Medicare Annual Enrollment Period 2026: What Florida Residents Need to Know

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# Medicare Annual Enrollment Period 2026: What Florida Residents Need to Know

Florida's Medicare AEP runs October 15-December 7. Here's what changes in 2026, what to watch for, and how to make a smart plan decision.

Author: Lynsey Brennan, Licensed Medicare Advisor | Published June 27, 2026 Reading time: 6 min read

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Quick Answer

The Medicare Annual Enrollment Period (AEP) runs October 15 through December 7 every year. During this window, you can switch Medicare Advantage plans, move between Medicare Advantage and Original Medicare, or change your Part D drug plan — with coverage starting January 1, 2026. If your current plan is changing its costs, network, or drug formulary, this is your one reliable opportunity each year to make a change.

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Key Takeaways

• The AEP window is October 15-December 7; changes take effect January 1, 2026.
• Florida's Medicare Advantage enrollment rate is 56.1%, above the national average of ~54% (CMS Medicare Monthly Enrollment, 2024).
• The 2026 Part D out-of-pocket cap is $2,000/year — a significant change from prior years — thanks to the Inflation Reduction Act.
• The 2026 standard Part B premium is $185/month, with a $257 annual deductible (CMS, November 2025).
• Medicare Advantage and Medigap serve very different needs — understanding the difference before AEP opens can save you from a costly mismatch.

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Table of Contents

1. What the AEP Actually Lets You Do 2. 2026 Medicare Cost Changes You Should Know 3. Florida's Medicare Landscape: What the Numbers Tell Us 4. Medicare Advantage vs. Medicare Supplement in 2026 5. Part D Drug Coverage: A Real Improvement Worth Understanding 6. Common Mistakes Florida Seniors Make During AEP 7. How to Prepare Before October 15

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What the AEP Actually Lets You Do

The Annual Enrollment Period is not the only time you can make Medicare changes, but it is the most flexible. During October 15-December 7, you can:

• Switch from one Medicare Advantage plan to another
• Drop a Medicare Advantage plan and return to Original Medicare (Parts A and B)
• Join, switch, or drop a standalone Part D prescription drug plan
• Enroll in Medicare Advantage if you're currently on Original Medicare

What the AEP does not let you do automatically: switch from Medicare Advantage to a Medigap (Medicare Supplement) plan without passing medical underwriting in most states, including Florida. There are limited exceptions, but this is a real constraint worth knowing before you make a move. Check the Medicare enrollment periods guide for a full breakdown of when each window applies.

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2026 Medicare Cost Changes You Should Know

A few numbers matter most heading into this AEP:

Part B premium and deductible: The 2026 standard Part B premium is $185/month, and the annual Part B deductible is $257 (CMS, November 2025). These apply whether you're on Original Medicare, a Supplement plan, or most Medicare Advantage plans.

Medicare Advantage out-of-pocket maximum: In 2026, the cap on in-network out-of-pocket costs under Medicare Advantage plans is $9,350 (CMS, 2025). This is a ceiling, not a target — individual plans may set their limits lower, and some do. You'll want to compare actual plan limits, not just the maximum allowed.

Part D changes: The $2,000 annual out-of-pocket cap on prescription drugs is now in effect for 2025 and carries into 2026 under the Inflation Reduction Act. Covered insulin remains capped at $35/month under Medicare Part D. These changes are meaningful for anyone managing ongoing prescriptions. See the Part D drug coverage guide for more detail on how the cap works in practice.

For a full look at what costs apply to your situation, the 2026 Medicare costs page is a good starting point.

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Florida's Medicare Landscape: What the Numbers Tell Us

Florida is one of the most Medicare Advantage-heavy states in the country. As of 2024, 56.1% of Florida Medicare beneficiaries are enrolled in Medicare Advantage plans (CMS Medicare Monthly Enrollment, 2024), compared to the national average of approximately 54% (CMS, 2024).

That high enrollment rate reflects real choice — Florida's urban and suburban markets, including South Florida, the Tampa Bay area, and Orlando, typically offer a wide range of plans from carriers like Humana, UnitedHealthcare, Aetna, and others. But more options also means more room for mismatches between what a plan offers and what you actually need.

If you want to dig into enrollment data, network coverage maps, and county-by-county plan availability, the Florida Medicare data page has state-specific detail.

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Medicare Advantage vs. Medicare Supplement in 2026

This is the most common question I hear, and it doesn't have a universal answer. Both approaches have genuine trade-offs.

Medicare Advantage plans often come with lower monthly premiums — sometimes $0 above your Part B premium — and many include extras like dental, vision, and hearing coverage. The trade-off is a network. You typically need to use in-network providers, and your costs can vary depending on how much care you use throughout the year, up to that $9,350 in-network cap.

Medicare Supplement (Medigap) plans charge a higher monthly premium but cover most or all of the cost-sharing gaps in Original Medicare. You can generally see any provider that accepts Medicare, with no network restrictions. That flexibility matters a lot if you travel frequently, spend time in multiple states, or want predictable out-of-pocket costs.

One honest note: if you're currently on a Medicare Advantage plan and want to switch to Medigap, Florida does not potential issue rights for most people outside of specific enrollment windows. That means an insurer can ask about your health history and may decline coverage or charge higher premiums. This is a real barrier that catches people off guard.

The Medicare Advantage vs. Supplement comparison walks through this in detail, and the Medicare Advantage guide and Medigap guide each cover their respective options more deeply.

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Part D Drug Coverage: A Real Improvement Worth Understanding

The $2,000 out-of-pocket cap under Part D is the most significant change for Medicare beneficiaries in years. Before this took effect, people with high drug costs could spend $3,000, $5,000, or more annually on prescriptions under the catastrophic coverage phase. That ceiling is now gone.

The cap applies to what you pay out of pocket — deductibles, copays, and coinsurance all count toward it. Once you hit $2,000, you pay nothing more for covered drugs for the rest of the plan year.

That said, the cap only applies to drugs covered on your plan's formulary. If a drug you take isn't covered, or is placed on a high-cost tier, that's still a problem worth addressing at plan review time. Running a formulary check before AEP closes is one of the most practical things you can do. The plan comparison tool can help you check drug coverage across available plans.

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Common Mistakes Florida Seniors Make During AEP

A few patterns come up again and again:

Not reviewing the Annual Notice of Change. Every fall, your plan is required to send you this document. It lists every cost and benefit change for the coming year. Many people set it aside without reading it — and then discover in January that their premium, copay, or formulary changed.

Assuming last year's plan is still the best option. Plans change every year. A plan that was a good fit in 2025 may have dropped a provider, added a prior authorization requirement, or changed drug tier placements.

Focusing only on the monthly premium. A $0 premium plan can come with high specialist copays or a narrow hospital network. The full cost picture matters more than the premium line.

Switching without checking provider network. If you have established specialists or a preferred hospital system, verify they're in-network on any new plan before you enroll.

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How to Prepare Before October 15

You don't need to wait until October 15 to get ready. In fact, the weeks before AEP opens are the best time to:

1. Pull out your current plan's Annual Notice of Change when it arrives in late September 2. Make a list of your regular doctors, specialists, and medications 3. Review your actual healthcare use from the past year — hospitalizations, specialist visits, prescriptions 4. Decide what matters most: lowest premium, predictable costs, network flexibility, or extras like dental and vision 5. Schedule a review with a licensed Medicare advisor before the rush of October and November

If you'd like help sorting through your options before AEP opens, I'm happy to do a no-cost, no-pressure review with you. Visit the Medicare FAQ if you have specific questions, or use the plan comparison tool to start looking at what's available in your county.

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Frequently Asked Questions

Q: Can I switch Medicare Advantage plans during the AEP if I'm happy with my coverage? A: Yes — the AEP lets you switch plans even if you're satisfied, though there's usually no reason to change if your plan's costs, network, and drug coverage are staying the same. If you haven't received or reviewed your Annual Notice of Change, that's the first step before deciding to stay or switch.

Q: Does the $2,000 Part D out-of-pocket cap apply to Medicare Advantage drug coverage too? A: Yes, the $2,000 cap applies to Medicare Part D drug coverage whether it comes through a standalone Part D plan or through the drug coverage built into a Medicare Advantage plan. The cap applies to drugs on your plan's formulary — drugs not covered by your plan don't count toward it.

Q: If I switch from Medicare Advantage to Original Medicare during AEP, can I automatically get a Medigap plan? A: Not in most cases in Florida. Outside of specific potential issue situations — such as your plan leaving the market — insurers can use medical underwriting and may decline your application or charge higher premiums based on your health history. This is one reason to think carefully before dropping Advantage coverage without a clear path to Medigap.

Q: What's the deadline to make AEP changes for January 1, 2026 coverage? A: December 7, 2026 is the last day to submit enrollment changes during the AEP. Changes made by that date take effect January 1 of the following year. Missing that deadline typically means waiting until the next AEP or qualifying for a Special Enrollment Period.

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The Bottom Line

AEP is a real opportunity — but only if you use it intentionally. With Florida's high Medicare Advantage enrollment rate, more options available than ever, and meaningful 2026 changes to Part D costs, reviewing your plan before December 7 is worth the time. Don't assume your current plan is still the best fit without checking. If you'd like a straightforward, one-on-one review of your options with no sales pressure, schedule your free Medicare review here or call me directly at 561-247-0678.

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Sources

• CMS Medicare Monthly Enrollment, 2024 — Florida and national Medicare Advantage enrollment figures
• CMS, November 2025 — 2026 Part B premium ($185/month) and Part B deductible ($257)
• CMS, 2025 — 2026 Medicare Advantage in-network out-of-pocket maximum ($9,350)
• Inflation Reduction Act — Part D $2,000 annual out-of-pocket cap (effective 2025) and $35/month insulin cap

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This article is for educational purposes and is not affiliated with or endorsed by the federal Medicare program or any government agency. HealthPlan Connect is a private, licensed Medicare advisory service. FL License #G007269.