Why Florida Seniors Need an Annual Medicare Plan Review

Florida has more Medicare plan options than almost any other state—over 50 Medicare Advantage plans, all 10 standardized Medigap plans, and 20+ Part D plans in most counties. This competition benefits you, but only if you're in the right plan. Here's why annual reviews matter, especially for Florida Medicare beneficiaries.

!A plan review in Florida, representing an annual Medicare plan review

Why Florida Is Different

> 56.1% of Florida beneficiaries are in Medicare Advantage, and plans change every year — which is why an annual plan review matters. (Source: CMS Medicare Monthly Enrollment, 2024.)

Florida leads the nation in Medicare Advantage enrollment, with over 50% of Florida Medicare beneficiaries in MA plans. This high enrollment attracts intense competition among insurers.

Every year, carriers adjust their plans to compete:

• New $0 premium options emerge
• Benefits expand (better dental, vision, hearing coverage)
• Network arrangements change
• Drug formularies shift

The result: The best plan this year might not be the best plan next year. And a better option might exist that wasn't available before.

What Changes Year to Year

Premiums

Medicare Advantage and Part D premiums change annually. A plan that cost $0 last year might have a $30 premium next year—or a plan that cost $50 might drop to $0.

Drug Formularies

Insurance companies renegotiate drug pricing annually. Your medication might:

• Move to a higher cost tier (more expensive)
• Move to a lower cost tier (less expensive)
• Require new restrictions (prior authorization, step therapy)
• Be removed from the formulary entirely

A formulary change alone can add $100+ per month to your drug costs.

Provider Networks

Doctors and hospitals negotiate contracts with Medicare Advantage plans each year. Your doctor might:

• Leave your plan's network
• Switch from "preferred" to "participating" status (higher costs for you)
• Join a different plan's network that you're not enrolled in

Network changes can force you to choose between your doctor and your plan.

Extra Benefits

Medicare Advantage plans compete on extras like:

• Dental coverage (some plans now cover implants and major work)
• Vision coverage (frames, lenses, contacts)
• Hearing aid allowances
• Over-the-counter allowances
• Transportation to appointments
• Fitness memberships

Benefits expand and contract as plans adjust their offerings.

Out-of-Pocket Maximums

The annual limit on what you pay out-of-pocket can change significantly. A lower maximum protects you from catastrophic costs.

Real Examples of Why Reviews Matter

Case 1: Drug Formulary Change

Maria had been on the same Medicare Advantage plan for three years. Her cholesterol medication was a $10 copay. In year four, the plan moved it to a higher tier—$67 copay. She was paying $684 more per year without realizing another plan covered the same medication for $12.

Case 2: Better Plan Became Available

James assumed his $89/month Medigap Plan G was the best available. When he finally compared quotes, he found an identical Plan G for $61/month—saving $336 annually for the same coverage.

Case 3: Network Change

Patricia's cardiologist left her Medicare Advantage network. She could have switched plans during AEP but didn't review her options. She ended up paying out-of-network rates for critical care.

When to Review Your Medicare Coverage

During Annual Enrollment (October 15 - December 7)

This is the primary window for making changes. Your plan sends an Annual Notice of Change (ANOC) each September—review it carefully.

When You Receive Your ANOC

The Annual Notice of Change details everything changing in your plan for next year:

• Premium changes
• Copay/coinsurance changes
• Drug formulary changes
• Network updates
• Benefit modifications

Compare these changes against your needs and alternatives.

When Your Situation Changes

Even outside enrollment periods, changes in your life should trigger a coverage review:

• New medications prescribed
• New diagnoses
• New doctors
• Change in how often you use healthcare
• Retirement or loss of employer coverage
• Move to a different area

Some changes qualify you for Special Enrollment Periods.

What to Compare

When reviewing your Medicare coverage, compare:

1. Total drug costs: Not just premiums—copays for your specific medications 2. Network coverage: Are your doctors and hospitals in-network? 3. Out-of-pocket maximum: How much could you pay in a bad year? 4. Extra benefits: Dental, vision, hearing, OTC allowances 5. Premium vs. cost-sharing tradeoff: Sometimes higher premiums mean lower total costs

Getting Help with Your Review

Florida's abundance of Medicare options makes self-comparison difficult. Dozens of plans, hundreds of combinations, and complex drug pricing make it easy to overlook savings.

A licensed Medicare advisor can:

• Compare all available plans (not just a few)
• Check your specific doctors across every option
• Calculate your drug costs under each plan
• Identify which plan offers the lowest total cost
• Explain the tradeoffs clearly

This service is free—advisors are paid by insurance companies, not by you.

Schedule Your Free Annual Review

Don't assume your current plan is still the best fit. Let us compare your options and make sure you're not overpaying.

Schedule your free Medicare review to see if a better plan is available for next year.

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This article is for educational purposes. Medicare plans change annually. Consult with a licensed Medicare advisor for personalized guidance specific to your situation.

Next steps: Take our 2-minute Medicare plan quiz, book a free Medicare review, or see our Medicare Advantage vs. Supplement comparison.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.