” that Medicare alone does not address. As a result, you have more complete coverage. One of the glaring holes in Medicare is the lack of prescription drug coverage. Fortunately, you can purchase a Medicare Part D plan to fill this need. More on Part D plans in a moment. To learn more about Medicare supplements, visit our Medicare supplement page, here.
Medicare Advantage
Under these plans, your Medicare benefits are delivered by a private insurer. These plans are more akin to the employer sponsored health plans you may have had in the past. While enrolled in a Medicare Advantage plan, you are still on Medicare, but now insurance company is responsible for delivering benefits at least as good as traditional Medicare. Important to note about these plans is that the benefits are almost always significantly enhanced from traditional Medicare. Often times, Medicare Advantage plans will cover prescriptions, hearing, vision, and dental coverage at no additional cost. Some Medicare Advantage plans even refund all or a portion of your Part B premium! Enroll in a Medicare Advantage Plan here, or view our Medicare Advantage Plans page here to learn more.
Part D Prescription Plans
Part D Plans help cover your prescription drug costs. Prescription drug plans under Medicare Part D are offered by private insurance plans, according to very specific governmental operating requirements to ensure they meet minimum standards.
These plans are available as a standalone plan, or you may enroll in a Medicare Advantage plan that has prescription drug coverage. Regardless of the option you choose, you will want to enroll in a Part D plan when you become eligible to ensure you are not penalized for late enrollment. For instance, your cost to participate in Part D will increase permanently if you do not enroll on-time.
Once you decide how you will participate in Part D, however, you will will want to pay particular attention to the copays, monthly premium, and whether your specific prescriptions will be covered by each plan you are considering. There will be differences in cost and covered medications, so be sure to have your Florida Medicare Advantage.com advisor compare Part D plans for you, or you may use our online Medicare Plan Finder here. For a more detailed explanation, visit our Medicare Part D page
Did you know?
You can change your Medicare Advantage plan at anytime if you are switching to a five star plan? Click Here for Details
