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Your Step-by-Step Guide to Medicare Basics & Enrollment in Florida

Turning 65? New to Medicare due to disability? You’re not alone in feeling overwhelmed by all the terms, timelines, and plan options. This Medicare 101 guide is designed to walk you through the essentials—so you understand how Medicare works, when to enroll, and what coverage choices you’ll need to make.


Whether you live in Winter Park, Orlando, or anywhere in Central Florida, our team can answer questions, compare plans, and help you make confident choices from day one.

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Who Qualifies

Eligibility: Who Can Get Medicare?

You may qualify for Medicare if you:


  • Are age 65 or older and a U.S. citizen (or legal permanent resident for at least 5 years)
  • Are under 65 with certain disabilities (eligible after 24 months of Social Security Disability benefits)
  • Have End-Stage Renal Disease (ESRD) or ALS, at any age


If you’re already receiving Social Security benefits when you turn 65, you’ll usually be enrolled automatically in Parts A and B. If not, you’ll need to apply through the Social Security Administration.

Medicare Basics: Parts A, B, C, and D

Medicare is divided into four parts:

01

Part A – Hospital Insurance

Covers inpatient hospital care, skilled nursing facility stays, hospice care, and some home health services. Most people pay no monthly premium for Part A.

02

Part B – Medical Insurance

Covers outpatient care, doctor visits, preventive services, lab tests, durable medical equipment, and more. Part B has a monthly premium and typically covers 80% of approved costs after the deductible.

03

Part C – Medicare Advantage

Offered by private insurers, these plans bundle Part A and B (and usually Part D), and may include extras like dental, vision, hearing, and fitness benefits.

04

Part D – Prescription Drug Coverage

Helps pay for prescription medications. Available as a standalone plan for those with Original Medicare or built into most Medicare Advantage plans.

Medicare Eligibility

Eligibility: Who Can Get Medicare?

You may qualify for Medicare if you:

  • Are age 65 or older and a U.S. citizen (or legal permanent resident for at least 5 years)

  • Are under 65 with certain disabilities (eligible after 24 months of Social Security Disability benefits)

  • Have End-Stage Renal Disease (ESRD) or ALS, at any age

If you’re already receiving Social Security benefits when you turn 65, you’ll usually be enrolled automatically in Parts A and B. If not, you’ll need to apply through the Social Security Administration.

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Medigap Enrollment

How to Enroll in Medicare

Your Initial Enrollment Period (IEP) lasts seven months: three months before your 65th birthday month, your birthday month, and three months after.



Ways to enroll:


  1. Online at SSA.gov

  2. By phone through the Social Security office

  3. In person at your local SSA office (appointment recommended)

If you’re still working and have employer health coverage, you may be able to delay Part B without penalty. Always confirm with your benefits administrator before making that choice.

Medicare Costs 101

  • Part A – Usually $0/month if you’ve worked 10+ years and paid Medicare taxes

  • Part B – Standard monthly premium (adjusted annually; higher for high-income earners)

  • Deductibles & Coinsurance – Medicare generally pays 80% for covered services after deductibles; you pay 20% unless you have supplemental coverage

  • Part C & Part D – Premiums vary by plan and carrier

Because Medicare doesn’t cover everything, many people choose a Medicare Supplement plan or a Medicare Advantage plan to limit out-of-pocket costs.

Medicare & Medicaid

Medicare vs. Medicaid in Florida

  • Medicare – Federal health insurance for seniors and certain disabled individuals

  • Medicaid – State/federal program providing health coverage to low-income individuals, including some Medicare beneficiaries (“dual eligibles”)

Florida Medicaid may help pay Medicare premiums and costs for those who qualify.

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Frequently asked questions

Frequently Asked Questions for New Medicare Beneficiaries

  • When will my Medicare coverage start?

    If you enroll during the three months before your 65th birthday month, coverage starts the first day of your birthday month.

  • Do I need Part B if I have employer insurance?

    If your employer has 20 or more employees and your coverage is considered creditable, you may delay Part B without penalty.

  • Does Medicare cover dental or vision?

    Original Medicare does not cover routine dental or vision, but many Medicare Advantage plans do.

  • What’s the difference between Medicare Advantage and Medigap?

    Medicare Advantage replaces Original Medicare with a private plan, often including extra benefits. Medigap works with Original Medicare to cover out-of-pocket costs.

  • What happens if I miss my Initial Enrollment Period?

    You may have to wait until the General Enrollment Period (Jan 1–Mar 31) and could face late penalties.

Free Medicare 101 Workshops & Personal Help

We offer free educational Medicare 101 seminars in the Winter Park area and virtual sessions for those who prefer to meet online. These events are designed to help you understand your choices before you enroll. Call us to find out the next seminar date.

Next Steps After Learning Medicare Basics

Unlock Your Potential

Once you understand the foundation, it’s time to decide: Original Medicare + Supplement + Part D, or Medicare Advantage?


We’ll help you compare all your options, check your doctors and prescriptions, and guide you through enrollment—at no cost to you.


Call (321) 214-4594 or contact us today to schedule your free Medicare planning session.

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