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Your Florida Medicare Guide for 2026

Everything you need to understand Medicare — from eligibility to enrollment to choosing the right Medigap plan. Written for Florida seniors by Florida specialists.

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Last reviewed: 2026-03-30

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Part 1: Medicare Eligibility & Enrollment

You're eligible for Medicare at age 65 if you're a U.S. citizen or permanent resident who has lived in the U.S. for at least 5 years. You may also qualify earlier if you have a qualifying disability or End-Stage Renal Disease (ESRD).

Key Enrollment Periods

Initial Enrollment Period (IEP): A 7-month window — 3 months before through 3 months after your 65th birthday. This is your primary enrollment opportunity. Missing it results in permanent late penalties.

General Enrollment Period (GEP): January 1 – March 31 each year. Coverage starts July 1. Late enrollment penalties apply.

Special Enrollment Periods (SEP): If you're covered by an employer health plan through active employment at 65, you can delay Medicare without penalty and use an SEP when that coverage ends.

Apply at ssa.gov/benefits/medicare or call 1-800-772-1213.

Part 2: Original Medicare — Parts A & B

Part A — Hospital Insurance

Premium: $0 for most people (requires 40 quarters of Medicare taxes)

Covers: Inpatient hospital care, skilled nursing facility care, hospice care, some home health care

2026 Deductible: $1,736 per benefit period (not per year — per hospital stay separated by 60+ days)

Part B — Medical Insurance

Premium: $185/month standard (higher for higher-income enrollees via IRMAA)

Covers: Doctor visits, outpatient care, preventive services, medical equipment, lab tests

2026 Deductible: $283/year

Coinsurance: 20% of Medicare-approved amounts — with no out-of-pocket cap

⚠️ The 20% Problem: Original Medicare's 20% Part B coinsurance has no annual limit. A $200,000 cancer treatment course leaves you with $40,000 in coinsurance. This is why Medigap exists.

Part 3: Medigap — Your Florida Supplement Options

Medigap (Medicare Supplement) insurance fills the gaps in Original Medicare — paying the deductibles, coinsurance, and copays that Medicare doesn't cover. Plans are standardized by federal law, meaning Plan G from Company A covers exactly the same services as Plan G from Company B.

The 4 Plans We Offer in Florida

PlanPart A DeductiblePart B 20%Excess ChargesMax Annual Exposure
Plan G✓ Covered✓ Covered✓ Covered$283
Plan N✓ CoveredCopays apply✗ Not covered$283 + copays
HDG✓ After deductible✓ After deductible✓ After deductible$2,870 deductible
Plan F*✓ Covered✓ Covered✓ Covered$0

*Plan F only available to those eligible for Medicare before January 1, 2020

The Medigap Open Enrollment Period — 6 months from when you turn 65 and enroll in Part B — is when you get guaranteed acceptance regardless of health. Learn more about this critical window →

Part 4: Making Your Choice

Your Medigap decision comes down to three factors:

  1. Your health: Chronic conditions → Plan G. Generally healthy → Plan N or HDG.
  2. Your budget: Lower premium risk → HDG. Higher premium certainty → Plan G.
  3. Your doctors: See specialists who may charge excess amounts → Plan G covers them. Plan N does not.

Then compare carriers. Since coverage is identical across carriers for the same plan letter, the only variables are premium, rate history, and financial strength. T65Navigator compares 20+ Florida carriers simultaneously — for free.

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