Florida Medicare questions, answered plainly

Nothing. Independent Medicare agents are paid by the insurance carriers when you enroll, so comparing plans, answering questions and reviewing your coverage each year is free to you. Your premium is the same whether you enroll through us, another agent or the carrier directly.

You get a Special Enrollment Period to choose a new plan and, because you lost coverage through no fault of your own, generally a guaranteed-issue right to buy a Medigap policy without health questions, usually within 63 days of the coverage ending. AvMed’s exit and UnitedHealthcare’s county cuts for 2026 both qualify. Call before the deadline on your notice.

No. Your six-month Medigap open enrollment at 65 is the guaranteed window, plus guaranteed-issue events such as a plan leaving your county. Outside those, Florida insurers can use medical underwriting. Because Florida requires issue-age rating, the policy you buy at 65 is also priced on that age for good, which is one more reason to buy early.

Florida requires insurers to set your premium by the age at which you buy and prohibits raising it because you got older. Premiums still rise with the carrier’s filed increases, which apply to everyone in the block. The rule rewards buying at 65 and holding on; someone who waits until 72 pays a 72-year-old’s rate for life.

Yes. Since 2009 Florida gives people under 65 on Medicare a six-month guaranteed-issue window when they enroll in Part B, and insurers must offer them at least one plan. Premiums for under-65 policies are higher. You get a fresh open enrollment for every plan at 65.

Both accept Original Medicare and therefore every Medigap policy. Each contracts with some Medicare Advantage plans and not others, and the list changes yearly. If Mayo, Moffitt, Cleveland Clinic Florida, Baptist Health or Tampa General is your care, we confirm the plan’s status in writing before you enroll.

Medicare Advantage and Part D plans are tied to your county of residence, so the move gives you a Special Enrollment Period to choose plans sold here. A Medigap policy from another state usually stays in force but may be re-rated for Florida. If you came from a state with continuous guaranteed issue, such as New York or Connecticut, know that Florida does not have it; see our New to Florida page.

A Medigap policy with Original Medicare works anywhere in the country that takes Medicare. Most Medicare Advantage plans cover only emergencies outside their service area, though a few PPOs have travel benefits. Choose based on where you actually see doctors; we look at both addresses.

Usually not. A FEMA-declared disaster opens a Special Enrollment Period for people who lived in a declared county, or who rely on someone who did, and missed a valid election period because of it. Part D plans must also allow early refills in the emergency area. Our Hurricanes page has the details.

Usually neither. TFL pays secondary to Medicare and its pharmacy is creditable Part D coverage. You do need Part B, and you must keep it. Our Veterans page covers the exceptions.

In most cases, yes. VA medical care is not creditable coverage for Part B, so delaying Part B adds a lifelong penalty, and VA care does not cover you at non-VA hospitals in an emergency. Many Florida veterans keep both.

Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Election Period is October 15 to December 7, and Medicare Advantage Open Enrollment runs January 1 to March 31. Moving to Florida, losing a plan, a disaster declaration, or qualifying for Medicaid or Extra Help each open a Special Enrollment Period.

Part B premium $202.90 a month, Part B deductible $283, Part A hospital deductible $1,736 per benefit period, Part D out-of-pocket cap $2,100, maximum Part D deductible $615. IRMAA surcharges begin at $109,000 of modified adjusted gross income for a single filer and $218,000 for a joint return, looking back two tax years. See our costs page for the full table.

Possibly. Florida’s Medicare Savings Programs (QMB, SLMB and QI) pay the Part B premium for people with limited income and resources, and QMB also covers Medicare’s deductibles and copays. Apply through ACCESS Florida at myaccessflorida.com; SHINE (1-800-963-5337) can help. Qualifying also enrolls you in Extra Help for Part D.

Florida’s Medicaid managed-care program for long-term services: nursing-facility care and the home- and community-based services that keep people out of one. Eligibility runs through DCF and the CARES assessment, and there is a waitlist for home-based care. Florida aligns its D-SNPs with these plans so one organization can coordinate Medicare and Medicaid.

SHINE (Serving Health Insurance Needs of Elders), Florida’s State Health Insurance Assistance Program, run by the Department of Elder Affairs through the Area Agencies on Aging: 1-800-963-5337. It is free and independent, and we point people to it.

No. We represent a number of insurance organizations and products in Florida, not all of them. For a complete list, use Medicare.gov, 1-800-MEDICARE or SHINE.

Ronilin Weidauer, licensed Florida insurance agent (NPN 19427652, FL License #W690636), which you can verify with the Florida Department of Financial Services or the NIPR. Darin Weidauer, the agency’s founder, gerontologist and Registered Social Security Analyst, writes the pages; Ronilin is who takes your call and handles your enrollment.

We work with Floridians statewide by phone and video, which is how most people prefer it across a state this long. If you are in Arizona for part of the year, our sister agency has offices in Mesa and Sun City.