Medicare Advantage FAQs

How do I choose a plan?

Choosing a health plan is not as easy as it once was. Of course, the costs, coverage, and out-of-pocket maximum are important, but just as important are the doctors and hospitals covered in the provider network and the plan's quality ratings. So, before you enroll in a plan, make sure you're not trading quality, service, and the doctors and hospitals you trust for premiums and copayments that seem too good to be true

Who is eligible to enroll?

For Medicare Advantage plans

Florida Hospital SunSaver (HMO-POS) and Florida Hospital Explorer plans (HMO-POS)

To be eligible to enroll, you must:

  • live in our service area (Volusia County and Flagler County in Florida), and
  • be entitled to Medicare Part A and enrolled in Medicare Part B, and continue to pay your Part B premium (unless otherwise paid for under Medicaid or another third party), and
  • not be diagnosed with End-Stage Renal Disease (ESRD).

Once we verify your eligibility with Medicare, your coverage will become effective the first day of the month after we receive your enrollment form.

When can I enroll?

The Annual Enrollment Period is from October 15-December 7. For most people, this is the only time they can choose their Medicare Advantage plan, unless they qualify for a special election period. Some of the reasons that may qualify you for a special election period include:

  • You can enroll when you first become eligible for Medicare (3 months before you turn age 65 to 3 months after the month you turn age 65).
  • If you receive Medicare due to disability, you can join during the 3 months before to 3 months after your 25th month of disability.
  • If you move into an area where your previous coverage is no longer available, you may choose a new plan in your new service area.
  • If you have both Medicare and Medicaid.
  • If you qualify for "extra help."
  • If you live in an institution.
  • Other special circumstances (such as losing employer group coverage).

Please contact customer service for more information.

Can I change my coverage?

Most people cannot change to a different Medicare Advantage plan after December 7, but you may disenroll from your plan between January 1 and February 14. If you disenroll from your current Medicare Advantage plan during this time, you will return to Original Medicare—and if your current plan includes Part D prescription coverage, Medicare will allow you to choose a stand-alone Part D plan (this is also called a PDP).

There are also special situations that may qualify you to change your coverage during other times of the year (for example moving to another area), so please contact customer service for more information.

Medicare Advantage Disenrollment Form

Member Disenrollment Rights & Responsibilities


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Last updated: 10/01/2014