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Medicare Advantage Plans Volusia County, FL

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A Guide to Medicare Advantage Plans For Volusia County FL Residents

Volusia County, with its blend of suburban tranquility and lakeside charm, offers an ideal setting for seniors in search of optimal healthcare solutions. Noted for its natural beauty and peaceful residential areas along Florida's northeastern region, Volusia County provides a unique context for exploring healthcare alternatives, especially Medicare Advantage Plans. These plans are valued for their flexibility, providing options beyond Original Medicare that can be tailored to accommodate the nuanced health needs and lifestyles characteristic of Volusia County's serene and varied environment.


Medicare Advantage Plans in Volusia County are provided by private insurers approved by Medicare, ensuring coverage that not only adheres to the foundational Medicare benefits but also includes additional services specifically tailored to meet the community's health demands. This might include wellness programs designed for suburban living, access to a broad network of healthcare providers experienced in managing conditions more prevalent in quieter, residential settings, and benefits that support a suburban lifestyle.


The sections that follow will delve into the details of Medicare Advantage Plans, focusing on their applicability to Volusia County residents. Whether you are approaching Medicare eligibility or considering transitioning to a plan that better reflects your lifestyle in this distinctive Floridian suburb, this guide aims to clarify your healthcare options, helping you navigate towards well-informed healthcare decisions in Volusia County's unique setting.

Where Are These Plans Available?

The Medicare Advantage Plans shown on this page are available in all areas of Volusia County, including:

Why Volusia County Residents Choose Medicare Advantage Plans

Volusia County's appeal, with its serene lakes and community-focused lifestyle, continues to attract retirees seeking a blend of suburban comfort and natural charm. This increasing population highlights the necessity for comprehensive healthcare coverage that adapts to the varied lifestyles of its residents. The presence of numerous Medicare-approved private insurers in Volusia County ensures that residents have a broad selection of healthcare plans at their disposal. These plans are not just comprehensive; they are designed to be flexible, catering to the specific health and lifestyle needs of those residing in this tranquil community.


This wide range of options allows for a more personalized healthcare experience, enabling Volusia County residents to choose plans that align most closely with their unique health objectives and lifestyle choices. The ability to customize healthcare coverage is crucial for enhancing the quality of life for retirees in Volusia County, affording them the opportunity to relish the city’s blend of community spirit and scenic beauty, all while maintaining confidence in their healthcare arrangements.

Holistic Health Coverage


Unlike Original Medicare, which primarily covers hospital and medical services, Medicare Advantage Plans often integrate additional benefits. This means Volusia 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 Volusia 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 Volusia 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 Volusia 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 Volusia County residents, some plans in Volusia 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 Volusia County residents should consider to make an informed decision.

Understanding How Medicare Advantage Plans Operate in Volusia 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 Volusia 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 Volusia County offer added benefits such as dental, vision, hearing, and wellness programs. Some also include prescription drug coverage, ensuring Volusia 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. Volusia 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, Volusia County residents can see any doctor or specialist they prefer, usually at a higher cost.


It's important to evaluate local healthcare providers in Volusia 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.



Volusia County's unique combination of suburban tranquility and scenic lakefront settings necessitates healthcare plans that address a broad spectrum of needs. For the city's residents, gaining a deep understanding of Medicare Advantage Plans is essential. This knowledge allows them to align their health priorities with the most appropriate coverage options. This insight is particularly critical in Volusia County, where the diversity of healthcare requirements reflects the community's blend of serene residential areas, rich natural environments, and relaxed lakeside living. Grasping the fundamental workings of Medicare Advantage Plans is key for Volusia County residents, enabling them to confidently choose health insurance plans that seamlessly align with their lifestyle against the city's backdrop of suburban calm and natural beauty.

2025 Medicare Advantage Plans In Volusia County, FL

Aetna

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Aetna Medicare FL Select H1609-059-0 HMO $0.00 $0.00 $3,300 Y Y
Aetna Medicare Eagle H5521-440-0 PPO $0.00 N/A $5,500 N Y
Aetna Medicare FL Explorer Premier H5521-434-0 PPO $0.00 $590.00 $4,150 Y Y
Aetna Medicare Premier H5521-269-0 PPO $0.00 $590.00 $4,900 Y Y

Cigna

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Cigna Preferred Medicare H5410-027-0 HMO $0.00 $0.00 $2,500 Y Y
Cigna Preferred Savings Medicare H5410-028-0 HMO $0.00 $0.00 $3,300 Y Y
Cigna Courage Medicare H5410-057-0 HMO $0.00 N/A $3,400 N Y

Florida Blue

Plan Name Plan Code Plan Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
FHCP Medicare Premier Advantage H1035-040 HMO $0.00 $0 $3,650 Yes Yes
FHCP Medicare Rx H1035-006 HMO $0.00 $295 $3,900 Yes Yes
FHCP Medicare Rx Savings H1035-014 HMO $0.00 $395 $8,300 Yes Yes
BlueMedicare Patriot H5434-044 PPO $0.00 $0 $5,500 No Yes
BlueMedicare Value H5434-031 PPO $0.00 $150 $4,900 Yes Yes
FHCP Medicare Rx Plus H1035-002 HMO-POS $49.00 $0 $3,400 Yes Yes
BlueMedicare Choice R3332-001 Regional PPO $67.40 $250 $6,500 Yes Yes
FHCP Medicare Rx Plus POS H1035-002 HMO-POS $119.00 $0 In-Network: $3,400; Out-of-Network: $8,000 Yes Yes

CarePlus

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
CareFree Platinum Giveback H1019-140-0 HMO $0.00 $0.00 $3,400 Y Y
CareAccess H1019-144-0 HMO $0.00 $0.00 $4,900 Y Y
CareSalute H1019-131-0 HMO $0.00 N/A $6,350 N Y

Devoted

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Devoted CORE Florida H1290-050-0 HMO $0.00 $590.00 $4,900 Y Y
Devoted EXTRA Florida H1290-057-0 HMO $0.00 $590.00 $4,900 Y Y
Devoted GIVEBACK Florida H1290-049-0 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 H5434-044-0 PPO $0.00 N/A $5,500 N Y
BlueMedicare Value H5434-031-0 PPO $0.00 $175.00 $5,100 Y Y
FHCP Medicare Premier Advantage H1035-040-0 HMO $0.00 $295.00 $5,100 Y Y
FHCP Medicare Rx Savings H1035-014-0 HMO $0.00 $590.00 $9,350 Y Y
FHCP Medicare Rx Plus H1035-002-0 HMO-POS $49.00 $0.00 $3,400 Y Y

Freedom Health

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Freedom Platinum Plan Rx H5427-089-0 HMO $0.00 $0.00 $2,000 Y Y
Freedom Medicare Plan Rx H5427-059-0 HMO $0.00 $0.00 $3,000 Y Y
Freedom Savings Plan H5427-052-0 HMO $0.00 N/A $3,400 N Y
Freedom Platinum Rewards Plan Rx H5427-102-0 HMO $0.00 $0.00 $3,400 Y Y

Humana

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Humana Gold Plus H1036-044-0 HMO $0.00 $0.00 $3,200 Y Y
Humana Gold Plus Giveback H1036-157-0 HMO $0.00 $0.00 $3,700 Y Y
Humana USAA Honor Giveback (HMO) H1036-290-0 HMO $0.00 N/A $6,700 N Y
Humana USAA Honor Giveback (PPO) H5216-257-0 PPO $0.00 N/A $6,000 N Y
Humana Full Access Giveback H5216-393-0 PPO $0.00 $0.00 $6,700 Y Y
HumanaChoice Florida H5216-070-0 PPO $0.00 $275.00 $6,750 Y Y
HumanaChoice Florida H7284-009-0 PPO $0.00 $350.00 $5,500 Y Y
HumanaChoice R5826-074 R5826-074-0 Regional PPO $23.00 $395.00 $7,550 Y Y
HumanaChoice R5826-018 R5826-018-0 Regional PPO $43.00 N/A $7,550 N Y
HumanaChoice R5826-005 R5826-005-0 Regional PPO $172.00 $100.00 $6,700 Y Y

Optimum Healthcare

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Optimum Gold Rewards Plan H5594-022-0 HMO $0.00 $0.00 $3,400 Y Y

Simply Healthcare

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Simply Freedom H9469-006-0 PPO $0.00 $150.00 $5,000 Y Y

United Healthcare

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
AARP Medicare Advantage Patriot No Rx H2406-130-0 PPO $0.00 N/A $7,900 N Y
AARP Medicare Advantage Patriot No Rx R0759-002-0 Regional PPO $0.00 N/A $7,900 N Y
AARP Medicare Advantage from UHC H1045-026-0 HMO-POS $0.00 $175.00 $3,200 Y Y
AARP Medicare Advantage from UHC H2406-013-0 PPO $0.00 $420.00 $5,900 Y Y
AARP Medicare Advantage from UHC R0759-001-0 Regional PPO $23.00 $570.00 $7,900 Y Y
AARP Medicare Advantage CareFlex H1045-067-0 HMO-POS $0.00 $495.00 $6,700 Y Y

WellCare Health Plans

Source: wellcare.com

Plan Name Plan Code Type Premium Deductible Out of Pocket Max Prescription Coverage Medical Coverage
Wellcare Simple H1032-194-0 HMO $0.00 $420.00 $2,600 Y Y
Wellcare Giveback H1032-193-0 HMO $0.00 $420.00 $5,000 Y Y
Wellcare Patriot Giveback H1032-239-0 HMO $0.00 N/A $4,500 N Y

Factors to Consider When Choosing a Medicare Advantage Plan in Volusia County, FL

As a Volusia 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


Volusia 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.

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 Volusia 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


Volusia 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 Volusia County residents. Look for local reviews, testimonials, or even community groups where you can gather firsthand feedback about different Medicare Advantage Plans.

Enrollment and Eligibility: Navigating Medicare Advantage Plans in Volusia County, FL

Transitioning to a Medicare Advantage Plan in Volusia 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 Volusia 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 Volusia 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 Volusia 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 Volusia 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 Volusia County. By understanding the enrollment process and eligibility criteria, you can embark on this journey confidently, ensuring peace of mind for your golden years.

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Frequently Asked Questions about Medicare Advantage Plans in Volusia County, FL

  • How do Medicare Advantage Plans differ from Medigap?

    Medicare Advantage Plans (Part C) are alternatives to Original Medicare, combining Part A and B and often offering added benefits. Medigap, on the other hand, is supplementary insurance sold by private companies to cover gaps in Original Medicare coverage, like deductibles and co-pays.

  • Can I have both a Medicare Advantage Plan and Medigap?

    No, you cannot. If you're enrolled in a Medicare Advantage Plan, it's illegal for anyone to sell you a Medigap policy unless you're switching back to an Original Medicare plan.

  • If I have a pre-existing condition, will Medicare Advantage Plans in Volusia County accept me?

    Yes. Medicare Advantage Plans can't refuse coverage based on any pre-existing conditions, except End-Stage Renal Disease (ESRD). However, there are specific Medicare Advantage Special Needs Plans available for those with ESRD.

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

    Absolutely. During the Medicare Advantage Open Enrollment Period (January 1st to March 31st), you can switch back to Original Medicare and also make one additional plan change.

  • Are prescription drugs covered in all Medicare Advantage Plans in Volusia County?

    Not always. While many plans do offer prescription drug coverage, some might not. Ensure you select a plan that meets your medication needs or consider a standalone prescription drug plan.

  • How are emergency services covered under these plans?

    Medicare Advantage Plans are required to cover emergency and urgently needed care even if the care is provided out of network and without a referral. Still, always review your plan details to understand potential out-of-pocket costs.

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