Medicare Plans & Guidance in Florida
Medicare is an important part of retirement and disability planning, but the rules and options can be complex: Parts A, B, C, D, supplements, enrollment periods, penalties, and provider networks. This page is designed as a clear starting point for Florida residents who want to understand their options and compare plans with licensed help.
Who This Page Is For
This Medicare information is useful for individuals turning 65 who are preparing for their first Medicare enrollment and want to understand timelines and choices. It also serves Florida residents who are already enrolled in Medicare and are considering a coverage review during an enrollment period. In addition, individuals under 65 who qualify for Medicare due to disability may find this information useful as they navigate their options. Adult children and caregivers who are helping a parent or loved one with Medicare decisions can also use this page to get oriented before discussing specific plans.
Whether the priority is lowering overall medical costs, keeping trusted doctors and specialists, or exploring extra benefits, having clear information and side-by-side comparisons makes it easier to choose a path that fits real-life needs.
When can I change my plan?
For most people on Medicare, the real power comes once a year, during a window known as the Annual Enrollment Period (AEP). This is the main time when beneficiaries can take a fresh look at their coverage and decide whether their current plan still fits their health needs and budget.
The Annual Enrollment Period runs every year from October 15 to December 7. During those weeks, people with Medicare can switch from Original Medicare to a Medicare Advantage plan, move from one Medicare Advantage plan to another, or return from Medicare Advantage to Original Medicare and enroll in a stand-alone Part D prescription drug plan. It is also the time when many people adjust their Part D drug coverage if their medications, premiums, or pharmacy preferences have changed.
Changes made during the Annual Enrollment Period do not take effect right away. Instead, any new coverage chosen during this window typically begins on January 1 of the following year. That timing makes the fall a key moment to look ahead: beneficiaries are weighing next year’s premiums, drug formularies, and networks before they arrive.
Outside of the Annual Enrollment Period, options to change coverage are more limited. Some people qualify for a Special Enrollment Period if they move, lose certain coverage, become eligible for Extra Help, or experience another qualifying life event. In those situations, they may be able to change Medicare Advantage or Part D plans outside the normal fall window. For everyone else, the Annual Enrollment Period remains the main opportunity each year to review coverage and make a change.
Medicare in Plain Language
Medicare Part A, often called Hospital Insurance, helps cover inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health services.
Medicare Part B, or Medical Insurance, helps cover doctor visits, outpatient care, lab work, preventive services, and certain types of medical equipment.
Together, Parts A and B are known as Original Medicare. Original Medicare is administered by the federal government and generally allows access to any doctor or facility that accepts Medicare. It does not include a built-in annual maximum on out-of-pocket costs, and it does not typically cover routine dental, vision, or hearing services.
Medicare Advantage, also called Part C, consists of plans offered by private insurance companies that are approved by Medicare. These plans combine Part A and Part B coverage and often include prescription drug coverage as well. Many Medicare Advantage plans also offer extra benefits such as routine dental, vision, hearing, fitness programs, and over-the-counter (OTC) allowances. These plans usually rely on networks of doctors and hospitals and include an annual maximum on out-of-pocket spending.
Medicare Part D focuses on prescription drug coverage. Some people enroll in stand-alone Part D plans to pair with Original Medicare. Others choose Medicare Advantage plans that include Part D drug coverage as part of the same policy. Plan design affects the monthly premium, the deductible, the copay or coinsurance amounts, and which medications are covered on the plan’s formulary.
Medicare Supplement policies, often called Medigap plans, are offered by private insurance companies and are designed to help pay some of the costs that Original Medicare does not cover. This can include certain deductibles, copayments, and coinsurance. Medigap plans work alongside Original Medicare, not with Medicare Advantage plans.
The most suitable combination of these options depends on several factors, including current health conditions, prescription medications, preferred doctors and hospitals, travel patterns, and budget.
What To Expect From a Medicare Review
A typical Medicare review with us includes:
1. Eligibility & Location Check
Confirm current Medicare status (new to Medicare, already enrolled, or qualifying through disability)
Identify plans available in the individual’s county and ZIP code
2. Doctors & Facilities Review
List primary care providers, specialists, and preferred hospitals
Check which plans list these providers in-network (when applicable)
3. Prescription Drug Analysis
Review current medications and preferred pharmacies
Estimate potential drug costs under different plan designs
4. Plan Comparison
Narrow down options to a short list of plans
Compare:
Monthly premiums
Copays and coinsurance
Deductibles
Annual out-of-pocket limits
Extra benefits (dental, vision, hearing, fitness, OTC, etc.)
5. Decision & Enrollment Support
If a plan is selected, a licensed agent can assist with the application and enrollment process
If no plan feels suitable, there is no requirement to enroll through us.
The review is educational and consultative in nature, with an emphasis on helping each Medicare-eligible individual understand available options.
Ready for a Medicare Review?
By submitting your information, you agree that a licensed agent from North Summit Insurance may contact you by phone, text, or email about Medicare plan options. You are under no obligation to enroll in a plan.
Important Notices and Disclaimers
North Summit Insurance is an independent insurance agency. North Summit Insurance and its licensed agents are not connected with or endorsed by the U.S. government or the federal Medicare program.
North Summit Insurance and its agents may not offer every plan available in every area. Any information provided is limited to the plans that are offered by the agency in the client’s area. For information on all options, individuals can visit the official Medicare website at Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or contact the State Health Insurance Assistance Program (SHIP).
The purpose of this information is the solicitation of insurance. By calling the phone number listed on this page or submitting a contact form, a licensed insurance agent or producer may contact the individual to discuss Medicare Advantage, Medicare Supplement, or Medicare Part D prescription drug plan options.
Specific wording and additional disclosures may be required by individual insurance carriers or regulatory bodies. North Summit Insurance updates this page periodically to align with current guidelines, and the most current compliance requirements are also reflected in plan-specific materials and enrollment documents.