The two paths
| Option | How it works | What you need |
|---|---|---|
| State Group Insurance health plan, secondary to Medicare (nationwide PPO, or HMO in its service area) | Medicare pays first; the State plan pays second, and pays first when Medicare doesn't pay. The State's drug coverage pays first for most drugs and is creditable. | Part B strongly advised: the plan pays as if you had it. |
| State group Medicare Advantage and Prescription Drug (MA-PD) plan, HMO or PPO | Replaces Original Medicare; medical and Part D drug coverage in one group plan. | Part A and Part B for you and every family member on the policy; a copy of your Medicare card at People First. |
Both options use the same Medicare coverage tiers: Medicare I (you alone), Medicare II (you and eligible dependents, at least one eligible for Medicare) and Medicare III (you and one dependent, both eligible for Medicare). Premiums are set by the State for each tier and posted on MyBenefits.
How the State's MA-PD plans work
- Who can join: retirees, COBRA participants, surviving spouses, laid-off employees and vested legislators who are in a State Group Insurance health plan and enrolled in Medicare Parts A and B. Active employees can't.
- Optional and year-round: there's no automatic enrollment. Requests that People First completes by the 20th take effect on the first of the next month; after the 20th, on the first of the second month. Leaving an MA-PD follows the same timeline.
- No retroactive enrollment: if People First can't verify your Medicare before the MA-PD start date, DMS says you'll be moved into the State Group Insurance PPO plan.
What not to do
Don't add outside plans without asking. DMS says members of the secondary State plan should not enroll in a separate Part D plan, and that retirees who buy Part C, Part D or Medigap coverage on the private market should cancel the State plan. A retiree who cancels can't re-enroll later.
Medicare also allows only one Medicare Advantage or Part D plan at a time, so an individual plan would conflict with a State MA-PD. If you're thinking about individual coverage, read State Group Insurance vs. individual Medicare plans and call People First first. The full picture, including the FRS Health Insurance Subsidy, is on Florida state retirees and Medicare. You can also request a call from a licensed insurance agent to talk through how individual plans would compare.
Who to call
People First Service Center: 866-663-4735 (TTY 866-221-0268), weekdays 8 a.m. to 6 p.m. ET, for eligibility and enrollment. For what a specific plan covers, DMS says to contact that plan.
Related questions
Do Florida state retirees need Part B?
What happens without it.
What happens to State Group Insurance at 65?
The steps when Medicare starts.
Local government retirees and Medicare
County, city and school district plans.
Sources
- Florida DMS, MyBenefits — Medicare Advantage and Prescription Drug (MA-PD)
- Florida DMS, MyBenefits — Retirees
- Florida DMS, MyBenefits — Retirees FAQ
More questions in this guide
- Do Florida state retirees need Medicare Part B?
- Can Florida county, city and school district retirees stay on their employer health plan with Medicare?
- What is the FRS Health Insurance Subsidy and can I use it with Medicare?
- What happens to my Florida State Group Insurance when I turn 65?
Part of the guide: Florida state retirees and Medicare · All questions
Frequently asked questions
Can I switch between the secondary State plan and an MA-PD during the year?
Yes. DMS says MA-PD enrollment is open year-round, and once you have Medicare Parts A and B you may change your health plan election at any time during the plan year. Enrollment and disenrollment follow the same 20th-of-the-month timeline.
Which MA-PD plans can I join?
It depends on where you live: the State's group MA-PD plans are HMOs and PPOs offered in their service areas. MyBenefits lists the current plans and how to reach each one.
Will someone call me to enroll in a State MA-PD plan?
No. DMS says you will never be called to enroll, and official communications carry the DMS or division logo. Treat an unexpected call about your State coverage as a warning sign.
Medicare in your Florida county
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