Medicare in Florida

One in five Florida residents have Medicare coverage

Resources for Florida beneficiaries

State Health Insurance Assistance Programs (SHIPs) provide free, in-depth, one-on-one insurance counseling and assistance to Medicare beneficiaries, their families, friends, and caregivers. SHIPs operate in all 50 states.

In Florida you can reach SHIP at 1-800-96 ELDER (1-800-963-5337) or online here.

Snapshot of Medicare in Florida

Total Medicare enrollment in Florida

In 2015 there were more than 4 million Medicare beneficiaries in Florida – about 20 percent of the state’s population. Nationwide, about 17 percent of the US population is enrolled in Medicare.

The states with the highest percentage of beneficiaries are West Virginia and Maine with about 23 percent each. Those with the lowest percentage are Alaska (11 percent) and Utah (12 percent). In raw numbers, Alaska has the least recipients at 83,863 and California (which has about an eighth of the country’s population within its borders) has the most at 5.6 million (14 percent of its population). This doesn’t count the US Territories, which mostly have low total enrollment in Medicare (Northern Mariana Islands had just 2,075 Medicare enrollees in 2015).

Read about Medicare’s open enrollment period and other important enrollment deadlines.

Breakdown of the aged vs. disabled

Individuals who qualify by virtue of their age alone make up 86 percent of Florida Medicare enrollees. The balance — 14 percent — are on Medicare as the result of a disability. Kentucky has the highest percent of Medicare recipients listed as disabled (25 percent), followed by Alabama, Mississippi, West Virginia and Arkansas. Hawaii has the smallest percentage at 10 percent, followed by New Jersey, and North and South Dakota at 13 percent each.

Medicare spending per recipient

In 2014, Medicare’s per-enrollee spending in Florida was $10,610. That’s according to a standardized spending report from CMS, which eliminates spending differences that stem from strictly geographic differences in costs (eg, higher labor costs or overhead expenses in higher cost-of-living areas like Alaska). The report only considers spending in Original Medicare, as opposed to Medicare Advantage.

Louisiana had the highest per-capita Medicare spending, at $10,754, while Hawaii had the lowest, at $5,967.

Florida is one of just four states where standardized per capita Medicare spending exceeded $10,000 in 2014. The others are Louisiana, Texas, and Mississippi.

Medicare spending overall

Total Medicare spending in Florida was $39.1 billion in 2009 (latest available data). With the largest and smallest numbers of recipients, itʼs no surprise that California accounts for $50.6 billion of overall Medicare spending while Alaska spends only $553 million. Total Medicare spending for all states and the District of Columbia was $471 billion in 2009.

Medicare Advantage in Florida

Medicare Advantage offers health benefits for Medicare beneficiaries through private plans instead of through Original — or traditional — Medicare (the federal government’s fee-for-service program). These plans are one option for consumers who desire additional benefits beyond what Original Medicare offers, but are not considered a wise option by some consumers who are concerned that government spends more per enrollee on the private plans than it does on Original Medicare. Medicare Advantage plans are available with no premium other than the cost of Part B, but they also have provider networks that are more limited than Original Medicare, and total out-of-pocket costs can be considerably higher than enrollees would pay if they had Original Medicare plus a Part D plan plus Medigap.

There were 1,564,757 people in Florida enrolled in Medicare Advantage plans in 2015. That’s about 40 percent of the state’s total Medicare population. Nationwide, 31 percent of Medicare beneficiaries are enrolled in a Medicare Advantage program.

Minnesota is the only state where more than half (53 percent) of Medicare eligibles enrolled in a Medicare Advantage plan. Alaska is the only state to have zero percent enrolled in Medicare Advantage, although five states have Medicare Advantage enrollment (as a percentage of the state’s Medicare enrollees) in the single digits: Wyoming with 3 percent, New Hampshire and Vermont with 7 percent, and Maryland and Delaware with 8 percent.

Stand-alone Medicare Prescription Drug plans

Florida had 1,406,540 Medicare beneficiaries – about 35 percent of the state’s total Medicare population – enrolled in stand-alone prescription drug plans in 2015. Nationwide, about 43 percent of Medicare enrollees had coverage under a stand-alone Part D plan in 2015 (this does not include Medicare Advantage enrollees who have integrated Part D coverage as part of their Medicare Advantage plan).

Florida has 22 stand-alone Part D plans with premiums ranging from about $18 to $175 per month.

Medicare prescription drug coverage — called Medicare Part D — was the result of legislation passed in 2003 and signed into law by President George W. Bush in 2006. It is a bit of a controversial program because it was an unfunded liability — meaning that the vast majority of costs fell on taxpayers — and the law also barred Medicare from negotiating lower drug prices with drug makers.

But by the end of its first decade, Medicare Part D was providing coverage for almost three quarters of all eligible Medicare beneficiaries nationwide, including those who have Part D coverage as part of their Medicare Advantage plan.

For those under 65 in Florida

Are you under 65 years of age? We have information on Florida health insurance and the Florida health insurance marketplace at our health insurance site.