Medicare Advantage Plans Duval County, FL
A Guide to Medicare Advantage Plans For Duval County FL Residents
Often referred to as Part C, they are an alternative to Original Medicare plans. They're offered by private insurance companies approved by Medicare and often come with added benefits, making them a compelling choice for many. In Duval County, with its bustling health scene and diverse needs, these plans can be particularly appealing, offering tailored health coverage options that resonate with local requirements.
In the upcoming sections, we'll delve deeper into the many facets of Advantage, ensuring that Duval County residents have a clear and comprehensive understanding of their choices. Whether you're just starting your Medicare journey or considering a switch, this guide aims to shed light on your options right here in Duval County, FL.
Where Are These Plans Available?
The Medicare Advantage Plans shown on this page are available in all areas of Duval County, including:
Why Duval County Residents Choose Medicare Advantage Plans
Holistic Health Coverage
Unlike Original Medicare, which primarily covers hospital and medical services, Medicare Advantage Plans often integrate additional benefits. This means Duval County residents can enjoy coverage for vision, hearing, dental, and even wellness programs – all under one plan.
Cost Efficiency
With Medicare Advantage Plans, there's often a cap on out-of-pocket costs. For budget-conscious retirees in Duval County, this provides an added layer of financial security, ensuring that unexpected health issues don't lead to overwhelming expenses.
Local Network Benefits
Many Medicare Advantage Plans have strong affiliations with Duval County's leading health providers and specialists. This ensures that members have access to top-tier healthcare services without venturing far from home.
Prescription Drug Coverage
A significant number of these plans come with built-in prescription drug coverage. Given the rising cost of prescription medications, this feature becomes a pivotal decision-making factor for many Duval County seniors.
Personalized Care Coordination
Several plans offer coordinated health services, ensuring seamless communication between your healthcare providers. This is particularly beneficial for those managing multiple health conditions, as it simplifies the healthcare journey.
Enhanced Lifestyle Benefits
Reflecting the active lifestyles of many Duval County residents, some plans in Duval County FL incorporate perks like gym memberships or wellness classes, further enhancing the quality of life in this beautiful Florida haven.
While the advantages are plentiful, it's essential to align them with individual needs. As we journey further, we'll provide insights into how these plans operate and factors Duval County residents should consider to make an informed decision.
Understanding How Medicare Advantage Plans Operate in Duval County, FL
Medicare Advantage Plans, at their core, are designed to provide a comprehensive healthcare solution. But how do they differ from Original Medicare, and what nuances should Duval County residents be aware of? Let's demystify these questions.
Structure of Medicare Advantage Plans
Medicare Advantage Plans are essentially an all-in-one alternative to Original Medicare. While Original Medicare segregates coverage into Part A (hospital insurance) and Part B (medical insurance), Medicare Advantage Plans, or Part C, rolls these services, along with often additional benefits, into one package.
Coverage Variance
Beyond the standard hospital and medical services, many plans in Duval County offer added benefits such as dental, vision, hearing, and wellness programs. Some also include prescription drug coverage, ensuring Duval County residents don’t have to enroll in a separate Part D plan.
Network Restrictions
HMO (Health Maintenance Organization): Requires members to use a network of doctors, unless in the case of emergencies. Duval County residents choosing this plan might need a referral to see a specialist.
PPO (Preferred Provider Organization): Offers more flexibility in choosing healthcare providers. While it encourages members to use its network of doctors, Duval County residents can see any doctor or specialist they prefer, usually at a higher cost.
It's important to evaluate local healthcare providers in Duval County Florida and their affiliations with these plan types to make the best choice.
Coverage Variance
With Medicare Advantage Plans, the premium might vary based on the coverage and the insurance provider. However, many plans offer premiums as low as $0, though members still need to pay the Part B premium.
Benefits Coordination
Medicare Advantage Plans are known for their cohesive health coordination. They often come with built-in care coordination services, ensuring that all your health needs – from general check-ups to specialized treatments – are streamlined and managed efficiently.
For residents, understanding how Medicare Advantage Plans operate is crucial to aligning their health priorities with coverage options that support their vibrant, active way of life.
2025 Medicare Advantage Plans In Duval County, FL
Aetna
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Aetna Medicare Eagle | H5521-347 | PPO | $0.00 | $0.00 | $5,500 | N | Y |
| Aetna Medicare FL Explorer Premier | H5521-434 | PPO | $0.00 | $0.00 | $4,150 | Y | Y |
| Aetna Medicare Premier | H5521-269 | PPO | $0.00 | $0.00 | $4,900 | Y | Y |
| Aetna Medicare Premier | H5521-033 | PPO | $0.00 | $0.00 | $6,750 | Y | Y |
| Aetna Medicare FL Select | H1609-021 | HMO | $0.00 | $0.00 | $3,300 | Y | Y |
| Aetna Medicare Choice | H1609-028 | HMO-POS | $0.00 | $0.00 | $5,900 | Y | Y |
CarePlus
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| CareOne Plus | H1019-113 | HMO | $0.00 | $0.00 | $3,500 | Y | Y |
| CareFree Platinum Giveback | H1019-094 | HMO | $0.00 | $0.00 | $3,900 | Y | Y |
| CareAccess | H1019-144 | HMO | $0.00 | $0.00 | $4,900 | Y | Y |
Cigna
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Cigna Preferred Medicare | H5410-043 | HMO | $0.00 | $0.00 | $3,200 | Y | Y |
| Cigna Courage Medicare | H5410-057 | HMO | $0.00 | $0.00 | $3,400 | N | Y |
| Cigna Preferred Savings Medicare | H5410-044 | HMO | $0.00 | $0.00 | $4,000 | Y | Y |
Devoted Healthcare
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Devoted CORE Florida | H1290-029 | HMO | $0.00 | $590.00 | $4,900 | Y | Y |
| Devoted SELECT Florida | H1290-044 | HMO | $0.00 | $590.00 | $4,900 | Y | Y |
| Devoted EXTRA Florida | H1290-059 | HMO | $0.00 | $590.00 | $4,900 | Y | Y |
| Devoted GIVEBACK Florida | H1290-031 | HMO | $0.00 | $590.00 | $6,750 | Y | Y |
Florida Blue
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| BlueMedicare Patriot | H5434-041 | PPO | $0.00 | $0.00 | $5,500 | N | Y |
| BlueMedicare Value | H5434-031 | PPO | $0.00 | $175.00 | $5,100 | Y | Y |
| BlueMedicare Select | H5434-002 | PPO | $112.90 | $290.00 | $5,900 | Y | Y |
| BlueMedicare Premier | H1035-033 | HMO | $0.00 | $0.00 | $3,500 | Y | Y |
| BlueMedicare Classic | H1035-019 | HMO | $0.00 | $0.00 | $5,500 | Y | Y |
Gold Kidney
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Gold Advantage | H1526-005 | HMO-POS | $0.00 | $0.00 | $2,900 | Y | Y |
| Gold Loyalty | H1526-006 | HMO-POS | $0.00 | $0.00 | $5,500 | N | Y |
Humana
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Humana Gold Plus H1036-068 | H1036-068 | HMO | $0.00 | $0.00 | $3,300 | Y | Y |
| Humana Gold Plus Giveback H1036-270 | H1036-270 | HMO | $0.00 | $0.00 | $3,900 | Y | Y |
| Humana USAA Honor Giveback (HMO) | H1036-290 | HMO | $0.00 | $0.00 | $6,700 | N | Y |
| Humana USAA Honor Giveback (PPO) | H5216-257 | PPO | $0.00 | $0.00 | $6,000 | N | Y |
| HumanaChoice Florida H5216-070 | H5216-070 | PPO | $0.00 | $275.00 | $6,750 | Y | Y |
| Humana Full Access Giveback H5216-393 | H5216-393 | PPO | $0.00 | $0.00 | $6,700 | Y | Y |
| HumanaChoice Florida H7284-009 | H7284-009 | PPO | $0.00 | $350.00 | $5,500 | Y | Y |
| HumanaChoice R5826-074 | R5826-074 | Regional PPO | $23.00 | $395.00 | $7,550 | Y | Y |
| HumanaChoice R5826-018 | R5826-018 | Regional PPO | $43.00 | $0.00 | $7,550 | N | Y |
| HumanaChoice R5826-005 | R5826-005 | Regional PPO | $172.00 | $100.00 | $6,700 | Y | Y |
Simply Healthcare
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Simply Freedom | H9469-003 | PPO | $0.00 | $150.00 | $6,800 | Y | Y |
| Simply More | H5471-110 | HMO | $0.00 | $0.00 | $3,450 | Y | Y |
| Simply Extra | H5471-112 | HMO | $0.00 | $0.00 | $3,450 | Y | Y |
United Healthcare
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| AARP Medicare Advantage from UHC FL-0005 | H1045-026 | HMO-POS | $0.00 | $175.00 | $3,200 | Y | Y |
| AARP Medicare Advantage CareFlex from UHC FL-37 | H1045-067 | HMO-POS | $0.00 | $495.00 | $6,700 | Y | Y |
| AARP Medicare Advantage Patriot No Rx FL-MA2 | H2406-130 | PPO | $0.00 | $0.00 | $7,900 | N | Y |
| AARP Medicare Advantage Patriot No Rx FL-MA01 | R0759-002 | Regional PPO | $0.00 | $0.00 | $7,900 | N | Y |
| AARP Medicare Advantage from UHC FL-0021 | H2406-013 | PPO | $0.00 | $420.00 | $5,900 | Y | Y |
| AARP Medicare Advantage from UHC FL-0031 | R0759-001 | Regional PPO | $23.00 | $570.00 | $7,900 | Y | Y |
Wellcare
| Plan Name | Plan Code | Type | Premium | Deductible | Out of Pocket Max | Prescription Coverage | Medical Coverage |
|---|---|---|---|---|---|---|---|
| Wellcare Patriot Giveback | H1032-238 | HMO | $0.00 | $0.00 | $6,000 | N | Y |
| Wellcare Simple | H1032-205 | HMO | $0.00 | $420.00 | $2,500 | Y | Y |
| Wellcare Giveback | H1032-204 | HMO | $0.00 | $420.00 | $5,000 | Y | Y |
Factors to Consider When Choosing a Medicare Advantage Plan in Duval County, FL
As a Duval County resident, you’re blessed with a plethora of choices for healthcare plans to ensure your well-being. When it comes to selecting the right plan, several local factors can influence your decision. Let’s delve into these nuances to help you make an informed choice.
Local Healthcare Providers and Affiliations
Duval County is home to a myriad of world-class healthcare facilities. Before committing to a plan, research which local hospitals, clinics, and doctors are affiliated with your chosen Medicare Advantage Plan. This ensures you receive top-quality care without compromising on convenience.
Duval County-Specific Health Trends
Certain health conditions might be more prevalent in Duval County due to its climate, lifestyle, or demographics. Assessing any such local health trends can help you prioritize certain coverages or benefits within your plan.
Cost and Budget
While many plans might boast a $0 premium, always consider the potential out-of-pocket expenses. These can include deductibles, co-pays, and co-insurance. Factor in your expected health needs and any current conditions to gauge potential costs accurately.
Plan Type and Flexibility
Do you often travel outside Duval County or even out of state? Then a PPO, with its flexible provider choices, might be more suitable than an HMO, which could restrict you to local networks except in emergencies.
Additional Benefits
Duval County’s active lifestyle might make plans with added wellness benefits, like fitness memberships or health classes, more appealing. Additionally, consider if you need extras like dental, vision, or hearing coverage, which aren’t part of Original Medicare.
Pharmacy and Prescription Needs
Some Medicare Advantage Plans might have affiliations with specific pharmacies or offer mail-order prescription services. Given the importance of timely medication, especially for seniors, this is a crucial factor to weigh in.
Customer Service and Reviews
Nothing speaks louder than the experience of fellow Duval County residents. Look for local reviews, testimonials, or even community groups where you can gather firsthand feedback about different Medicare Advantage Plans.
Duval County offers a delightful backdrop for retirement. And, with the right Medicare Advantage Plan in place, you can ensure that your healthcare experience is just as enriching.
Enrollment and Eligibility: Navigating Medicare Advantage Plans in Duval County, FL
Transitioning to a Medicare Advantage Plan in Duval County doesn't have to be overwhelming. The key is understanding when and how to enroll, along with the necessary eligibility criteria. Here’s a streamlined guide to help Duval County residents navigate this process with ease.
Eligibility Requirements For Medicare Beneficiaries
Age: Typically, eligibility starts at age 65, but some individuals might qualify earlier due to specific disabilities or conditions.
Residency: You must reside in the service area of the plan you wish to join. For our focus, that would be Duval County, FL or its immediate vicinity.
Existing Medicare:
You should already be enrolled in Medicare Part A and Part B.
Initial Enrollment Period (IEP)
This is your first opportunity to enroll in a Medicare Advantage Plan. It begins three months before the month you turn 65 and extends three months after your birthday month. For instance, if you turn 65 in April, your IEP runs from January to July.
Annual Election Period (AEP)
Occurring from October 15th to December 7th each year, this is the time when you can change from Original Medicare to an Advantage Plan, switch between Medicare Advantage Plans, or revert to Original Medicare..
Medicare Advantage Open Enrollment
From January 1st to March 31st, individuals already in a Medicare Advantage Plan can switch to a different one or go back to Original Medicare.
Special Enrollment Periods (SEPs)
SEPs are circumstantial windows outside the regular enrollment periods when Duval County residents can make changes to their Medicare Advantage Plans. Events like relocating outside your plan's service area, losing current coverage, or your plan leaving the Medicare program can trigger an SEP.
Late Enrollment Penalties
It’s vital to enroll during your Initial Enrollment Period unless you have qualifying health coverage elsewhere. Delaying can result in higher premiums for Medicare Part B and potentially for your Medicare Advantage Plan, depending on its structure.
Switching Between Plans
If you're already in a Medicare Advantage Plan in Duval County but wish to switch, it's best to join the new plan directly. This will automatically end your old plan and start the new one.
Choosing the right Medicare Advantage Plan is an essential step towards securing your health and well-being in Duval County. By understanding the enrollment process and eligibility criteria, you can embark on this journey confidently, ensuring peace of mind for your golden years.