Part A: Hospital Coverage
Part A primarily covers inpatient hospital care, skilled nursing facility care under certain conditions, hospice care, and some home health care. Most people qualify for premium-free Part A based on their work history.
Medicare Advantage, Supplement and Part D
The right Medicare plan depends on your doctors, not a TV ad
Medicare decisions should be based on your specific doctors and prescriptions, not whichever plan has the most advertising budget. Michael Cuevas has spent 36 years helping South Florida families navigate Medicare. He compares Advantage and Supplement options against the providers you actually use.
Independent broker
Pembroke Pines & Broward County
Licensed in 6 states
Start here
Understanding Medicare
Before comparing plans, it helps to understand the basic pieces of Medicare.
Part B: Medical Coverage
Part B covers the healthcare services you receive outside of the hospital: doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Part B has a monthly premium, and higher-income beneficiaries may pay more based on income.
Part C: Medicare Advantage
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They provide your Part A and Part B benefits through the private plan and commonly include prescription drug coverage. Many plans also add dental, vision, hearing, or fitness benefits.
Part D: Prescription Drug Coverage
Part D helps cover prescription medications. It can be bought as a standalone drug plan alongside Original Medicare or built into many Medicare Advantage plans. Each plan has its own list of covered medications, costs, and preferred pharmacies, which is why plans should be compared against the prescriptions you actually take.
A real case
Why the plan has to match your providers
One client was locked out of a specialty provider their Medicare Advantage plan did not cover. We found a Medicare Supplement plan that included that provider, and they got the treatment they needed.
That is the whole job. A plan that looks good on premium can still block the one doctor you cannot do without. Michael checks the providers and prescriptions first, then works out the money.
Path one
Medicare Advantage
Medicare Advantage, also known as Part C, lets you receive your Medicare benefits through a private insurance company.
Depending on the plan, Medicare Advantage may offer:
- Low or $0 additional monthly plan premiums
- Medical copays and coinsurance as services are used
- An annual maximum out-of-pocket limit
- Prescription drug coverage built into many plans
- Dental, vision, hearing, and other additional benefits
- HMO or PPO provider networks
Medicare Advantage can fit someone who prefers lower monthly premiums and bundled benefits and is comfortable receiving care within the plan network and rules.
Best suited for: people who value lower monthly costs, bundled benefits, and are comfortable with provider networks and paying copays as they use healthcare.
Path two
Medicare Supplement (Medigap)
Medicare Supplement insurance works alongside Original Medicare rather than replacing it.
Original Medicare stays your primary coverage, and the Supplement policy helps pay the deductibles, coinsurance, and other gaps Medicare leaves behind, depending on the plan selected.
Medicare Supplement plans generally provide:
- Predictable healthcare expenses
- Very little out-of-pocket cost when receiving Medicare-covered care, depending on the plan
- Access to any provider nationwide who accepts Medicare
- No traditional HMO or PPO provider network
- No referral requirement for specialists
Medicare Supplement policies do not typically include prescription drug coverage, so beneficiaries who want drug coverage generally add a separate Part D plan.
Best suited for: people who value provider flexibility and predictable medical expenses, and are comfortable paying a higher monthly premium for lower costs when care is used.
The real fork in the road
Medicare Advantage or Medicare Supplement
Once you have A and B, you pick one of two roads. Neither is better in the abstract. The right one depends on your health, your doctors, your travel and your budget for surprises.
| Medicare Advantage (Part C) | Original Medicare plus a Supplement | |
|---|---|---|
| Monthly cost | Often a low or zero plan premium on top of your Part B premium | A Medigap premium plus a Part D premium on top of Part B |
| Cost when you use care | Copays each time, up to an annual out-of-pocket maximum | Most or all of the gaps covered, so very little at the point of care |
| Doctor choice | A network. Going outside it costs more or is not covered | Any provider in the country who takes Medicare |
| Referrals | HMO plans usually require one. PPO plans usually do not | No referrals |
| Extras | Commonly bundles dental, vision, hearing and a fitness benefit | No extras. You buy dental and vision separately |
| Switching later | You can change during the annual window each fall | Florida has a birthday rule, so each year you get a window to switch to an equal or lesser plan without underwriting |
People get that last row wrong more often than any other one on this table. Florida is one of the few states with a Medigap birthday rule. See the FAQ.
The part people forget
Do not forget prescription drug coverage
The important question is not simply which plan costs less. It is which structure fits the way you want to receive and pay for your healthcare.
Prescription coverage is one of the most important parts of choosing Medicare coverage. Two plans can look similar on paper and produce very different drug costs.
When we compare plans, we look at:
- The medications you currently take
- Whether they are included on the plan formulary
- Drug tiers and copays
- Deductibles
- Preferred pharmacies
- Estimated annual prescription costs
The lowest-premium drug plan is not always the least expensive plan once your actual medications are considered.
Local context
Broward County is one of the largest Medicare markets in Florida
Broward County is one of the largest Medicare markets in the country, with a large and growing Medicare-eligible population. That means Medicare Advantage is a highly competitive market here, with dozens of plan options available across the county. [VERIFY BEFORE PUBLISHING: specific Broward County plan counts.]
The upside of that many options is choice. The downside is noise: more plans, more mailers, more television advertising, and more ways to pick the wrong one for your doctors. Michael narrows the field to the plans that actually keep your providers in network, then compares those on cost.
How we narrow the field
What Michael looks at before recommending a plan
A Medicare recommendation should never come from a television commercial or from whichever plan has the lowest premium. Before helping you choose coverage, Michael considers:
Your Doctors
Are your physicians and preferred hospitals in network under the coverage you are considering?
Your Prescriptions
How does each plan cover the medications you actually take?
Your Healthcare Needs
How often do you use healthcare, and which services matter most to you?
Your Budget
Would you rather pay more each month for predictable expenses, or pay less monthly and share more of the cost when you use care?
Your Travel
Do you spend significant time outside your local area or want greater nationwide provider flexibility?
Your Long-Term Options
Your first Medicare decision can affect your ability to change coverage later. Michael explains why a particular option may be right for you, rather than simply telling you which plan to buy.
Questions
Medicare questions
When should I start looking at Medicare?
Begin learning about Medicare several months before turning 65. Your Initial Enrollment Period generally starts three months before the month you turn 65 and runs through three months after your birthday month.
Do I have to enroll in Medicare at 65 if I am still working?
Not always. If you or your spouse are actively working and you have qualifying employer-sponsored coverage, you may be able to delay certain parts of Medicare without a late-enrollment penalty. The rules depend on your situation, so review your employer coverage before deciding.
Will a broker push me toward the plan that pays him most?
Carriers pay a licensed agent the same amount no matter which Medicare plan you pick, and CMS sets that amount, so there is nothing pulling the advice one way. Michael decides on whether your doctors are in network and your prescriptions are on the drug list. That is why he checks both before he mentions premium.
Does Florida have a Medicare Supplement birthday rule?
Yes. Florida has a Medigap birthday rule. During a 63-day window after your birthday each year, you can switch to a Medicare Supplement plan with equal or lesser benefits without going through medical underwriting. That is a real advantage Florida beneficiaries have that most states do not, and it is worth planning around.
Can I keep my doctors?
That depends on the type of coverage you choose. Medicare Advantage plans generally use provider networks, while Medicare Supplement coverage works with Original Medicare and generally lets you see any provider nationwide who accepts Medicare. Michael checks your doctors before recommending coverage.
What about my prescriptions?
Every drug plan has its own formulary, its own tiers and its own preferred pharmacies, so the same prescription can cost very different amounts depending on the plan. Bring your bottles or a list with the doses and Michael prices your actual drugs, not a generic estimate.
Does it cost anything to work with First Community?
There is typically no additional cost to you for Medicare plan assistance. If you enroll in a plan through us, the insurance company generally compensates the agency.
Find the Medicare Plan That Fits Your Doctors
Whether you are turning 65, already on Medicare, or want a second opinion on your current plan, Michael compares your options against the doctors and prescriptions you already have and explains the tradeoffs before you decide.
Rather just talk it through? Call Michael Cuevas at 561-234-8810.