Pros and Cons of FL Medicare Advantage Plans

Pros and Cons of FL Medicare Advantage Plans

There are both pros and cons of FL Medicare Advantage plans and our agents here at Florida Healthcare Insurance are happy to help you determine whether it matches your healthcare needs. Medicare Advantage plans have become increasingly popular over the years, especially in Florida, and we’ve compiled some helpful information on what you need to know before choosing your plan.

What is Medicare Advantage? Is it available in Florida?

Yes, with Medicare Advantage, you must use Florida healthcare providers within the plan’s network. With Original Medicare, you use Medicare-approved providers of your choice. First, let’s start with understanding what Medicare Advantage is. You may have heard it coined as Medicare Part C. It is a private, Medicare-approved health insurance plan designed for individuals who are registered for both Parts A&B of Original Medicare. It combines coverage for doctor visits, hospital care, and other medical services in one plan. This means rather than paying deductibles plus 20% (coinsurance) of your medical services, you will only be paying the plan’s copays. Every penny you spend on Part A and Part B services is contributed towards your out-of-pocket maximum. Once you hit that maximum, your Part C will pay 100% for the remaining year. Most plans also include a Florida Medicare Part D or prescription drug coverage. Let’s take a look at some of the pros of Medicare Advantage:

Pros and Cons of FL Medicare Advantage Plans

Pros of FL Medicare Advantage:

  • Costs are less than the Original Medicare 
  • Individuals can receive additional benefits offered by the plan like coverage for hearing, dental, vision, along with special discounts on certain health-related products and wellness programs.
  • You could be eligible for subsidies to help cover your prescription drug coverage and premiums!
  • Serves as a “one-stop” center for all your health and prescription drug coverage needs

Let’s take a look at how some Florida Medicare Advantage plans can fall short:

Cons of FL Medicare Advantage:

  • May limit your freedom of choice in Florida health care providers
  • Requirements for pre-authorization and staying in-network can be lengthy, which can be challenging for those with chronic conditions or severe health needs
  • Higher costs could arise for those facing serious illness
  • Individuals could pay more out of pocket for service until they reach the plan cap

The Bottom Line

Overall, Florida Medicare Advantage plans are best for healthy adults who prefer low premiums and are comfortable with managed care. MAPD plans have different rules, networks, and enrollment periods. Regardless of which plan you choose, remember you are always covered for urgent and emergency care. Most Florida Medicare Advantage plans include prescription medicine coverage, and benefits can differ from year to year, so it’s important to understand how a plan works before enrolling — which is why we’re here! We know how complicated the shopping process can be! We suggest speaking with one of our expert agents today to help see if a Florida Medicare Advantage plan is right for you!

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