Updated October 29, 2021 | Reading time: 9 minutes
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You’ll have your pick of the litter in Florida —but how do you choose?
Nearly two million residents in the state of Florida use Medicare Advantage for their healthcare. More than 1,400 Medicare Advantage plans exist in the state, meaning the average Floridian will have access to more than a dozen options for their healthcare. With so many options available, choosing can be difficult.
This article will review Medicare Advantage basics, as well as lay the foundation for you to make the right choice for your healthcare. Let’s get started.
Saving money on Medicare Advantage is easy. Just use the Insurify Medicare comparison tool to find the right Medicare plan for you. Uncover options in your area at no cost to you. Try it today!
What Is the Best Medicare Advantage Plan in Florida?
The best Medicare Advantage plan in Florida ultimately depends on the enrollee—i.e., you. Your specific healthcare needs, preferences, and budget play an important role in finding the right Medicare plan. For example, a generous prescription drug formulary can be an advantage for many, but if your medications aren’t on that formulary, the plan won’t be advantageous to you.
That being said, we analyzed Medicare Advantage plans across the state and graded them based on a few factors, including:
Customer satisfaction
Comprehensiveness
Premium costs
Deductible costs
Out-of-pocket limits
Copay costs
Accessibility
Visit our ranking methodology page to learn more about how we rank the best Medicare Advantage plans in Florida.
This CareOne Plus plan offers a lot of value to its enrollees. You’ll find low-cost prescription co-pays, plus $0 copays to see a primary care doctor, specialist, or for preventative checkups. There’s also no copays for diagnostic procedures and lab services.
You also receive generous hearing, vision, and dental benefits for all routine care. And mental health service copays are all set at $0 per visit. Inpatient care at the hospital or in skilled nursing facilities also come with some of the lowest copays around. It’s no wonder this plan tops our list.
We should note that, depending on where you live, this plan may have slightly higher costs.
2. Leon Medicare
Insurify Composite Score: 78.01
Monthly Premium: $0
Annual Health Deductible: $0
Annual Prescription Deductible: $0
Out-of-pocket Spending Limit: $1,000
CMS Rating: 5 Stars
Counties: Miami-Dade
Not-to-be-missed is this plan’s low out-of-pocket threshold. It’s the lowest on the list, and as of this writing, in the state. At least for 5-star plans. And the low costs don’t stop there. You’ll also get some of the best copay rates for prescriptions, hearing, vision, and even comprehensive dental.
You also get $0 copays for primary care, preventive, and specialist visits. Plus $0 for mental health services visits to skilled nursing facilities. and for durable medical equipment. With wellness programs and several other low-cost services, it’s no wonder this plan takes second place.
3. HealthSun HealthAdvantage Plan
Insurify Composite Score: 78.01
Monthly Premium: $0
Annual Health Deductible: $0
Annual Prescription Deductible: $0
Out-of-pocket Spending Limit: $3,450
CMS Rating: 5 Stars
Counties: Miami-Dade, Broward, Palm Beach,
This highly-rated plan comes with many generous benefits, including prescription, hearing, dental, and vision coverage. All at a low cost. You’ll also get a $0 copay for mental health care, the first 20 days at a skilled nursing facility, and podiatry care.
What’s very useful is the coverage for doctor visits. Your primary care, specialist, and preventative visits have no copay. Lab services are covered too.
Just remember that prices do shift depending on your county.
4. CareOne Platinum
Insurify Composite Score: 78.01
Monthly Premium: $0
Annual Health Deductible: $0
Annual Prescription Deductible: $0
Out-of-pocket Spending Limit: $3,750
CMS Rating: 5 Stars
Counties: Indian River, Brevard, Hillsborough, Pasco, Pinellas, Lake, Osceola, Marion, Seminole, Orange, Sumter, Duval, Clay
This five-star plan offers a lot of low-cost benefits. However, you will find additional copays here that you wont in other CareOne plans. A major benefit of this plan is the access to out-of-network benefits. And seniors with certain health care needs or who just want added freedom, will prefer the flexibility this plan offers.
Just keep in mind that, for many services, going out-of-netowkr will cost your more. That being said, great in-network benefits abound. That includes low-cost doctor visits, prescriptions, and diagnostic procedures. You’ll also get great in-network coverage for hearing, dental, and vision care.
Keep in mind too that, depending on your county, costs may vary a little here and there.
5. CareOne
Insurify Composite Score: 78.01
Monthly Premium: $0
Annual Health Deductible: $0
Annual Prescription Deductible: $0
Out-of-pocket Spending Limit: $2,500
CMS Rating: 5 Stars
Counties: Broward, Brevard, Indian River, Duval, Clay, Palm Beach
Here’s another CareOne plan with generous coverage. Low-cost prescriptions, low-cost doctors visits, and low-cost visits to urgent care top the list of benefits. You’ll also get valuable coverage for dental,. hearing, vision, and mental health care.
That’s not all. $0 copays for physical rehabilitation, ground ambulance, podiatry, and diabetic are also a major plus. And you’ll get access to wellness benefits like a nursing hotline and fitness coverage.
Again, we should note that costs do vary depending on your county.
6. CareFree Plus
Insurify Composite Score: 78.01
Monthly Premium: $0
Annual Health Deductible: $0
Annual Prescription Deductible: $0
Out-of-pocket Spending Limit: $3,400
CMS Rating: 5 Stars
Counties: Miami-Dade
This Miami plan offers great benefits to its enrollees. You’ll get low-cost prescriptions,. and $0 visits for primary care, specialist, and preventive doctor visits.
But the CareFree Plus plan is missing a few bells and whistles that the CareOne plans offer. Mainly comprehensive routine care for hearing, dental, and vision needs. But for people who don’t plan on using those benefits for another several year, this plan can offer low-costs with little hassle.
7. CareFree
Insurify Composite Score: 78.00
Monthly Premium: $0
Annual Health Deductible: $0
Annual Prescription Deductible: $100
Out-of-pocket Spending Limit: $3,400
CMS Rating: 5 Stars
Counties: Polk. Pasco, Pinellas, Hillsborough, Volusia, Duval, Clay, Orange, Seminole, Sumter, Lake, Marion, Osceola, Broward, Palm Beach
Here’s a well-reviewed plan that’s available to many. Again, you won’t find as many low-cost copays. And you won’t find as many bells and whistles. But this low-frills plan might be right for the person looking for just the basics.
The good news is that, in addition to low-cost prescription coverage, you will find routine dental, hearing, and vision services. You’ll also get generous coverage for hearing aids. And you’ll have access to wellness programs including fitness benefits.
While this plan doesn’t offer the cheapest copays on the market, it’s still low cost and comes with a large network. You’ll get generous coverage for Teir 1 and Tier 2 medications. You’ll also get free preventative and primary care visits. Plus, specialists are only $15 a visit.
Plus most hearing, dental, and visions services have a $0 copay as well. That includes dental cleanings, fluoride treatments, extractions, and restorative dental services. That’s a rare find. You’ll also get inexpensive mental health services and access to wellness programs.
Do keep in mind that costs may be higher depending on your county.
How Much Does Medicare Advantage Cost in Florida?
The average annual cost for Medicare Advantage premiums is $924.25 with an average deductible of $245.53. This is a little higher than the national average. However, Medicare beneficiaries who choose one of the top plans pay less, sometimes a lot less. Though the average cost for Medicare Advantage plans in Florida is higher than the national average, the cost for top plans is lower than the national average!
All of the top plans offer free copays for general doctor visits, making the cost of preventive care low. You’ll also be happy to know that all top plans include fitness benefits like the Silver Sneakers Program.
Bear in mind that these costs are in addition to your premium for Medicare Parts A and B. You may qualify for premium-free Medicare Part A, but everyone must cover Part B unless they qualify for
To uncover which plan option is best for you, try the Insurify Medicare comparison tool. With just your ZIP code, you can uncover the best plans in your area. Adjust coverage options and compare plans side-by-side. It’s the easiest way to get great Medicare!
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What is Medicare Advantage?
Medicare Advantage plans, a.k.a. Medicare Part C plans, are Medicare health plans administered by a private health insurance company. Any Medicare Advantage plan must cover everything that Original Medicare (a.k.a. Medicare Part A and Part B ) covers. Many plans cover more than Original Medicare plans.
Medicare Advantage plans come with certain costs:
Monthly premiums
Deductibles
Co-payments
Coinsurance
Insurance companies enter into a Medicare contract with the federal government to offer these products to consumers.
What Are the 4 Types of Medicare Advantage Plans?
Medicare Advantage plans come in four types, arranged here from most to least common:
1. Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Private Fee-for-Service (PFFS)
Medical Savings Account (MSA)
With an HMO plan, you’ll have access to a network of healthcare providers —doctors, hospitals, therapists, etc. These providers have contracts with your insurance company, which often makes the cost of care less expensive.
The trade-off is that you’re limited by the size of your network. You won’t be covered (or will be covered less) if you go to an out-of- network provider in most cases. Additionally, you’ll need a referral to see a specialist. Most Medicare Advantage plans are HMOs in Florida.
With a PPO plan, you’ll have access to a wider group of healthcare providers both in and out of your plan’s network. Out-of-network care will be significantly more expensive than in-network care. Additionally, these plans tend to be more expensive than the more tightly managed HMOs. But the payoff is freedom: you don’t need a referral to see a specialist.
With a PFFS Medicare Advantage plan, you can see any doctor who accepts Medicare and agrees to your plan’s policies and procedures. Some PFFS plans come with networks, and some do not. Either way, you won’t have to choose a primary care physician, and you won’t need referrals.
There is a lot of freedom with PFFS plans, but there is also a lot of confusion. You’ll need to verify that you’re covered with every visit. Costs can also be a problem—you’ll pay both the Part B premium and the PFFS premium.
MSA Medicare Advantage plans are rare in Florida. MSA plans are (very) high- deductible Medicare plans where Medicare beneficiaries can draw from a medical savings account to pay for care. Like non-Medicare health savings accounts, the money in your MSA is used tax-free when spent on healthcare. Unlike non-Medicare health savings accounts, your MSA plan provider funds the savings account—you’re not allowed to add any money.
What Are Medicare Special Needs Plans?
Medicare Special Needs Plans (SNPs) are Medicare Advantage plans tailored for Medicare beneficiaries with health conditions. These plans make it easier and more affordable for people with certain health conditions to get insurance plans.
In addition to regular SNPs, there are Dual-Eligible Special Needs Plans (D-SNPs ). These are healthcare plans designed for beneficiaries with certain health conditions and low income. Eligibility is based on income and asset levels, plus a diagnosis with certain health conditions.
What Are the Advantages of Medicare Advantage Plans?
There are many common advantages to a Medicare Advantage plan. However, these advantages must be premised: there is a wide variety of plans available. Not every plan will offer the same benefits and advantages.
That being said, advantages you’ll likely find in plans near you include:
Lower out-of-pocket costs
Caps on out-of-pocket spending
Prescription drug coverage (a.k.a. Medicare Part D) included
Additional healthcare services covered
What Are the Disadvantages of Medicare Advantage Plans?
Due to the wide variety of Medicare Advantage plans, the disadvantages of such plans are not uniform. Different plans have differing degrees of disadvantages. Generally speaking, Medicare Advantage plans have the following disadvantages:
You’ll be limited to your plan’s network, or out-of-network services will be more expensive.
You’ll likely need a referral to see a specialist.
You cannot use a Medigap plan with a Medicare Advantage plan.
Your network is limited to a geographic service area and won’t travel with you when you leave.
FAQ: Florida Medicare Advantage Plans
Many Medicare Advantage plans include prescription drug coverage, but not all. While a plan that includes prescription drug coverage offers the advantage of convenience, it may not be the appropriate plan for you. When choosing your coverage, be sure to examine the plan’s formulary. Your medications should be included in that formulary at a favorable rate. For some people, a stand-alone prescription drug plan (PDP) may be the best way to get their medications covered.
Medicare Supplement Insurance, a.k.a. Medigap, is meant to cover some of the costs of an Original Medicare plan. It can cover co-pays, deductibles, and coinsurance, whether used for Medicare Part A coverage (i.e., Hospital Insurance) or Medicare Part B coverage (i.e., Medicare Insurance). However, Medigap cannot be used in tandem with Medicare coverage from a Medicare Advantage plan. You must choose one or the other.
The Silver Sneakers program is a wellness program designed to encourage and reward seniors who stay active. Enrollment in a Silver Sneakers program gives you access to some gym facilities free of charge. Some Medicare Advantage plans do include the Silver Sneakers program, but not all.
There are several well-reviewed providers of Medicare Advantage plans. Among them Cigna, UnitedHealthcare, CarePlus, and others. However, great reviews are only one part of the equation. You must take into account your needs, preferences, and budget. Healthcare is never one-size-fits-all.
You can enroll in Medicare Advantage during your Initial Enrollment Period, Fall Open Enrollment, or during a Special Enrollment Period. Your Initial Enrollment Period is when you first sign up for Medicare—typically beginning three months before the month of your 65th birthday and ending three months after the month of your 65th birthday. Fall Open Enrollment runs from October 15 to December 7 every year. A special enrollment period, on the other hand, is triggered by a specific event, such as moving out of your plan’s coverage area.
You can make changes to your Medicare Advantage plan twice a year. During the Fall Open Enrollment Period and Medicare Advantage Open Enrollment, you can switch plans or add prescription drug coverage. Fall Open Enrollment lasts from October 15 to December 7, while Medicare Advantage Open Enrollment lasts from January 1 to March 31 every year.
Conclusion: Compare Before You Buy
Florida has one of the most diverse Medicare markets in the country. If you’ve decided that a Medicare Advantage plan is right for you, you’re going to have options. That’s why we recommend doing some comparison shopping before you buy.
Begin with your needs, preferences, and budget. When comparing plans, be sure to note:
The plan’s monthly costs, costs for service, and out-of-pocket maximums,
Whether the plan includes additional coverage for prescriptions, vision, dental, or hearing,
Whether the plan’s prescription drug coverage (if included) covers your medications at a favorable rate, and
The size and accessibility of the plan’s network of providers.
With a clear picture of what you need and an understanding of the differences between your available plans, you can narrow down your options quickly. If you’re stuck between two similar plans, dig into customer reviews, website design, and customer service availability.
And of course, don’t forget to use our Medicare comparison tool to help you find the right plan at the right price. Uncover all your options with Insurify.
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Data scientists at Insurify analyzed more than 40 million real-time auto insurance rates from our partner providers across the United States to compile the car insurance quotes, statistics, and data visualizations displayed on this page. The car insurance data includes coverage analysis and details on drivers' vehicles, driving records, and demographic information. Quotes for Allstate, Farmers, GEICO, State Farm, and USAA are estimates based on Quadrant Information Service's database of auto insurance rates. With these insights, Insurify is able to offer drivers insight into how companies price their car insurance premiums.
JJ StarrInsurance Writer
J.J. Starr is a health and finance writer with a background in banking, lending, and financial advising. She holds a Series 6, FINRA, and life insurance licensure and a master's degree from New York University. Through her writing, she strives to use her decade of experience to help consumers make sound financial choices. Connect with J.J. on LinkedIn.
