Not entirely. Most people pay no Part A premium but Part B has a $202.90/month standard premium in 2026 (higher-income beneficiaries pay more via IRMAA). Part D and Medicare Advantage plans also charge premiums that vary by plan, plus deductibles, copays, and coinsurance.

Health Insurance FAQ

Q: What's the difference between Medicare Advantage and Medicare Supplement (Medigap)?

Medicare Advantage (Part C) replaces Original Medicare with an all-in-one private plan, often including drug coverage, with low or $0 premiums but network restrictions. Medicare Supplement (Medigap) works alongside Original Medicare to cover copays, coinsurance, and deductibles, giving you freedom to see any Medicare-accepting doctor nationwide with more predictable out-of-pocket costs.

Q: Can I see any doctor I want with Medicare?

With Original Medicare or a Medicare Supplement plan, you can see any doctor in the U.S. who accepts Medicare — no referrals needed. With Medicare Advantage HMO plans you are limited to the plan's network and need referrals; PPO plans offer more flexibility but may charge more for out-of-network care.

Q: What is the Medicare Annual Enrollment Period (AEP)?

The Annual Enrollment Period (AEP) runs October 15 through December 7 each year. During AEP you can switch between Original Medicare and Medicare Advantage, change Advantage plans, join or switch Part D plans, or drop Part D. Changes take effect January 1 of the following year.

Q: What is a Medicare Special Enrollment Period (SEP)?

A Special Enrollment Period (SEP) allows Medicare coverage changes outside regular enrollment windows due to qualifying life events such as losing employer coverage, moving out of your plan's service area, or qualifying for Extra Help. Duration and allowed changes vary by SEP type. Contact us to determine if you qualify.

Q: What are Medicare Star Ratings?

Medicare rates Medicare Advantage and Part D plans annually on a 1–5 star scale. Ratings are based on customer service, member experience, managing chronic conditions, and medication safety. Plans rated 4 or 5 stars allow beneficiaries to switch plans outside of AEP through a Special Enrollment Period.

Q: Can I have Medicare and employer insurance at the same time?

Yes. If you are still working with employer coverage, you can delay Medicare without penalty. Once that coverage ends you have an 8-month SEP to enroll in Part B. For employers with 20+ employees, employer insurance pays first; for smaller employers, Medicare pays first.

Q: How do I apply for Medicare?

Apply through Social Security — online at ssa.gov, by calling 1-800-772-1213, or at your local Social Security office. If you're already receiving Social Security benefits when you turn 65, you'll be automatically enrolled in Parts A and B. Once enrolled, work with a licensed broker like USA Benefits Group to compare Supplement, Advantage, and Part D plans.

Have health insurance questions? We are here to help! Learn more insurance tips and guidelines in our library of helpful Insurance Tips:

What is health insurance?

Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. It can help cover the costs of hospital visits, surgeries, prescription drugs, and preventive care. It’s designed to protect you from significant healthcare costs and support your health and financial stability.

Who needs health insurance?

Everyone needs some form of health coverage to protect against the high costs associated with medical care. It’s particularly important for individuals who may not be able to afford the high costs of medical treatments out of pocket.

How much does health insurance cost?

The cost of health insurance varies based on several factors including location, age, health status, and the type of plan chosen. With some Marketplace (ACA) plans there is no or a very low cost to the person based on the Premium Tax Credit they qualify for.

How do I choose the best health insurance plan?

To find the best health insurance plan, consider your health needs, your budget, and any existing conditions. Working with USA Benefits Group as your insurance advisor, we help you compare different plans to understand your options and make an informed decision.

Can I get health insurance outside of open enrollment?

Yes, you can enroll in health insurance outside the standard open enrollment period if you qualify for a Special Enrollment Period. This can occur due to life events such as marriage, childbirth, or loss of other coverage.

What are the benefits of ACA-compliant plans?

ACA-compliant plans must cover a set of essential health benefits like preventive services, maternity care, and mental health services. They cannot deny coverage or charge more based on health status or pre-existing conditions.

How do I apply for health coverage?

Because the options for insurance plans are so complex, we recommend calling USA Benefits Group for a free consultation. There is no charge to you at all for our services! We can help you make an informed decision about your health insurance. HWe help you with a custom plan that meets your individual medical needs.

What if I receive a “balance bill” or “surprise bill” for my health insurance?

The No Surprises Act protects you from surprise medical bills from out-of-network providers during emergencies and certain other situations. This act requires that you are only charged in-network rates in these cases.

What changes did the Affordable Care Act make?

The Affordable Care Act (ACA) expanded access to health insurance, introduced subsidies to help make insurance more affordable, and mandated the coverage of essential benefits in all major medical plans. It also extended the ability for young adults to remain on their parents’ insurance plan until age 26.

Medicare FAQ: Your Questions Answered

Whether you’re turning 65 or re-evaluating your current coverage, understanding Medicare can feel overwhelming. Below are answers to the most common Medicare questions we hear from Florida beneficiaries.

When should I enroll in Medicare?

You are first eligible for Medicare when you turn 65. Your Initial Enrollment Period (IEP) is a 7-month window — it starts 3 months before your 65th birthday month, includes your birthday month, and ends 3 months after. If you are still working and covered by employer insurance, you may qualify for a Special Enrollment Period (SEP) and can delay enrollment without penalty. Enrolling during your IEP helps you avoid late penalties.

What happens if I miss my Medicare enrollment window?

If you don’t enroll during your Initial Enrollment Period and you don’t qualify for a Special Enrollment Period, you’ll have to wait for the General Enrollment Period (January 1 – March 31 each year), and your coverage won’t begin until July 1. More importantly, you may face a late enrollment penalty that adds to your premium for as long as you have Medicare — so it’s critical to enroll on time.

What is the Medicare Part B late enrollment penalty?

The Part B late enrollment penalty is 10% added to your monthly premium for every full 12-month period you were eligible but didn’t enroll. In 2026, the standard Part B premium is $202.90/month. This penalty is permanent — it applies for the entire time you have Part B. For example, if you delayed two years, your premium would be $202.90 + 20% = ~$243.48/month for life.

What does Medicare Part A cover?

Medicare Part A covers inpatient hospital stays, skilled nursing facility (SNF) care, hospice care, and some home health services. Most people don’t pay a premium for Part A if they (or their spouse) paid Medicare taxes for at least 10 years (40 quarters) while working. In 2026, the Part A deductible is $1,676 per benefit period.

What does Medicare Part B cover?

Medicare Part B covers medically necessary outpatient services — doctor visits, preventive care, lab tests, X-rays, durable medical equipment (like walkers and oxygen), mental health services, and some home health care. Part B pays 80% of approved costs after you meet your annual deductible ($283 in 2026). You are responsible for the remaining 20%, which is why many people add a Medigap or Medicare Advantage plan.

What is Medicare Part D, and do I need it?

Medicare Part D is prescription drug coverage. It’s sold by private insurers approved by Medicare. If you take any regular medications, Part D is almost always worth having. If you skip Part D when you’re first eligible and don’t have other creditable drug coverage, you’ll face a late enrollment penalty — 1% of the national base beneficiary premium for every month you delayed, added permanently to your premium.

What's the difference between Medicare Advantage and Medicare Supplement (Medigap)?

Medicare Advantage (Part C) replaces Original Medicare. Plans are offered by private insurers and typically include Parts A, B, and D in one plan, often with low or $0 premiums. They use networks (HMO/PPO) and require referrals or prior authorizations. Medicare Supplement (Medigap) works alongside Original Medicare — it fills in the gaps like copays, coinsurance, and deductibles. You keep your freedom to see any doctor who accepts Medicare nationwide. Medigap has higher monthly premiums but more predictable out-of-pocket costs.

Can I see any doctor I want with Medicare?

With Original Medicare (Parts A & B) or a Medicare Supplement plan, you can see any doctor or specialist in the U.S. who accepts Medicare — no referrals needed. With Medicare Advantage, you are generally limited to the plan’s network. HMO plans require referrals; PPO plans give more flexibility but may charge more for out-of-network providers. Always verify your doctors are in-network before choosing an Advantage plan.

What is the Medicare Annual Enrollment Period (AEP)?

The Annual Enrollment Period (AEP) runs from October 15 through December 7 each year. During AEP, you can: switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, join or switch Part D drug plans, or drop a Part D plan. Changes made during AEP take effect January 1 of the following year. This is the most important enrollment window for Medicare beneficiaries who already have coverage.

What is a Medicare Special Enrollment Period (SEP)?

A Special Enrollment Period (SEP) lets you make changes to your Medicare coverage outside of regular enrollment windows due to specific life events. Common qualifying events include: losing employer-sponsored coverage, moving out of your plan’s service area, your plan leaving the Medicare program, or qualifying for Extra Help (Low Income Subsidy). The duration and allowed changes depend on the SEP type. Contact us to determine if you qualify for an SEP.

What are Medicare Star Ratings?

Medicare rates Medicare Advantage and Part D plans each year on a scale of 1 to 5 stars, with 5 being the highest quality. Ratings are based on factors like customer service, member experience, managing chronic conditions, and drug plan safety. Plans rated 4 or 5 stars allow beneficiaries to switch plans outside of AEP through a Special Enrollment Period. When comparing plans, higher Star Ratings generally indicate better service and health outcomes.

Can I have Medicare and employer insurance at the same time?

Yes. If you (or your spouse) are still working and covered by an employer group health plan, you can delay Medicare enrollment without penalty. Once that coverage ends, you’ll have an 8-month SEP to enroll in Part B. If you do have both, the order they pay depends on employer size. For companies with 20+ employees, employer insurance pays first (primary) and Medicare pays second (secondary). For companies with fewer than 20 employees, Medicare pays first.

Is Medicare free?

Not entirely. Most people don’t pay a premium for Part A (hospital insurance) if they worked and paid Medicare taxes for at least 10 years. However, Part B has a monthly premium ($202.90 in 2026 for most people), and higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount (IRMAA). Part D and Medicare Advantage plans also charge premiums that vary by plan. There are also deductibles, copays, and coinsurance costs to consider.

How do I apply for Medicare?

You can apply for Medicare through Social Security — online at ssa.gov, by calling 1-800-772-1213, or by visiting your local Social Security office. If you’re already receiving Social Security retirement or disability benefits when you turn 65, you’ll be automatically enrolled in Medicare Parts A and B. Once enrolled in Original Medicare, you can work with a licensed broker like us to compare and enroll in Medicare Supplement, Medicare Advantage, and Part D plans available in your area.

Do I need a Medicare broker, and is it free?

Working with a licensed Medicare broker like USA Benefits Group is completely free to you. Brokers are paid by the insurance companies, not by clients. A broker can compare multiple plans across carriers side-by-side, explain the pros and cons of each option, and help you enroll — saving you significant time and potential costly mistakes. Unlike captive agents who only sell one company’s plans, independent brokers show you all your options.

📋 Still Have Questions? Get Our Free 2026 Florida Medicare Guide

Our plain-language guide covers enrollment timelines, plan comparisons, 2026 costs, and more — written specifically for Florida Medicare beneficiaries.