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Florida Medicare Advantage Plans

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Medicare Advantage Plans Information

How can you selling something so cheaply?
Can I still see my own doctor?
How is it different from Medicare Supplements?
When can I enroll?
Which plan is right for me?

At Sun Coast Legacy Advisors we stand ready to help. Our agents are licensed brokers who can clarify the program's ambiguities and help you select a Medicare plan that offers the coverage you need.

What you need to recognize first is that Medicare is more than just one insurance program. It's actually divided into four parts:

- Part A offers hospital benefits and is administered by the federal government.

- Part B, also administered by the federal government, provides physician benefits. These include such things as doctor bills, medical services, and some supplies that hospital insurance doesn't cover.

- Part C, otherwise known as Medicare Advantage, deals with HMO and PPO kinds of insurance plans. These are administered by private insurance companies who have contracted with the federal government. Though not administered federally, these plans still come under federal oversight.

- Part D delivers prescription drug benefits through what are called PDP plans. Again, these are administered by private insurance companies.

Besides Medicare Parts A & B, which are federally administered, another healthcare coverage option is available to you: Medicare Part C, better known as Medicare Advantage plans. These are offered by private insurance companies that have contracted with the federal government. If you're considering a Medicare Advantage plan, take a look at us, Sun Coast Legacy Advisors, here in Central Florida. We can help you select the best Medicare Advantage plan to address your needs.  

Should you option a Medicare Advantage plan, healthcare benefits that would have been addressed by Medicare Part A and Part B will be paid by the insurance company offering the plan, instead of by the Federal Government. After you've signed up, you're eligible for all the coverage of traditional Medicare Parts A and B - as well as, quite often, "extras" such as gym membership, extra hospital days, and Part D prescription drug coverage. Some Medicare Advantage plans may also provide dental, vision, and hearing benefits as well.  

The specifications of the specific plan you select as well as your geographic location will determine if you have to pay a monthly premium for your Medicare Advantage Plan. Regardless of which plan you choose, you'll have to keep on paying your Medicare Part B premium, unless you qualify for extra help. Please understand that most Medicare Advantage plans make use of provider networks.  

If you'd like to learn more about how much of an advantage a Medicare Advantage plan might give you, contact Sun Coast Legacy Advisors. Our insurance agents are here for you!

Can I See My Own Physician if I Choose a Medicare Advantage Plan?

When Medicare Advantage (Medicare Part C) was created, the idea was to give seniors with multiple options when planning to manage their health care. Some seniors discovered that traditional Medicare (Medicare Part A and Part B) was not adequate to meet their healthcare needs. The various types of plans available through Medicare Advantage give different levels of flexibility for insureds to choose their own provider. While these plans provide more comprehensive services than traditional Medicare, clients are encouraged to visit any doctor or medical facility that accepts payment from Medicare under traditional Medicare.

Health Maintenance Organizations (HMO) and Preferred Provider organizations (PPO) are two sorts of policies you can buy under Medicare Advantage. To find out more about these plans, please visit "Which MA plan is right for me?". The care is referred to as “coordinated” because the plans developed around a network of doctors and medical facilities working together to administer your care. When a plan sets up a “network,” it signs agreements with healthcare providers to provide care to plan members. Each coordinated care plan sets up its own network. The client may have to choose specific doctors and hospitals. This differs from Original Medicare, which permits you to visit any doctor or medical facility that accepts payment from Medicare.

While under an HMO Medicare Advantage plan, you’re required to select a primary care doctor, and that doctor is required to be a member of that HMO’s network. However, with a PPO plan, you may not be required to choose a primary care physician and presumably don’t need to go through a primary care physician in order to see a specialist.

With almost all PPO Medicare Advantage plans, you can see doctors not in the network of doctors who’ve agreed to provide care to the members of a Medicare Advantage plan or Medicare Part D prescription drug plan. These doctors are called "network providers" and "network pharmacies.” When you visit a network provider or pharmacy, you won’t have to pay the entire cost on your own. In those cases, you’ll usually pay a larger share of the cost of your care at a non-network health care provider. For example, the policy could pay 90% of the cost for care received in-network, but only 60% of the cost for the same care provided out-of-network.

It’s critical to look over your Medicare options with a local professional insurance agent. Contact Sun Coast Legacy Advisors today. We can help you determine if the policy you’re looking at will provide the benefits you require from the medical professionals and hospitals you prefer. We’ll go over your options with you and find a suitable plan for your needs.

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