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We serve members through many different plans, including Florida Blue’s Medicare Advantage members. This gives you the opportunity to see more patients and to provide much-needed dental care to seniors. If you participate in our BlueDental Choice Copayment network, you are in-network for Medicare Advantage. See the FAQs below for more information. Frequently Asked QuestionsIf you participate in our BlueDental Choice Copayment (PPO) network, you are considered an in-network provider for Florida Blue’s Medicare Advantage members. These members have a Medicare HMO or PPO medical plan, with embedded dental PPO. Members will present to your office with a Florida Blue BlueMedicare HMO or PPO Medicare Advantage ID card. To verify benefits, please refer to MyPatientsBenefits or contact Customer Service at 866-445-5148. You can find samples of the benefit plans and member ID cards in our Dental Manual. If a service isn’t covered by a member’s Medicare Advantage benefit plan, you are required by law to inform members in writing and in advance of treatment, outlining their financial responsibility. Reimbursement is paid according to the BlueDental Choice Copayment PPO schedule of allowances, which you can find in the Fee Schedules. If you have opted out of participation with Medicare, you are prohibited from providing services to Medicare members. If you provide services, you will not be reimbursed by Florida Combined Life. In addition, you are required by law to inform members in writing, and in advance of treatment, that you do not participate and they will be responsible for all charges. Yes, we require all providers who participate with Medicare Advantage to complete fraud, waste and abuse training annually. This training is provided by the Centers for Medicare & Medicaid Services (CMS); to access it:
Once you have completed the required training, please complete the and return it to . If you’re considering enrolling in a Medicare Advantage plan (also known as Medicare Part C) in Florida to meet your health insurance needs, you’re not alone. According to recent Census data estimates, approximately 4.5 million people ages 65 and older live in Florida, accounting for nearly 21% of the state’s total population. Considering that Florida’s average life expectancy is 79 years, maintaining health insurance coverage after retirement is essential for both physical and financial well-being. If you’re looking for the best Medicare Advantage plan to meet your specific needs, Forbes Health is here to assist with your search. Using the snapshot of your state’s market below, you can gain a better understanding of how many plan options you have, who the providers tend to be and how much you can expect to pay each month for a plan. You can also
download our checklist of easy-to-follow steps for a streamlined Medicare Advantage enrollment experience. Since Medicare Advantage plan eligibility is largely dependent on where you live, we gathered data specific to an urban, suburban and rural location in Florida to show how plan availability, monthly premium rates and in-network maximum out-of-pocket amounts can vary. Medicare Advantage Providers in FloridaA number of private health insurance providers offer Medicare Advantage plans in the state of Florida, including:
Plan availability varies by ZIP code, so not all providers listed above offer Medicare Advantage plans in every county of Florida. Top-Rated Medicare Advantage Plans in FloridaEvery year CMS rates Medicare Advantage (Part C) and Part D prescription drug plans to reflect the experience of being enrolled in such coverage. The agency uses a scale of one to five stars, with one star representing poor performance and five stars representing excellent performance. The following plans available in the state of Florida in 2023 earned five-star ratings from CMS.
To determine which of these plans might be available in your area, enter your ZIP code in Medicare.gov’s plan finder tool. The tool also displays each plan’s rating from CMS. Medicare Resources in FloridaIf you live in Florida and are looking for additional information about Medicare plans available and assistance with selecting the best coverage for your health care needs and budget, here are a few resources to help you get started.
While not exclusive to the state of Florida, Medicare.gov and CMS’s website are two more excellent tools for learning about the various components of Medicare coverage. You can also search for plans available in your ZIP code and compare options via Medicare.gov’s plan finder tool. How to Pick the Best Medicare Advantage Plan in FloridaWith that snapshot of your state’s Medicare Advantage coverage in mind, it’s time to consider the details involved in identifying the best plan for you, from in-network hospitals and providers to drug formularies and deductibles. For those approaching the age of 65, navigating another qualifying event or reviewing plan options ahead of the Medicare Advantage Open Enrollment period (which runs from January 1 to March 31 annually), we created the downloadable checklist below to simplify your enrollment experience. Your Medicare Advantage Plan Shopping Checklist (Text Version)Compare Top Medicare Plans From Blue Cross Blue Shield, a Forbes Health 5-Star Rated Carrier Click Get A Quote or call 1-877-898-0206 to speak with a licensed insurance agent. Frequently Asked Questions (FAQs)What is Medicare Advantage, also known as Medicare Part C?Medicare Advantage (Medicare Part C) is a type of health insurance provided by private insurance companies to U.S. adults ages 65 and up, as well as younger individuals with certain disabilities and health conditions. The federal government pays a flat fee per enrollee to the insurance companies, which then provide the core benefits of Original Medicare, payment to care providers and oftentimes additional benefits. How does Medicare Advantage differ from Original Medicare?Medicare Advantage covers everything included in Original Medicare, but most Medicare Advantage plans also include prescription drug coverage (Part D), and some plans provide dental and vision coverage and hearing aids and fitness benefits as well. These additional coverages and benefits vary by plan. While there are several distinctions between Original Medicare and Medicare Advantage, one noteworthy difference is people enrolled in a Medicare Advantage plan are responsible for paying both the monthly premium associated with Original Medicare Part B ($164.90 for most people in 2023) and the monthly premium associated with their Medicare Advantage (Part C) plan, which is described in the data above. If I choose a Medicare Advantage plan, what additional coverage do I need?It depends on the Medicare Advantage plan you pick. Some plans provide an extensive list of additional benefits, including (but not limited to) dental, vision, hearing health, prescriptions, over-the-counter, transportation, fitness memberships and more. However, if you enroll in a less comprehensive plan, you might need to seek additional coverage for a desired benefit your plan is missing. What is the most popular Medicare Advantage plan in Florida?Top-Rated Medicare Advantage Plans in Florida. HealthSun Health Plans, Inc. HealthSun HealthAdvantage Plan (HMO) HealthSun HealthAdvantage Plus (HMO) ... . Optimum HealthCare, Inc. Optimum Gold Plan (HMO) Optimum Gold Plus Plan (HMO) ... . UnitedHealthcare. Erickson Advantage Freedom (HMO-POS). What is the most popular Medicare Advantage plan?AARP/UnitedHealthcare is the most popular Medicare Advantage provider with 28% of all enrollment. Plans are well-rated and have affordable premiums and add-on benefits, a valuable combination that could account for AARP/UHC having the largest number of Medicare Advantage enrollees.
What are the Medicare Advantage plans in Florida?There are four types of plans available in Florida's Medicare Advantage program: Health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS), and special needs plan (SNP). Each offers a different level of flexibility in your network of care providers and varies in price.
Is Blue Cross Blue Shield in Florida Medicare?About Florida Blue Medicare
Florida Blue and Florida Blue Medicare are Independent Licensees of the Blue Cross and Blue Shield Association.
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