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As per the latest statistics revealed by the relevant authorities, there are around 4.3 million Medicare-related beneficiaries in the state of Florida. However, most of them also acquire their Medicare benefits via ‘Medicare Advantage’ plans.

Call us at 407-344-1228 for your FREE Medicare consultation, or email us at [email protected]  for any other insurance needs you may have.

A lot of these plans are offered by various private but Medicare-approved health insurance service providers. They deliver almost the same basket of benefits as Medicare Parts A and B (except for extended hospice care, which is still covered by Medicare Part A).

The typical ‘Medicare Advantage’ plan usually includes many extra benefits, including routine hearing and vision care, as well as prescription drug coverage (for specific drugs only). If you were to enroll in a particular Medicare Advantage Prescription Drug plan, then you will be able to get all of your Medicare benefits within one plan only. However, it is pertinent to note that with any Medicare Advantage plan, it is still mandatory to pay your monthly Part B premiums as well as the premiums of all other health insurance plans that you are availing at any given point in time.

Eligibility Requirements for Medicare in Florida

As a general rule, elderly patients who are at or over the age of 65 should be able to qualify for Medicare in Florida.This is due to the fact that this is a well-earned benefit that these people have already paid for, throughout their working lives.

Apart from the age criterion, there are also several other exceptions regarding Medicare eligibility for many younger, critically ill patients who might be suffering from ‘End-Stage Renal Disease’ or any other kind of disability, especially if it’s a disease due to which they cannot work anymore. The eligibility for Medicare benefits can be either for Medicare Part A or Part B. This is because these are the two types of benefits that are covered by Medicare in Florida.

As a general rule, hospital insurance is almost always associated with Medicare Part A while medical insurance is mostly related to Medicare Part B. Let us take a quick look at the following topics in order to understand if and how you can qualify for Medicare Parts A and/or Medicare Part B:

Medicare in Florida for People Under 65 Years of Age

In order to qualify for Medicare in the state of Florida, you should be at least 65 years old or above. However, there are various exceptions to this rule. In fact, many Medicare qualifications specifically state that disabled patients who are less than 65 years of age or who are already in the process of receiving Social Security Disability Insurance (SSDI) payments’ will automatically be deemed to be eligible for Medicare in Florida.

The cut off time period for such eligibility is centered around a minimum of 24 months of receiving these SSDI payments. This time limit is actually the two-year statuary waiting period that all patients must go through before they will automatically be enrolled for Medicare in Florida.In other words, such Medicare eligibility will be granted automatically on the 25th month of the receipt of an SSDI payment.

But there are exceptions to this rule as well. For example, anyone who is suffering from a disease known as Amyotrophic Lateral Sclerosis (ALS) won’t have to wait for 2 years before becoming eligible for Medicare in Florida.

Instead, all such unfortunate patients will have full Medicare eligibility and they will also start receiving their benefits from the very first month in which they get their initial SSDI payment. In such cases, it is the Social Security Administration (SSA) office that determines exactly who is qualified for such payments. This is why only those people who have paid enough taxes into their Social Security tax net will be able to avail such benefits.

Medicare in FloridaFor Patients Aged 65 And Above

Most people aged 65 and above automatically qualify for Medicare in the state of Florida. However, there are certain things to consider. In order to be considered eligible, the following situations must hold true for you.

  • First and foremost, Medicare is available for Americans only. In other words, the applicant must be a permanent legal resident of the US who has lived in the country for a minimum of 60 months, on a continuous basis.
  • It is imperative that the patient should be eligible for receiving various Social Security benefits from the US federal government.

All patients who meet both of the above stipulations will be able to qualify for Medicare in Florida.

Here, the total monthly Medicare premium will depend entirely on the total amount that has been paid in Medicare-related taxes throughout the patient’s working life. In a nutshell, the more taxes that have been paid by the patient, the smaller will be the premium amount for Medicare in the state of Florida.

However, this will only apply to Medicare Part B i.e. it will only cover medical insurance alone. The vast majority of individuals with Medicare eligibility will usually choose only Medicare Part A for hospital insurance alone. This is due to the fact that part A does not require any monthly premium payments.

Different Requirements for Medicare Florida

Other patients also have eligibility for Medicare facilities in Florida. These include children who are below the age of 20 and who are suffering from EndStage Renal Disease (ESRD).  However, it is important to point out that in order to qualify for Children’s Medicare, the parents or legal guardians of all of these young patients should also be either eligible for or receiving various Social Security benefits on their own.

This also includes individuals who are not American citizens. As long as they receiving Social Security benefits, they are eligible for Medicare coverage in the state of Florida. This holds particularly true for all those immigrants who work and pay their taxes in the US. If they have been doing so for at least 5 years and have paid enough taxes to Social Security, then they will be eligible for Medicare benefits, just like the United States citizen. Furthermore, these immigrants will be made to pay their monthly premiums on Medicare in Florida, at least as far as Part B is concerned, just like other American born citizens.

If you are eligible for Medicare benefits, then you will have to pay premiums based on your annual income level. Here’s what you should know.

  • If you are earning an amount less than $85,000 per year, then your total monthly premium will come to $134.
  • If you are earning between $85,000 and $107,000 then your monthly premium will be $187.50.
  • If your annual earnings are between $107,000 and $160,000 then your premium will come to $267.90.
  • If you earn between $160,000 and $214,000 then your monthly premium will come to $348.30.

The Importance of Medicare Advantage Plans

Many beneficiaries in the state of Florida typically get their Medicare benefits via their own individualized ‘Medicare Advantage’ plans. These plans are generally offered by private parties that include Medicare-approved health insurance companies.

Various Medicare Resources Available in Florida

A number of healthcare facilities and organizations offer Medicare facilities to eligible patients. Some of them include the following:

SHINE (Serving Health Insurance Needs of Elders)

SHINE is a health awareness program that has been designed for senior citizens by the Florida Department of Elder Affairs (FDEA). It is absolutely free for all (elderly) beneficiaries of the Florida Medicare program. Furthermore, it also provides answers and individual counseling sessions for all relevant Medicare questions courtesy highly trained counselors.

SHINE’s core mission is to help empower senior citizens residing in the state of Florida by helping them make well-informed healthcare choices

Florida Department of Elder Affairs (FDEA)

This is the main state level agency that actively administers various programs that are meant to benefit the geriatric population segment. This agency actively helps to promote the well-being of elderly patients. It also offers various health-related services, programs, reports, publications, and information regarding different health-related topics. Following are a few examples of the many different programs that are offered by the Florida Department of Elder Affairs:

  • Alzheimer’s Disease Initiative
  • The CCE program (Community Care for the Elderly)
  • Elder Helpline information and assistance service
  • Health and Wellness program


In light of the above, we can safely conclude that Medicare in Floridais absolutely vital for the elderly. Apart from that, Medicare insurance can also benefit critically ill younger patients as long as they or their parents have been paying their social security dues on time.

Call us at 407-344-1228 for your FREE Medicare consultation, or email us at [email protected]  for any other insurance needs you may have.

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