Medicare FAQs for Palm Beach County

No. Carriers pay the licensed agent. Your premium doesn't change whether you enroll through us or by yourself.

Your Initial Enrollment Period is a seven-month stretch around your 65th birthday month. It opens three months before that month and closes three months after it. Sign up during the first three months and your coverage starts without a gap. Miss the whole window and you may owe a late penalty. See turning 65 in Palm Beach County.

With Original Medicare and a Medigap policy, any doctor or hospital that accepts Medicare will take you, in Florida or any other state. With Medicare Advantage, it depends on the plan's network. Hospitals here belong to different systems, like Tenet's Palm Beach Health Network, HCA Florida and Baptist Health, plus Jupiter Medical Center, and one plan might contract with two of those systems while another picks different ones. Before you enroll, we search each plan's current provider directory for your doctors.

Neither one wins for everybody. Medigap carries a higher monthly premium, picks up most of the costs Original Medicare doesn't pay, and works without a network. Advantage plans tend to have lower premiums, use copays and networks, and often include dental, vision or fitness benefits. Your doctors, your prescriptions, your budget and where you spend the year will point you toward one. See Advantage vs. Medigap.

It can. Many Advantage plans cover only emergency and urgent care outside their service area, and a plan has to end your membership if you're away more than six months. Some plans add travel or visitor benefits, so ask before you enroll. Medigap goes with you to any doctor in the country who accepts Medicare. For drugs, check that your Part D plan has network pharmacies or mail order where you'll be staying.

Without coverage from current employment (yours or a spouse's), the surcharge equals 10% of the standard Part B premium times the number of full 12-month periods you were eligible for Part B and skipped it. In most cases the surcharge stays on your bill as long as you're enrolled in Part B. Our Part B penalty calculator gives you a rough figure.

Usually, yes. If you're without creditable drug coverage for 63 straight days or longer once you're eligible, Medicare tacks a penalty onto your Part D premium for as long as you keep drug coverage. Paying for a cheap plan you rarely use usually works out better than carrying that penalty for years. See Part D drug plans.

When FEMA declares an emergency or major disaster, Medicare offers a Special Enrollment Period to people in the affected area who missed a plan change they were eligible to make because of it. You can call 1-800-MEDICARE to use it. Medicare also expects drug plans to allow early refills in a declared disaster area, and Florida law requires state-regulated insurers to allow early refills when your county is under a hurricane warning or a state of emergency.

You don't have to, but a yearly look pays off. Plans can rework their networks, drug tiers and copays every January 1. A quick fall review tells you whether your plan still covers your doctors and drugs at the cost you expect. See Annual Open Enrollment.

Yes. Florida law requires Medigap insurers to offer policies to residents under 65 who have Medicare because of a disability or end-stage renal disease and are enrolled in Part B. You get a six-month window that starts when your Part B begins, plus a two-month window after group health coverage ends. During those windows, an insurer can't turn you down or charge more because of your health, though under-65 premiums usually run higher. When you turn 65, you get a new Medigap open enrollment period. SHINE can also help at 1-800-963-5337.

Florida law doesn't give Medigap holders a yearly birthday or anniversary switching window. Once your first open enrollment window has passed, and unless a federal guaranteed-issue right applies, a new insurer can review your health and say no. Keep your current policy until a new one has approved you.

Yes. We work across Palm Beach County, from Jupiter and Palm Beach Gardens to Wellington, Royal Palm Beach, Lake Worth Beach, Boynton Beach, Delray Beach and Boca Raton. If you split the year between here and another state, we'll plan around both. See all service areas.