Straight from Medicare.gov. Check every plan detail there before you choose.
Medicare Advantage plans in Florida, explained before you choose
I want you to see what a Medicare Advantage plan trades in networks, costs and extra benefits, and how to check one against your own doctors and prescriptions.
Jeannie Pond, Licensed Insurance Agent, NPN 8940178
No ofrecemos todos los planes disponibles en su área. Actualmente representamos 14 organizaciones que ofrecen 52 productos en su área. Comuníquese con Medicare.gov o llame al 1-800-MEDICARE para obtener información sobre todas sus opciones.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, las 24 horas del día, los 7 días de la semana
A Medicare Advantage Plan is another way to get your Medicare coverage besides Original Medicare, offered by private companies that must follow rules set by Medicare. You may need to use doctors in the plan's network, and plans have a yearly limit on what you pay for covered services.
What a Medicare Advantage Plan trades
- Networks
- You may need to use doctors and other providers in the plan's network and service area for non-emergency care. Some plans cover care out of network, but it may cost more.
- Referrals
- You may need a referral to see a specialist.
- A yearly limit
- Plans have a yearly limit on what you pay for covered Medicare services, which may differ in network and out of network.
- Extra benefits
- Plans may offer extra benefits that Original Medicare doesn't cover, like some vision, hearing and dental services.
- No Medigap beside it
- You can't buy a Medigap policy to cover your out-of-pocket costs while you have a Medicare Advantage Plan.
Original Medicare and Medicare Advantage, row by row
A Medicare Advantage Plan is another way to get your Medicare coverage besides Original Medicare. Follow each row across to see how the two ways handle the same thing.
The kinds of Medicare Advantage Plans, and your doctors
Medicare Advantage Plans come in a few types, and the type tells you a lot about which doctors you can see and whether you need a referral to see a specialist.
- HMO (Health Maintenance Organization)
- You generally must get care from providers and facilities in the plan's network, except emergency or urgent care or out-of-area dialysis. You usually choose a primary care doctor, and you need a referral to see a specialist. In an HMO Point-of-Service (HMOPOS) Plan, you may be able to get some services out of network, but you usually pay more.
- PPO (Preferred Provider Organization)
- Each plan has a network of doctors, hospitals and other providers. You may also go out of network, but you may pay more. You don't need to choose a primary care doctor, and you don't need a referral to see a specialist.
- Private Fee-for-Service (PFFS)
- You can go to any Medicare-approved provider or facility that accepts the plan's payment terms and agrees to treat you. If the plan has a network, you can use any provider in it. You don't need a primary care doctor or a referral. If your PFFS Plan doesn't offer drug coverage, you can get a separate Medicare drug plan.
- Special Needs Plan (SNP)
- All SNPs must offer Medicare drug coverage. If the SNP is an HMO, you generally must use its network (except for emergency, urgent care or out-of-area dialysis) and you generally need a referral. If it's a PPO, you can get Medicare-covered services out of network, without a referral. Some SNPs require a primary care doctor and others don't.
In an HMO or a PPO, if you want drug coverage you have to join one that offers it: you can't get a separate Medicare drug plan. There are also Medical Savings Account (MSA) Plans, which generally don't have network providers.
How to check a plan against your doctors and prescriptions
Compare plans in your area on Medicare.gov: what they cost and the services they provide.
Ask your doctors and pharmacies whether they are in network with the plan.
Check whether the plan covers each of your prescriptions before you join.
If your plan changes, or your life does
Outside the yearly enrollment windows, a Special Enrollment Period gives you a chance to change your Medicare Advantage coverage when certain things happen. What you can do, and when, depends on what happened.
You move out of your plan's service area. You can switch to another plan or go back to Original Medicare. Your chance begins when you move and lasts for 2 full months after. If you tell your plan before you move, it begins the month before. If you don't join a new plan, you're enrolled in Original Medicare when the old plan drops you.
Your plan leaves Medicare. You'll have to join another Medicare health plan or return to Original Medicare. If the plan's contract with Medicare isn't renewed, you can switch between December 8 and the last day in February of the following year.
You're new to Medicare. If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another one, or go back to Original Medicare with or without a drug plan, within the first 3 months you have Part A and Part B.
Before you join, talk to your employer, union or other benefits administrator. In some cases, joining a Medicare Advantage Plan might cause you to lose that coverage, for yourself and for your spouse and dependents, and you may not be able to get it back.
Before a Medicare Advantage appointment
Before a personal marketing appointment about Medicare Advantage plans, the agent must agree on and record a Scope of Appointment with you, in writing if you meet in person. The old 48-hour waiting period no longer applies.
Who I am, and where I'm licensed
Jeannie Pond is a licensed health insurance agent in Florida.
Jeannie Pond ayuda a sus clientes con planes Medicare Advantage, el Seguro Suplementario de Medicare y planes de medicamentos recetados de la Parte D.
Jeannie Pond, Licensed Insurance Agent, NPN 8940178. Florida W272782; Arizona 8940178; California 4524185; Georgia 2669678; Indiana 4017600 (health only); Michigan 8940178; New Jersey 3004406991; North Carolina 8940178; Tennessee 960426; Texas 1617709; Virginia 1447142 (health only); Washington 1346341.
Vista Consultants LLC dba Vista Insurance Services holds Florida insurance agency license L135539 (agency NPN 22164003), issued March 19, 2026, with Jeannie Pond as agent in charge.
Every kind of coverage, explained
Common Medicare Advantage questions
What are the trade-offs of a Medicare Advantage plan?
There are real trade-offs, and they're worth knowing before you join. You may need to use doctors in the plan's network and service area for non-emergency care, you may need a referral to see a specialist, and you may need the plan's approval (prior authorization) before it covers certain services. Plans have a yearly limit on what you pay for covered services, and they may offer extra benefits Original Medicare doesn't cover, like some vision, hearing and dental services. You can't buy Medigap while you're in one. (Source: Medicare.gov, Compare Original Medicare and Medicare Advantage, 2026.)
What does a Medicare Advantage plan cost each month?
It varies by plan. You keep paying your monthly Part B premium to stay in the plan, and you may also pay the plan's own premium, which can change each year. Deductibles, coinsurance and copayments vary by plan too. Most plans include Medicare drug coverage, so you don't have a separate Part D premium. (Source: Medicare.gov, What does Medicare cost and Compare Original Medicare and Medicare Advantage, 2026.)
Can I drop my Medicare Advantage plan and go back to Original Medicare?
Yes, at set times. During the Open Enrollment Period, October 15 to December 7 each year, you can move from a Medicare Advantage Plan to Original Medicare, with coverage starting January 1. From January 1 to March 31, if you're already in a Medicare Advantage Plan, you can drop it, return to Original Medicare and join a separate Medicare drug plan. A Medigap policy can be harder to buy then: outside your Medigap Open Enrollment Period you have no federal right to buy one unless a trial right applies, such as leaving within the first year after joining a Medicare Advantage Plan for the first time. (Source: Medicare.gov, Joining a plan, Learn how Medigap works and When can I buy a Medigap policy, 2026.)
Is there a limit on what I pay in a Medicare Advantage plan?
Yes. Plans have a yearly limit on what you pay for covered Medicare services, the limit varies by plan, and a plan may set different limits in network and out of network. Once you pay the plan's limit, the plan pays 100% of your covered health services for the rest of the calendar year. Original Medicare has no yearly limit on what you pay out of pocket unless you have other coverage, like Medigap. (Source: Medicare.gov, Medicare costs and Compare Original Medicare and Medicare Advantage, 2026.)
When can I join a Medicare Advantage plan?
First, during your Initial Enrollment Period, generally when you turn 65: it lasts seven months, starting three months before you turn 65, and you need both Part A and Part B to join. After that, the Open Enrollment Period runs from October 15 to December 7 each year, with coverage starting January 1, and a Special Enrollment Period may open after certain life events, like moving or losing other coverage. You must live in the plan's service area. (Source: Medicare.gov, Joining a plan, 2026.)
Want to talk through a Medicare Advantage plan?
Leave your name and how to reach you, and I'll call you back. Or call me.Medicare help in Lakeland and nearby cities
Jeannie Pond, Licensed Insurance Agent, NPN 8940178
No ofrecemos todos los planes disponibles en su área. Actualmente representamos 14 organizaciones que ofrecen 52 productos en su área. Comuníquese con Medicare.gov o llame al 1-800-MEDICARE para obtener información sobre todas sus opciones.
1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, las 24 horas del día, los 7 días de la semana