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2024 Medicare Advantage Plans Palmetto, FL

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What is a Medicare Advantage Plan?

At its core, Medicare Advantage, often referred to as Part C, represents an alternative to Original Medicare (Parts A & B). While Original Medicare plans provide beneficiaries with coverage for hospital services and outpatient care, Medicare Advantage plans take a more comprehensive approach.


Offered by private insurance companies approved by Medicare, Florida Medicare Advantage Plans often include everything Original Medicare coverage offers and more. It can cover additional services such as vision, hearing, dental, and even wellness programs. Some plans might even offer prescription drug coverage, which under Original Medicare would require a separate Part D plan.


What distinguishes Medicare Advantage for Palmetto residents is the potential for localized service options and networks. These plans contract with local health care providers to create a network, which can influence where and from whom you receive care. This can be beneficial, especially if you prefer certain hospitals or doctors in the Palmetto, FL area.

Why Palmetto, FL Residents Should Consider Medicare Advantage Plans

Palmetto, often characterized by its vibrant communities, scenic waterfronts, and rich history, is home to a significant number of seniors and retirees. These residents not only value the city's aesthetic and cultural offerings but also the accessibility to quality healthcare. Here's why Medicare Advantage Plans are particularly beneficial for the Palmetto community.

Localized Benefits


With many Medicare Advantage providers focusing on specific regions, Palmetto residents can expect tailored plans that cater to the local community's unique health needs and preferences. This means more localized healthcare facilities, providers, and resources at their fingertips.

Accessible Healthcare Facilities


Palmetto boasts a selection of top-notch medical facilities. Collaborations between these facilities and Medicare Advantage providers can enhance the ease of access and coordination of care for beneficiaries.

Community Integration


Several Medicare Advantage Plans conduct health fairs, informational seminars, and wellness programs in collaboration with local Palmetto communities. This not only spreads awareness but also fosters a sense of community among beneficiaries.

Cost Efficiency


Given the competitive healthcare market in Palmetto, many Medicare Advantage providers offer attractive plans with competitive rates, making it more cost-effective for residents. Additionally, with an Advantage plan, you don't need any Medicare Supplement Plan.

Local Testimonials


Talk to your neighbors, friends, or family members in Palmetto, and you're likely to come across many who've had positive experiences with their Medicare Advantage Plans. Their stories can provide insights and assurance about the effectiveness and reliability of these plans in the local context.

The symbiotic relationship between Palmetto's healthcare infrastructure and Medicare Advantage providers ensures that residents receive care that's not just effective but also resonates with their local lifestyle and preferences.

How to Choose the Right Plan in Palmetto

Selecting a Medicare Advantage Plan amidst the plethora of options available in Palmetto can seem like navigating a labyrinth. However, by assessing your needs against the offerings of various plans, you can simplify the decision-making process. Here's a guide tailored for Palmetto residents.

Doctor and Hospital Preferences


Begin by identifying your favorite healthcare providers in the Palmetto area. Check if they're affiliated with the Medicare Advantage Plans you're eyeing. Certain plans may necessitate referrals for specialists, so if you regularly see a specialist, it's crucial to consider this.


Travel Considerations


If you're someone who frequently travels outside of Palmetto, or if you migrate seasonally, ensure your plan covers healthcare services outside of your primary region. Typically, PPO plans offer more leeway in this regard compared to HMO plans.


Prescription Drug Coverage


Every Medicare Advantage Plan doesn't necessarily cover prescription drugs. If you're on specific medications, ensure your plan not only covers these drugs but also check the cost associated with them. There are also standalone prescription drug plans available if your preferred advantage plan lacks prescription coverage.


Out-of-Pocket Costs


Delve into the financial structure of potential plans. This includes evaluating premiums, deductibles, and copayments. Some plans might lure you with a $0 premium but could have higher costs elsewhere.


Plan Types


Understand the difference between various plans like Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) Plans, and Special Needs Plans (SNPs). Choose the one that aligns best with your healthcare requirements and lifestyle.



Sarasota's unique blend of metropolitan amenities and laid-back coastal charm requires healthcare plans that cater to diverse needs. Understanding the underlying operations of Medicare Advantage Plans ensures residents can align their health priorities with the right coverage options.

FAQs about Medicare Advantage Plans in Palmetto, FL

  • What is the primary difference between Original Medicare and a Medicare Advantage Plan?

    Original Medicare covers hospital (Part A) and medical (Part B) services and is provided by the federal government. Medicare Advantage, or Part C, is offered by private companies approved by Medicare and often includes additional benefits like vision, dental, hearing, and prescription drug coverage.

  • Can I switch from Original Medicare to a Medicare Advantage Plan?

    Yes, during specific enrollment periods, you can make the switch. The most common is the Annual Enrollment Period (AEP) which runs from October 15th to December 7th each year.

  • Do I still pay for Part B if I choose a Medicare Advantage Plan in Palmetto?

    Yes, even if you enroll in a Medicare Advantage Plan, you'll continue to pay your Part B premium, in addition to any premium the plan might charge.

  • If I have a pre-existing condition, can I still get a Medicare Advantage Plan?

    Absolutely. Medicare Advantage Plans can't deny you coverage due to pre-existing conditions, except for end-stage renal disease (ESRD). However, there are specific Special Needs Plans (SNPs) available for people with ESRD

  • How do I find out if my doctor in Palmetto accepts a specific Medicare Advantage Plan?

    The best approach is direct—simply ask your healthcare provider. Alternatively, most Medicare Advantage Plans have an online directory of network providers you can search.

  • Is emergency care covered if I travel outside of Palmetto or Florida with my Medicare Advantage Plan?

    Yes, emergency care is covered regardless of where you are in the U.S. However, for non-emergency care, it's best to check your plan's details or contact your provider to understand the coverage while traveling.

2024 Medicare Advantage Plans In Palmetto, FL

Aetna

Plan Name Plan Code Type Premium Deductible Out Of Pocket Max Prescription Coverage Medical Coverage
Aetna Medicare Premier Plus H5521-272 PPO $0 $0 $5,100 Yes Yes
Aetna Medicare Eagle H5521-306 PPO $0 $0 $5,000 No Yes
Aetna Medicare Select H1609-025 HMO $0 $0 $2,900 Yes Yes
Aetna Medicare Value H1609-026 HMO $0 $0 $6,700 Yes Yes
Aetna Medicare Choice H1609-028 HMO-POS $0 $0 $7,700 Yes Yes
Aetna Medicare Assure Plus H1609-047 HMO D-SNP $36 $0 $3,850 Yes Yes
Aetna Medicare Premier H5521-033 PPO $0 $0 $6,700 Yes Yes
SilverScript Choice S5601-022 PDP $53 $545 $5,030 Yes No
SilverScript Plus S5601-023 PDP $102 $200 $5,030 Yes No
Aetna Medicare Explorer Premier H5521-438 PPO $0 $0 $4,700 Yes Yes
SilverScript SmartSaver S5601-186 PDP $13.30 $280 $5,030 Yes No

Alignment Health Plan

Plan Name Plan Code Plan Type Premium Deductible Out Of Pocket Max Prescription Coverage Medical Coverage
Alignment Health Platinum H9943-002 HMO-POS $0 $0 $2,100 Yes Yes
The One H9943-004 HMO D-SNP $15.40 $0 $8,300 Yes Yes
Alignment Health Heart & Diabetes H9943-003 HMO C-SNP $0 $0 $2,900 Yes Yes

Cigna

Plan Name Plan Cod Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Cigna Preferred Medicare (HMO) H5410-029 HMO $0 $0 $2,200 Yes Yes
Cigna Preferred Savings Medicare (HMO) H5410-030 HMO $0 $0 $2,700 Yes Yes
Cigna TotalCare Plus (HMO D-SNP) H5410-032 HMO D-SNP $27 $0 $1,500 Yes Yes
Cigna TotalCare (HMO D-SNP) H5410-046 HMO D-SNP $28 $0 $2,950 Yes Yes
Cigna True Choice Medicare (PPO) H7849-048 PPO $0 $0 $4,700 Yes Yes
Cigna Courage Medicare H5410-057 HMO $0 $0 $3,400 No Yes
Cigna True Choice Courage Medicare H7787-002 PPO $0 $0 $5,700 No Yes

Devoted

Source: devoted.com

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Devoted CORE Manatee (HMO) H1290-025 HMO $0 $0 $3,200 Yes Yes
Devoted ESSENTIALS Manatee (HMO) H1290-032 HMO $0 $0 $4,900 Yes Yes
Devoted CHOICE Manatee (PPO) H9884-007 PPO $0 $150 $4,900 Yes Yes
Devoted PREMIUM (HMO) H1290-044 HMO $16 $0 $3,400 Yes Yes

Florida Blue

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
BlueMedicare Patriot (PPO) H5434-042 PPO $0.00 $0 $5,500 No Yes
BlueMedicare Value (PPO) H5434-024 PPO $0.00 $0 $4,900 Yes Yes
BlueMedicare Premier (HMO) H1035-045 HMO $0.00 $0 $2,900 Yes Yes
BlueMedicare Complete (HMO D-SNP) H1035-032 HMO D-SNP $0.00 $0 $3,200 Yes Yes
BlueMedicare Classic (HMO) H1035-019 HMO $0.00 $0 $4,900 Yes Yes
BlueMedicare Choice (Regional PPO) R3332-001 Regional PPO $67.40 $0 $6,500 Yes Yes
BlueMedicare Select (PPO) H5434-002 PPO $97.70 $0 $5,900 Yes Yes

Humana

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Humana Gold Plus (HMO) H1036-265-002 HMO $0 $0 $3,300 Yes Yes
Humana Gold Plus (HMO) H1036-074 HMO $0 $0 $3,000 Yes Yes
HumanaChoice Florida (PPO) H5216-304 PPO $0 $0 $4,700 Yes Yes
HumanaChoice Florida (PPO) H5216-393 PPO $0 $0 $6,500 Yes Yes
HumanaChoice Florida (PPO) H5216-072 PPO $0 $0 $5,400 Yes Yes
Humana USAA Honor (HMO) H1036-119 HMO $0 $0 $3,900 No Yes
Humana USAA Honor (PPO) H5216-257 PPO $0 $0 $5,100 No Yes
Humana Fully Integrated (HMO D-SNP) H1036-280 HMO $0 $0 $0 Yes Yes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H1036-299 HMO $0 $0 $2,400 Yes Yes
Humana Gold Plus Lung (HMO C-SNP) H1036-312 HMO $0 $0 $2,400 Yes Yes
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) H1036-160 HMO $0 $0 $3,300.00 Yes Yes
HumanaChoice Florida (PPO) H5216-392 PPO $22 $0 $3,400.00 Yes Yes
HumanaChoice (Regional PPO) R5826-074 PPO $31 $1,300 $7,550 Yes Yes
Humana Gold Plus SNP-DE (HMO D-SNP) H1036-102 HMO $0.00 - $31.30 $0 $1,500.00 Yes Yes
Humana Gold Plus SNP-DE (HMO D-SNP) H1036-314 HMO $0.00 - $32.70 $0 $3,400.00 Yes Yes
HumanaChoice Florida SNP-DE (PPO D-SNP) H5216-394 PPO $0.00 - $37.70 $0 $5,000.00 Yes Yes
Humana Walmart Value Rx Plan (PDP) S5884-190 PDP $46.00 $0 N/A Yes No
HumanaChoice (Regional PPO) R5826-018 PPO $59.00 $1,300 $7,550.00 No Yes
Humana Basic Rx Plan (PDP) S5884-105 PDP $81.70 $545 N/A Yes No
Humana Premier Rx Plan (PDP) S5884-157 PDP $115.10 $0 N/A Yes No
HumanaChoice (Regional PPO) R5826-005 PPO $173.00 $750 $6,700.00 Yes Yes

Molina Healthcare

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Molina Medicare Choice Care H8130-010 HMO $0 $0 $8,300 Yes Yes
Molina Medicare Choice Care Select H8130-011 HMO $0 $0 $8,300 Yes Yes
Molina Medicare Complete Care Select H8130-009 HMO D-SNP $35 $233 $3,400 Yes Yes
Molina Medicare Complete Care H8130-001 HMO D-SNP $36 $0 $3,400 Yes Yes

Simply Healthcare

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Simply Freedom Extra H9469-004 PPO $0 $0 $6,400 Yes Yes
Simply Freedom H9469-007 PPO $0 $0 $5,000 Yes Yes

United Healthcare

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
AARP Medicare Advantage from UHC FL-0010 (HMO-POS) FL-0010 HMO-POS $0 $0 $2,900 Yes Yes
AARP Medicare Advantage from UHC FL-0006 (HMO-POS) FL-0006 HMO-POS $0 $0 $3,800 Yes Yes
AARP Medicare Advantage from UHC FL-0017 (PPO) FL-0017 PPO $0 $0 $4,900 Yes Yes
AARP Medicare Advantage from UHC FL-0031 (Regional PPO) FL-0031 Regional PPO $0 $0 $7,900 Yes Yes
AARP Medicare Advantage Patriot No Rx FL-MA01 (Regional PPO) FL-MA01 Regional PPO $0 $0 $7,500 No Yes

WellCare Health Plans

Source: wellcare.com

Plan name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Wellcare All Dual H1032-124 HMO D-SNP $34 $0 $8,300 Yes Yes
Wellcare Dual Liberty H1032-175 HMO D-SNP $0 $0 $8,850 Yes Yes
Wellcare Giveback H1032-198 HMO $0 $300 $5,000 Yes Yes
Wellcare No Premium H1032-199 HMO $0 $0 $2,900 Yes Yes
Wellcare No Premium Open H5199-012 PPO $0 $100 $3,400 Yes Yes
Wellcare Dual Access Open H5199-016 PPO D-SNP $0 $0 $8,850 Yes Yes
Wellcare Premium Enhanced Open H5199-010 PPO $93 $0 $3,500 Yes Yes
Wellcare Dual Reserve H1032-202 HMO D-SNP $37.70 $0 $1,500 0 Yes

Enrollment Process for Medicare Advantage in Palmetto, FL

Embarking on the Medicare Advantage enrollment process can seem overwhelming, but for Palmetto residents, this guide seeks to simplify each step.

Determine Eligibility


Before diving in, ensure you're eligible. Typically, if you're 65 or older, or if you're under 65 with certain disabilities, you qualify. You should also be enrolled in Medicare Part A and Part B.

Research Plans


Utilize resources like the official Medicare website to compare available Medicare Advantage Plans in Palmetto. Take note of benefits, provider networks, and costs.

Special Enrollment Periods (SEPs)


While many enroll during the Annual Enrollment Period (AEP), there are SEPs for specific situations, like if you've just moved to Palmetto or lost your current coverage. Familiarize yourself with these periods to take advantage of them if needed.

Seek Expert Guidance


Consider setting up a consultation with a local Medicare insurance agent or counselor in Palmetto. They can offer tailored insights, answer questions, and guide you through the enrollment nuances.

Verify Medications


If you take prescription medications, review the plan's formulary to ensure your drugs are covered and to understand the associated costs. Goodfriend Health Insurance Advisors can also assist with this using our prescription drug lookup form.

Enroll


Once you've chosen a plan, you can enroll directly through the insurance company, a licensed insurance agent, or using Medicare's online tools.

Review Annually


Healthcare needs and available plans can evolve. Palmetto residents are encouraged to review their Medicare Advantage Plan annually during the AEP to ensure it still aligns with their needs.

Important Dates To Remember


Annual Enrollment Period (AEP): October 15 to December 7.


Medicare Advantage Open Enrollment Period: January 1 to March 31. (For those who want to switch or drop their current Medicare Advantage Plan)


Initial Enrollment Period (IEP): This is the seven-month period when you're first eligible for Medicare, encompassing the three months before, the month of, and the three months after your 65th birthday.

Post-Enrollment


After enrolling, you'll receive a welcome packet and membership card from your Medicare Advantage provider. Ensure you understand all the information and utilize available resources, like customer service or member portals, to get the most out of your plan.

As you embark on this journey, remember that choosing a Medicare Advantage Plan is about securing your health and peace of mind. And while the process might have its complexities, the Palmetto community and available resources are here to support you every step of the way.

Local Resources and Support for Palmetto Residents

Understanding and navigating Medicare Advantage Plans can be a smoother experience with the right support. Fortunately, Palmetto, FL, is home to various local resources designed to help residents make informed decisions about their healthcare.

Senior Centers in Palmetto


Many local senior centers offer informational sessions on Medicare. They occasionally host guest speakers from insurance companies or health organizations to provide insights into Medicare Advantage.

Palmetto Health Clinics 


Some health clinics in the area, especially those specializing in senior health, have in-house consultants or collaborations with Medicare educators who can provide clarity on plans and benefits.

Medicare Workshops


Keep an eye out for workshops or seminars, which are often advertised in local newspapers or community bulletins. These events aim to demystify the complexities of Medicare and offer hands-on assistance.

State Health Insurance Assistance Program (SHIP)


SHIP offers free, localized health benefits counseling for Medicare beneficiaries. Palmetto residents can access Florida's SHIP for tailored assistance.

Goodfriend Health Insurance Advisors


If you're considering several plans or providers, a local insurance broker can be invaluable. They can compare various plans, considering your personal healthcare needs and financial situation, and guide you toward the best options. We have a 5 star rating and are proud to serve residents in all of Manatee County Florida with professional guidance to making the right individual choice. Schedule a consultation with us to get assistance!

Local Support Groups


Some community centers or churches in Palmetto host support groups for seniors where discussions about Medicare often arise. These peer-driven groups can offer insights based on personal experiences.

Online Community Forums


Palmetto-specific online forums or social media groups can be a platform to ask questions, share experiences, or gather recommendations regarding Medicare Advantage Plans.

Community Health Fairs


These events, typically hosted annually, offer a wealth of information on health and wellness. Insurance providers often have booths or representatives available to answer questions about Medicare Advantage.

While the maze of Medicare might seem intricate, the community and resources in Palmetto ensure that residents are never navigating it alone. By leveraging these local assets, seniors can empower themselves with the knowledge and confidence to choose the right Medicare Advantage Plan tailored to their unique needs.

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