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Posted 01/11/2023 in Medicare Advantage

Medicare Insurance in Fort Lauderdale

Medicare Insurance in Fort Lauderdale

Medicare Insurance in Fort Lauderdale, Fl

If you live in the Fort Lauderdale area, we recommend working with a certified, licensed Medicare agent because choosing the wrong Medicare plan can be costly. Medicare agents can help you compare different options and costs. 

Find your local Medicare Agents in  Fort Lauderdale.

You can use the Medicare Certified Agent Directory to find your best Medicare agent. Click the drop-down menu on the website's home page and select Florida. Then, click Search Now. 

All about Medicare

Medicare is a health insurance program for adults aged 65 and older (or disabled people under 65). The program helps cover health care costs, providing affordable health care. But you should understand that Medicare doesn't cover everything. Original Medicare doesn't have the most out of your pocket. 

With Medicare, you have options for getting your insurance coverage. There are two main ways how to get covered by Medicare:

  • Original Medicare: Includes Medicare Part A and B
  • Medicare Advantage: A plan approved by a private company that offers an alternative to the original Medicare for your health and drug insurance. You'll still need Parts A and B, but you won't use them.  

The Four Parts of Medicare

You will enroll in these two parts with the Social Security Office or the Railroad Retirement Board. Medicare parts A and B are essential coverage. Private insurance companies offer Parts C and D. Eligible beneficiaries include:

  • People aged 65 and older.
  • Certain young people with disabilities.
  • People with end-stage renal disease (ESRD). 

Medicare Part A: 

Part A is also known as hospital insurance. Medicare Part A includes medical services, such as inpatient hospitalizations, care in qualified nursing facilities (SNFs), blood, home health care, and hospice care. 

Medicare Part B:

It covers the costs of doctors and other health care providers. Part B includes medical services, preventive services, outpatient hospitals, emergency services, and other medical services such as DME (durable medical devices), chemotherapy, radiation therapy, intermittent or partial home health care, and rehabilitation services.

Medicare Part C:

Part C is also called Medicare Advantage. They are an alternative to Original Medicare. It may also include additional benefits that original Medicare doesn't cover. Medicare Advantage plans include prescription drugs, hearing, vision, dental and fitness programs, meals after surgery, and more. 

Medicare Part D: 

Part D, or Prescription Drug Plan (PDP), was created by the federal government to reduce prescription drug retail costs, but private insurance companies offer these plans. 

Sometimes, original Medicare coverage isn't enough, and many seniors (and other eligible people) choose to sign up for Medicare Advantage or Part C which includes medications. There are several Medicare Advantage plans in the Fort Lauderdale area.

Types of Medicare Advantage Plans

Understanding all the differences is essential in choosing the plan best suits your unique needs and specific conditions. There are several Medicare Advantage plans with many different considerations. 

  • Health Maintenance Organization (HMO): HMO plans use a network of providers. For your insurance company to pay for a doctor's visit or other health care needs, you must use approved providers in your network. Exceptions include out-of-area emergencies, emergency or urgent care, and out-of-area dialysis. You'll need to review your plan's benefits to see if your drugs are covered. It's also best to ensure that your favorite doctor is in the network. You may have to pay the total cost of the services if you don't get a referral from your primary care doctor. 

  • Preferred Provider Organization (PPO) Plans: PPO members can use in-network and out-of-network providers for care, including hospitalizations. You will usually pay less when using in-network providers. If you leave the network, you may incur higher copayments or coinsurance costs and a higher maximum out-of-pocket amount. 

  • Special Needs Plans (SNPs): Special needs plans are for people with specific health needs, such as diabetes, end-stage renal disease, HIV/AIDS, chronic heart failure, and dementia. Special needs plans also offer Medicare prescription drug coverage that focuses on drugs used by those with the illness. To coordinate your health needs, you must choose a primary care provider or care coordinator. 

  • Private Fee-for-Service Plans: Private Fee-for-Service Plans offer Medicare benefits that can help cover out-of-pocket expenses not covered by Original Medicare. It does not require its members to see only in-network healthcare providers, but the provider must accept its terms each time you visit.

  • Medical Savings Account (MSA) Plans: Medical Savings Account or MSA is similar to Health Savings Account. 

  • HMO-POS (Point-of-Sale): HMO-POS covers the same features as an HMO plan. However, there is a big difference. HMO POS plans allow members to use healthcare providers (with their PCP's referral) outside the plan's network to take advantage of some or all of their services. 

How to choose the best Medicare Advantage Plan

If you've chosen a Medicare Advantage plan, you have to ask these questions before signing up:

  • Does the plan offer prescription drug coverage? Check and find out if your prescription drugs are covered. 
  • Are my current providers part of the network? Am I ready to switch providers if they are not part of the plan's network? You'll need to ensure that the plan's network covers your doctor and your favorite hospitals if you decide to change providers. 
  • Does the plan offer any additional benefits? Look for a program that provides all the "additional" benefits vital to you, such as dental care, hearing aids, and vision and gym memberships. 

Considerations to know when choosing a Medicare Advantage plan 

  • Decide which plan fits your budget. In addition to the monthly premium, remember to consider deductibles, copayments, and the maximum Out of Pocket. The maximum out-of-pocket protects you because this is the most money you'll spend on medical expenses during that calendar year.
  • Consider how often you seek medical help. Remember to schedule future care and that your needs may change over time. 
  • You also need to know what types of providers are near you. 

Another insurance that goes alongside your original Medicare Parts A and B is the Medicare Supplement Insurance or Medigap.

What do we mean by Medigap?

Original Medicare requires you to pay deductibles, copayments, and excess charges if doctors don't accept the assignment. With Orignal Medicare, you must pay deductibles and copayments unless insurance covers them.

Medigap insurance is a contract that helps cover gaps in your original Medicare. It helps support and cover cost-sharing, such as paying deductibles, copayments, and coinsurance. It is standardized, making it almost easy to compare prices between insurance companies that offer the same program. 

All Medigap plans also cover additional benefits for a 365-day inpatient stay beyond what Medicare offers. Exceeding your hospital stays is also rare.

Medigap Plans in Fort Lauderdale

Medigap Plan F:

Plan F is the most comprehensive Medigap plan. It covers 100% of services approved by Medicare. You don't have any copay or deductible for all Medicare-approved medical services. You can get a plan F if you obtained Medicare insurance (A or B) before January 1, 2020. 

Medigap Plan G:

Medigap Plan G is best for eligible new participants. It is a popular and comprehensive alternative to Plan F. It covers everything covered by Plan F, except for the Part B deductible. In 2022, the Part B deductible was $233; in 2023, it is $226. 

Medigap Plan N:

The Medigap N plan generally costs less than plans F and G

  • You will pay the Part B deductible (currently 233 USD in 2022 and 226 USD in 2023).
  • You will pay a $20 copay to see a medical provider.
  • If you need emergency care and are not immediately hospitalized, you'll have to pay $50.
  • Excess Doctor Fees: If your doctor doesn't accept "Medicare Assignment, you'll pay the 15% excess doctor charge.

It's important to note that most doctors in the U.S. currently do not charge excessive doctor fees, which could change. Excess Doctor Fees are 15% of the Medicare-approved rate, and there is no cap on these expenses.

Original Medicare doesn't pay for specific expenses, such as hearing aids, routine dental, vision and hearing tests, eyeglasses, contact lenses, prescription drugs, long-term care, or custodial care. If Medicare doesn't pay for it, your Medigap plan won't pay for it either. 

Why should you consider buying a Medicare supplement plan? 

There are several things to consider when signing up for a Medicare supplement plan: 

  • You can see any doctor in the United States who accepts Medicare. You won't need a referral, and there are no networks. 
  • Medicare supplement plans are standardized plans, so the options are less confusing.
  • An insurance company can't cancel your policy if you pay your premiums on time, even if you have health problems. 
  • Medicare supplement policies usually have a higher premium than Medicare Advantage plans, and premiums typically increase annually. 
  • You need a drug plan to avoid a lifetime penalty in the future, even if you're not taking any medications. 

How To Enroll In Medicare

For some, enrollment in Medicare is automatic, while for others, it may depend on when and how they are eligible. 

Here are the ways to sign up for Medicare Part A and Medicare Part B:

  • You can sign up by calling the National Social Security number 800 (1-800-772-1213) between 8:00 a.m. and 7:00 p.m., Monday through Friday. 
  • Enroll online at www.socialsecurity.gov.
  • You can also sign up by visiting your local Social Security office. 

If you worked on a railroad, you can enroll for Medicare by contacting the Railroad Retirement Board (RRB) at 1-877-772-5772 (TTY user 1-312-751-4701). They are open Monday to Friday from 9:00 a.m. to 3:30 p.m. to speak with an RRB representative. 

Medicare Enrollment Periods to Remember

  • Medicare General Enrollment Period - Let's say you didn't enroll during the Initial Enrollment Period (IEP) when you were first eligible. In this case, you can do so during the general registration period. The general enrollment deadline for Original Medicare is January 1 to March 31 of each year. 

Remember that you may have a penalty if you don't have "creditable coverage" and don't enroll when you first qualify. 

  • Medicare Special Enrollment Period - When you first qualify, you've already covered by a "creditable" group health insurance through an employer or union. In that case, you can choose not to enroll in Part B. You can sign up at any time (during a Special Enrollment Period) if you decide to switch from group insurance to Medicare or lose your group coverage. 

When your employment or group health insurance ends, whichever comes first, your eight-month Special Enrollment period begins. If you enroll during SEP, you usually won't have to pay the late enrollment fee. The Special Registration Period doesn't apply if you're eligible for Medicare because you have an ESRD. 

  • Medicare Advantage plan enrollment - You can sign up for a Medicare Advantage plan in two main registration periods, the first Election Period and the Annual Election Period. There are also "special election periods" where you can register. 
    1. Initial Coverage Election Period: Most beneficiaries are initially eligible to sign up for the Medicare Advantage plan during Initial Coverage Election Period. Unless you delay enrollment in Medicare Part B, this is also considered your initial enrollment period (IEP). 
    2. Annual Election Period: You can add, remove, or change your Medicare Advantage plan. The yearly Election Period runs from October 15 to December 7

  • Medicare Advantage Open Enrollment Period - The open enrollment period for Medicare Advantage is a limited annual enrollment period. It runs from January 1 to March 31 of each year. You must have a Medicare Advantage Plan to use this enrollment period, and insurance agents cannot market to you about it. During this time, you can: 
    1. Change or switch your Medicare Advantage plan if you already have a Medicare Advantage plan. 
    2. Cancel your Medicare Advantage plan subscription and return to your Original Medicare

  • Medicare Part D Enrollment Period - Your initial enrollment period for Part D coincides with your initial enrollment period for Medicare Part B. You can enroll in a stand-alone Medicare prescription drug plan during your initial enrollment period in Part D. You are eligible for prescription drug coverage if: 
    1. Your health insurance plan covers the place where you live.
    2. You have Medicare Part A or Part B. 

Let's say you don't sign up for prescription drug coverage when you first qualify for Part D. You may have to pay late enrollment fees if you apply for an exemption from prescription drug coverage that meets the requirements for 63 or more consecutive days. 

  • Annual Election Period for Medicare Part D - Let's say you didn't enroll for prescription drug coverage during the IEP. You can sign up for prescription drug coverage during the Annual Election Period (AEP). During AEP, you can:
    1. Drop a Medicare prescription drug plan.
    2. Enroll in a Medicare prescription drug plan.
    3. Change from a Medicare Advantage plan that doesn't include prescription drug coverage to a Medicare Advantage plan that does (and vice versa) 
    4. Enroll in a Medicare Advantage plan with prescription drug coverage.

  • Medicare Supplement insurance plans enrollment - The best time to enroll for Medicare supplement insurance (Medigap) is during the individual Medigap open enrollment period. It is valid for six months starting on the first day of the month you turn 65 and have Part B. This is because the insurance company cannot ask you any questions about your health during the Medigap enrollment period. 

You can sign up for a Medigap plan at any time. But, the insurance company doesn't have to accept you in their program if you have health problems and do not enroll during the enrollment period or any other "guaranteed Issue" period. 

Now that you have learned how Medicare works let us discuss how a Medicare agent can help you find the best Medicare plan in Fort Lauderdale that will suit your needs.

How does a licensed broker help you find the best Medicare plan options?

  • Medicare agents represent numerous insurance companies: Their resources are trusted. They can provide transparent options from several carriers if you choose the one that suits you best. They offer a variety of plans with recommendations. 
  • In-depth knowledge: There are numerous combinations of plans, benefits, rules, and exceptions that only Medicare agents can explain. They know how to help you get the best value for your money. Medicare brokers must pass several classes and exams each year. 
  • Brokers listen and understand your insurance coverage requirement: They study the market to find the right policy. An agent can save you money by comparing plans with all carriers.
  • Medical underwriting: If you buy Medicare supplemental insurance policy, Medicare brokers can help you determine if you meet insurance requirements. You won't waste time signing up for plans that exclude you based on your health status. 
  • They can also help you complete application forms and prepare applications for claims. You can request them to help you out with the enrollment and claims. You will answer the questions, and they'll take care of the rest.

Type of agent or broker that is right for you

  • Independent agent - When you work with a Reliable, independent Medicare insurance agent, you can choose from various policies.
  • Captive agent - These agents can only sell you plans from the insurance company they represent. Captive agents are usually experts in all the options offered by their organization. However, you can't get information about plans from other Medicare insurance companies. 

What are the advantages of working with an independent Medicare Agent?

Medicare has complicated terminology and complex enrollment deadlines, and many plans look similar. For this reason, working with a specialized insurance agent is essential. Here are several reasons why you need to work with one of our members who specialize in Medicare insurance: 

  • There is no additional charge to use one of our members: Your premium is the price you would have if you had purchased the policy directly from the insurers. Medicare agents are incentivized to maintain their relationship with you.
  • Advice: Licensed professional insurance brokers can guide you to ensure that you choose the best deal for your specific needs. Depending on your needs and budget, Medicare agents can help you decide what level of insurance coverage is best for you. They do it every day. Based on experience, they can advise you if you have any problems with choosing health insurance. When you contact a representative, they will offer you their services without you having to register. 
  • Time savings: Medicare agents help ensure you don't waste your time.
  • Choice of options: Trusted brokers generally know the options and can help you resolve them faster than you do on your own. 
  • Policy comparison: With the wide variety of insurance policies available on the market, choosing the best policy for your specific needs and current status can be confusing. The Medicare agent's job is to save you time comparing plans and making unbiased recommendations. 

Medicare brokers will help you narrow down your options when you apply for health insurance. They'll ask you about your health goals and offer options and solutions to help you achieve them within your budget. They get paid when they sign you up, so let your broker help you complete the application form! 

Do I need a Medicare agent near me? 

As long as the Medicare brokers in your state are licensed to sell Medicare, you don't need to work with a representative who lives nearby. A representative from another state provides the same service. However, it is often best to work with a local agent, as they may know more about local plans than national agencies. 

Even when you work with a local insurance agent, it's convenient to work with them over the phone or online. You don't have to travel to see an agent or make them come to your home. Thanks to our technology, you don't have to visit a local office to meet with an agent. 

Use our site, CertifiedMedicareAgents.com, to find your broker today!