Florida Seniors Are Among the Most Exposed to the Medicare Gap Suze Orman Is Warning About — Here's What That Gap Actually Costs » Live Insurance News

You paid into Medicare for decades. You turned 65. You thought the hard part was over.

Financial author and television host Suze Orman — along with Fidelity Investments’ 2026 annual retiree healthcare cost estimate — is flagging something that most people approaching Medicare do not fully understand: the program covers a lot, but not everything. And the gap between what Medicare covers and what retirees actually spend has reached a number that stops people cold.

Fidelity estimates that a 65-year-old retiring in 2026 will spend an average of $185,500 on healthcare and medical expenses throughout retirement. That is a 7.5 percent increase from the prior year’s estimate. It does not include long-term care.

For Florida seniors — 4.7 million of them on Medicare, the second-largest Medicare population in the country — understanding where that gap comes from is not an abstract exercise.

What Medicare Actually Costs You Each Month

Medicare’s monthly bill surprises many new enrollees. The program is not free.

Medicare Part B — which covers doctor visits, outpatient care, and most medical services — carries a standard premium of $202.90 per month in 2026. That is up from $185 last year, and the increase absorbed nearly a third of the average retiree’s Social Security cost-of-living adjustment before any other bills arrived.

Part B also carries a $283 annual deductible and 20 percent coinsurance on most services with no annual cap on what you owe. There is no ceiling. A $100,000 hospital procedure leaves you responsible for $20,000 in coinsurance — and Medicare will not cap that at any point in the year.

Part A — which covers inpatient hospital care — is generally premium-free for people who qualify. But it carries a $1,736 deductible per benefit period. If you are hospitalized twice in a year for separate conditions, that deductible can apply twice.

Higher-income Medicare enrollees face additional IRMAA surcharges on top of those premiums. Modified adjusted gross income above $109,000 for single filers or $218,000 for joint filers triggers escalating additional monthly charges.

The 54 Percent Problem

Fifty-four percent of pre-retirees believe Medicare will cover all of their healthcare expenses in retirement, according to Fidelity’s 2026 State of Retirement Planning research.

That belief is incorrect — and the cost of holding it can be significant.

Original Medicare’s list of exclusions catches people off guard consistently. Routine dental care is not covered. Vision exams for glasses are not covered. Hearing aids are not covered. Long-term custodial care — the kind that pays for assisted living or home health aides — is not covered under standard Medicare.

“Health care is the most unpredictable expense because Medicare doesn’t cover everything,” certified financial planner Tyler End told AARP. “Out-of-pocket costs, deductibles, prescription drugs and the potential need for long-term care add up.”

Why Florida Is a Particularly High-Stakes State for This Conversation

Florida has 4.7 million Medicare beneficiaries — second only to California nationally. Florida is where people retire. It is where the healthcare years begin in earnest.

Florida also has one of the highest rates of Medicare Advantage enrollment in the country — which means many Florida seniors are navigating a system where the out-of-pocket exposure looks different than Original Medicare but is not zero. Medicare Advantage plans in 2026 carry a maximum out-of-pocket limit of more than $9,000, though most plans cap at around half that. An unexpected major illness can exhaust that cap and leave a Florida senior absorbing thousands of dollars in costs they did not budget for.

And Florida does not restrict excess charges. In states like Connecticut, Massachusetts, New York, and several others, doctors are banned from charging more than the Medicare-approved amount for a service. Florida has no such ban. A Florida Medicare beneficaries on Original Medicare who sees a doctor who does not accept Medicare assignment can be charged up to 15 percent above the Medicare-approved rate — and Medicare will not cover that excess.

What Medigap Does — and What It Costs in 2026

Medigap is supplemental insurance that wraps around Original Medicare. It fills the gaps — covering coinsurance, deductibles, and in some plans, excess charges — so that a Medicare beneficiary knows what their exposure is before they need care.

From recent reports, Orman appears to lean toward Medigap for people who want predictable healthcare costs — noting that the monthly premium may be worth the certainty it provides compared to the uncapped 20 percent coinsurance exposure of Original Medicare alone. In her own words on her website: “The monthly premium for a Medigap policy depends on your state, but in 2026 it typically costs around $150 to $250 a month, though in high-cost states it may push into $300 or more a month.” She specifically cautions that Medicare Advantage — while lower in upfront costs — can be more expensive than Original Medicare plus Medigap for people with chronic conditions that require regular care.

In Florida, Medigap Plan G is the most commonly purchased plan among new Medicare enrollees since Plan F was closed to new enrollees in 2020. Plan G covers essentially everything Original Medicare does not — except the Part B deductible of $283 — and it covers excess charges. For a Florida Medicare beneficiary worried about the 15 percent excess charge gap, Kiplinger’s 2026 Medigap analysis identifies Plan G as the plan specifically designed to address it.

Florida allows Medigap insurers to use attained-age pricing — meaning your premium increases as you get older. A 65-year-old buying Plan G pays considerably less than a 75-year-old buying the same plan. The window to buy at the lowest rate is the six-month open enrollment period that begins when you first enroll in Part B.

The AEP Connection — 32 Days From Now

The Annual Enrollment Period opens October 15 — 32 days from today. This is when Medicare Advantage members can switch plans, switch from Medicare Advantage to Original Medicare, or change their Part D prescription drug plan.

For Florida seniors who are in Medicare Advantage and considering whether Original Medicare plus a Medigap plan would be a better fit — particularly those who use their coverage frequently or are managing chronic conditions — AEP is the window to make that evaluation and act on it.

The Medicare helpline is 1-800-633-4227. Florida’s SHINE program — Serving Health Insurance Needs of Elders — provides free, unbiased Medicare counseling and can be reached at 1-800-963-5337.

Sources

- ✅ The Street — Fidelity $185,500 estimate, 7.5% increase, 54% pre-retirees mistaken, Part B $202.90/$185, Part A $1,736, Part B $283 deductible, 20% coinsurance no cap, IRMAA $109K/$218K, Tyler End AARP quote, September 13, 2026

- ✅ Suze Orman official — Medigap $150-$250/$300+ high cost states, MA $9,000 max OOP/$4,500 typical, Orman Medigap vs MA analysis, MA more expensive with chronic condition, September 2026

- ✅ Kiplinger — Plan G covers excess charges, Connecticut/Massachusetts/Minnesota/New York/Ohio/Pennsylvania/Rhode Island/Vermont ban excess charges, Part B $283 deductible gap, September 2026

📝 Florida AHCA / CMS / KFF — Florida 4.7 million Medicare beneficiaries, Florida MA enrollment rate among highest nationally, Florida attained-age Medigap pricing, Florida no excess charge ban, Plan F closed new enrollees 2020, Medicare 1-800-633-4227, Florida SHINE 1-800-963-5337, AEP October 15-December 7