Helping make Medicare easier to understand.
Serving Our Community, Helping Our Seniors.
Habla Español & Pale Kreyòl
HealthSun is built around coordinated South Florida Medicare Advantage care, with an HMO-focused network and Special Needs Plans in Miami-Dade, Broward and Palm Beach.
The biggest question is not how many benefits the plan advertises. It is whether the HealthSun network, medical-center relationships, specialists, prescriptions and costs fit the healthcare you actually use.
Miami-Dade • Broward • Palm Beach
HealthSun is highly localized. The same carrier can look different by county, plan family and eligibility group.
HealthSun is part of the Elevance Health family of affiliated health plans.
Current Medicare coverage is concentrated in Miami-Dade, Broward and Palm Beach.
Plan numbers, benefits, OTC amounts and network details can change between counties.
With HealthSun, your ZIP code tells us what may be available. Your doctors tell us whether it may actually work.
Ask whether each provider participates with the exact HealthSun Medicare plan you are considering.
Primary care physician
Medical center
Cardiologist
Endocrinologist
Oncologist
Orthopedist
Hospital
Lab, imaging and therapy
HealthSun’s local medical-center relationships can matter as much as the individual doctor.
Current formulary
Drug tier
Prior authorization
Step therapy
Quantity limits
Part B vs Part D
Network pharmacy
Mail delivery
“Part D included” does not mean every prescription is covered affordably.
The logo stays the same. The plan doesn’t.
Current families include HealthAdvantage, HealthAdvantage Plus, MediMax, MediSun, VitalCare and Full Dual variations depending on eligibility.
Current documents show county-specific HealthAdvantage, Plus, MediMax, MediSun, VitalCare and Full Dual options depending on plan.
Current offerings include HealthAdvantage, HealthAdvantage Plus, MediSun Plus, VitalCare and Full Dual Plus products depending on eligibility.
Compare exact plan number, benefits, OTC, network details and eligibility before enrolling.
HealthSun’s current individual Medicare portfolio is HMO-based, so network fit matters more than broad out-of-network flexibility.
Standard HMO Medicare Advantage families with county-specific versions.
Designed for qualifying people with Medicare + Medicaid. Current products include MediSun Plus, Extra and Full Dual variations.
Designed for qualifying beneficiaries with diabetes, chronic heart failure and certain cardiovascular disorders. Licensed-practitioner verification applies.
Another HealthSun HMO family currently available in selected South Florida counties.
Routine care generally centers on participating HealthSun doctors, hospitals and providers.
Emergency, urgently needed care, renal dialysis and certain authorized care may be covered outside the service area, but routine HMO care is much more local.
Some benefits are plan-specific. Others can require separate SSBCI eligibility. Never assume an advertisement establishes your personal benefit.
Current HealthSun plans include OTC benefits, but monthly amounts and expiration rules vary by plan and county.
Certain qualifying chronically ill members can receive approved food and utility benefits. SSBCI requirements apply.
Preventive and comprehensive dental can include fillings, crowns, root canals and, on some plans, implant coverage.
Check provider, allowance, frequency, hearing-aid models and member cost—not just the headline amount.
Routine medical transportation is available on certain plans. Some D-SNP products can provide more extensive transportation subject to plan rules.
Applicable plans include fitness membership, but it should remain secondary to network, prescriptions and medical costs.
Certain plans include personal emergency-response systems for members who may benefit from added monitoring support.
Certain HealthSun plans may reduce part of the Medicare Part B premium. Availability and amount vary by plan.
HealthSun can help connect members with housing, food assistance, financial aid, behavioral-health and community resources.
Qualifying for VitalCare does not automatically mean you qualify for food or utility benefits, and vice versa.
These plans use different eligibility rules and should not be treated as interchangeable.
Eligibility centers on Medicare + Medicaid. The Medicaid level matters because cost-sharing protections vary by category.
MediSun Plus
MediSun Extra
MediSun Full Dual Plus
MediSun Full Dual Extra
Eligibility centers on qualifying chronic conditions such as diabetes, chronic heart failure and certain cardiovascular disorders. HealthSun confirms the condition through a licensed practitioner.
$0 premium does not mean $0 healthcare.
Can I receive my care?
What is my worst-case medical exposure?
What does an admission cost?
Especially if you see several regularly.
Surgery and imaging.
Formulary + pharmacy.
Evaluate together.
Only after the medical plan works.
| Your Priority | What to Verify |
|---|---|
| Keep my PCP | Exact HealthSun plan participation |
| Keep my medical center | Exact center / plan relationship |
| Keep my specialists | Exact network participation |
| Use my hospital | Hospital contract |
| Prescription coverage | Formulary + pharmacy + authorization |
| Snowbird / out-of-area care | HMO limits + alternatives |
| Medicare + Medicaid | D-SNP eligibility + Medicaid level |
| Diabetes / heart condition | VitalCare eligibility + verification |
| Food / utilities | SSBCI eligibility |
| Dental / implants | Exact plan schedule + authorization |
Start with the county and care team, then compare prescriptions, eligibility and costs.
Internal comparison links come first. Use official Gold Kidney resources only for plan-specific verification.
HealthSun is a South Florida Medicare Advantage company founded in 2005 and headquartered in Miami. It currently serves Medicare beneficiaries in Miami-Dade, Broward and Palm Beach counties.
HealthSun is an Elevance Health-affiliated company; its provider materials identify it as wholly owned by Elevance Health.
No. Both are associated with Elevance Health, but they are separate health plans with different Medicare contracts, provider networks and products.
HealthSun currently serves Medicare beneficiaries in Miami-Dade, Broward and Palm Beach counties.
HealthSun’s current individual Medicare portfolio is HMO-based, including standard HMO, HMO D-SNP and HMO C-SNP coverage.
Yes. Current products include MediSun and MediSun Full Dual HMO D-SNP plans.
Yes. HealthSun currently offers VitalCare HMO C-SNP coverage for beneficiaries meeting applicable chronic-condition requirements.
Current VitalCare coverage is designed for qualifying beneficiaries with diabetes mellitus, chronic heart failure and/or specified cardiovascular disorders.
Yes. HealthSun’s current Medicare plans include Part D prescription coverage subject to the exact plan formulary and pharmacy rules.
Some plans do. Implant coverage is plan-specific and should be verified using the exact dental schedule, annual allowance, network and authorization rules.
Yes. Current HealthSun plans include monthly OTC benefits, but the amount varies by plan and county.
Certain qualifying chronically ill members can receive healthy-food benefits under applicable SSBCI rules. Not every HealthSun member qualifies.
Certain HealthSun plans provide routine medical transportation, and some current D-SNP products offer extensive transportation subject to plan rules.
Routine coverage outside HealthSun’s service area is limited. Emergency care, urgently needed care, renal dialysis and certain preapproved care can still be covered.
HealthSun can be a strong option when its South Florida HMO network includes your doctors, medical center and hospital, your prescriptions are covered well, and the plan’s costs and benefits fit your needs.
HealthSun’s value depends on how its HMO network, medical-center relationships, specialists, prescriptions and Special Needs Plan eligibility fit you—not simply on supplemental benefits.
Helping make Medicare easier to understand.
Independent Medicare Guidance
Medicare Plan Assistance is an independent insurance agency and is not Medicare, HealthSun Health Plans, Elevance Health, Carelon or a government agency.
HealthSun plan availability, networks, premiums, copays, maximum out-of-pocket amounts, prescription formularies, authorization requirements, OTC allowances, dental benefits, transportation, food and utility eligibility, Part B reimbursement, Star Ratings and Special Needs Plan eligibility can vary by county, plan, contract and plan year.
Before enrolling, review the exact plan’s Summary of Benefits, Evidence of Coverage, Provider Directory, Drug Formulary and applicable CMS Star Rating.