Florida residents pay an average of $515 a month for health insurance. This is too expensive for some residents, especially in a state that has a high number of retirees. Fortunately, there is the federally-funded Florida Medicare insurance program that offers health insurance coverage for individuals who are older than 65. This program also provides health coverage for those with disabilities.
Medicare is made up of 2 parts, which are called Medicare Part A and Part B. Medicare Part A normally does not require a monthly premium payment, although in some cases this is required. It may also come with deductibles and coinsurance payments. Medicare Part A covers the cost of inpatient care and other hospital services.
Medicare Part B covers medical treatments and supplies, and typically requires monthly premiums. It also has deductibles and copayments. Together with Medicare Part A, the combined coverage is also known as Original Medicare.
Residents of Florida may obtain additional coverage through private health insurance carriers. These will require premiums in addition to the premiums for Medicare Part B, although the cost will depend on which carrier the health insurance plan comes from.
One of these plans is known as the Medicare Advantage Plan. This plan offers coverage that is the same as the coverage offered by both Medicare Part A and Part B. However, the plan may also cover other medical services that are not covered by Original Medicare. These are also known as Medicare Part C.
Another option is to purchase Medicare Part D coverage, which helps pay for the cost of prescription drugs. This plan can be combined with Medicare Part A and Part B to provide a more comprehensive coverage for beneficiaries.
Even Medicare expenses may be too expensive for some residents of Florida. Those whose incomes are within certain limits may qualify for a Medicare Savings Program (MSP), depending on their income.
The Qualified Medicare Beneficiary (QMB) program is for individuals who earn less than $1,025 a month. Those who live with their spouses can also qualify if their combined monthly income is no greater than $1,374. QMBs receive financial assistance to help pay for the premiums of both Medicare Parts A and B, as well as deductibles and copayments.
The next program is for Specified Low-Income Medicare Beneficiaries (SLMB), who can have their premiums for their Medicare Part B covered. Those who are eligible for this program must earn no more than $1,226 a month, while married couples may qualify with a combined monthly income of less than $1,644.
The program for Qualified Individuals (QI) may also cover the premiums for Medicare Part B. This comes with a monthly income ceiling of $1,377. Those who are living with their spouse can also qualify with a combined monthly income of $1,847 a month. While the benefit is the same as for the SLMBs, the QI program may have limited funding. QIs receive benefits on a “first come, first served” basis.
Medicare Part A premiums may be covered for Qualified Disabled and Working Individuals, should their monthly income not exceed $4,105. With married couples, the combined monthly income limit is $5,449.
The Extra Help program also exists to provide low-income subsidies to cover prescription drugs for qualified individuals. These individuals must earn no more than $18,090 per year, while their resources (such as savings, stocks, and bonds) should not total more than $13,820. Married couples can qualify with an annual income that does not exceed $24,360 while their combined resources should total no more than $27,600.
These figures are for 2017, and they tend to increase slightly every year. It is advisable that you apply for any of these programs if your income is only slightly higher than the stated ceilings.
It is required by federal law that all states must have a program that offers counseling regarding Medicare rules and services. This is the State Health Insurance Assistance Program (SHIP), but in Florida, this is known as the Serving Health Insurance Needs of Elders, or SHINE.
SHINE offers unbiased advice regarding Medicare options and rules for Medicare beneficiaries and applicants in the state of Florida. These include one-on-one counseling sessions, and the sessions are completely confidential.