Shahriar Ekbatani – Understanding the Florida Medicare System

By admin / March 20, 2018

Medicare is the primary health insurance for older Americans. As you age, navigating your way through the financial health care decisions is complicated and studies show that very few actually understand how it all works and how to use it to their best benefit.

For a state like Florida that currently has one of the largest senior populations in the country, Medicare is a major business that requires and has a huge infrastructure.

Medicare Coverage in Florida

The original Medicare is delivered to two parts and is fully federally funded health care insurance that is for all eligible Medicare beneficiaries:

  • Medicare Part A covers inpatient hospital.
  • Medicare Part B covers doctor’s services and visits and any durable medical equipment needed.
  • Many who receive mediocre will opt to receive coverage that goes far beyond what Medicare Parts A and B cover. In this case they will utilize Medicare Part C also known as a Medicare Advantage Plan. Part C plans will cover all of the areas of Parts A and B but also adds vision, dental, hearing, and prescription drug services coverage. There is an additional premium for Medicare Part C.
  • Medicare Part D is stand-alone coverage focused on prescription drug plans and work in conjunction with Medicare Parts A and B.

There are options for Medicare patients who reside in Florida. They have the following choices from which to choose.

  1. They may receive their coverage from Original Medicare, or
  2. They may receive coverage through a Medicare-approved insurance company that offers Medicare Advantage plans.

It is important to point out that not every Medicare plan may be available everywhere in Florida.

There is often a gap between what the actual medical costs are and what Medicare will pay. For this reason many seniors purchase Medicare Supplement Insurance, or Medigap. This service provides coverage for out-of-pocket costs including deductibles, copayments and, in some cases, medical care when traveling outside of the US. This coverage has additional fees that each recipient is required to pay.

Florida Programs to Assist Low Income Medicare Patients

In Florida many seniors cannot pay their Medicare and other healthcare related premiums so the state has set up programs to assist them. Two are worthy of note:

 The Florida Medicare Savings: This program is designed to assist those Medicare eligible seniors whose income is below a certain limit. They help these seniors with the payment of out-of-pocket costs including premiums, deductibles and prescription medication.

The Florida Serving Health Insurance Needs of Elders (SHINE): Seniors often need assistance in navigating through the Medicare system. Many cannot read well or have the physical strength to go to meetings. SHINE is designed to help seniors to gain a full understanding of how the program works, any changes that occur and their rights while in the program. SHINE is funded by a government body called the Centers for Medicare and Medicaid Services (CMS) and managed and operated by a network of volunteers and funded by a grant from.

For those living in Florida who will reach the age where they will need to interact with the state’s Medicare system like professional photographer Shahriar Ekbatani, it is comforting to know that Florida takes a serious approach to helping its seniors get health coverage. As a result, the state has thousands of workers specifically dedicated to senior healthcare. There are Medicare offices throughout all of Florida’s cities and support services that can tend to those in need.

About the author


Click here to add a comment

Leave a comment: