Medicare Advantage plans are set to change in 2026, and seniors across Florida will need to pay close attention. Some plans will disappear, others will raise premiums, and benefits may shift in ways that catch people off guard.
For many, that could mean paying more out of pocket, seeing a trusted doctor leave the network, or losing extras like dental, vision, or prescription drug coverage.
The good news is that you don’t have to face these changes alone. Medicare Information Project helps seniors review plan options, compare costs, and avoid unexpected gaps in coverage.
Why Are Plans Changing in 2026?
Every year, the Centers for Medicare & Medicaid Services (CMS) reviews how it funds Medicare Advantage. In 2026, federal reimbursement formulas are shifting while healthcare costs continue to rise.
This combination is pushing insurers to make adjustments, and in some cases, to pull out of certain Florida counties altogether.
Another factor is CMS’s Star Ratings system. Plans that score four or five stars typically get extra funding and often remain available. Plans with lower ratings don’t receive the same support and are more likely to disappear.
In simple terms, higher-rated plans get rewarded and lower-rated plans get cut.
The new federal rules under the Inflation Reduction Act also play a role. Medicare has begun negotiating drug prices with pharmaceutical companies. While this is meant to lower costs long term, it can cause short-term changes in which prescriptions each plan covers.
Hospitals and provider groups are also asking insurers for higher payments, which may lead to smaller provider networks.
Here in Florida, seniors typically have more Advantage options than those in rural states. But even in Tampa Bay, insurers trim or remove plans that aren’t performing. That’s why reviewing your coverage every fall is so important.
How Medicare Advantage Changes Could Affect You
So what does all of this mean for everyday seniors? The effects won’t be the same for everyone, but most people will notice changes in at least one area.
Doctor access is often the first concern. If your plan narrows its network, your physician may no longer be included. For example, if your Tampa primary care doctor drops out of your network, you may have to switch doctors or pay out-of-network rates.
Monthly costs tend to rise almost every year. Even if premiums stay low, copays for visits or prescriptions may increase. A $10 copay today could be $20 next year. For seniors living on fixed incomes, even small hikes add up quickly.
Drug coverage is another big change area. Each plan keeps a formulary — basically, an official list of covered medications. Formularies are updated annually, and a prescription you depend on may move to a higher tier or be dropped. That can mean paying hundreds more for the same medication.
Then there are the extra benefits like dental, vision, hearing, gym memberships, or transportation. These perks often attract people to Advantage plans, but they’re not guaranteed. Insurers usually cut back on them first when costs rise.
Finally, the out-of-pocket maximum — the most you could pay in a year — is expected to increase again. For 2025, it’s $8,850 for in-network care. If you face serious health issues in 2026, you could hit a higher cap before the plan fully covers costs.
For a closer look at where Medicare leaves gaps, see our guide on what Medicare doesn’t cover.
Why Timing Matters
Medicare works on strict deadlines, and missing them can cost you. Think of it as three key checkpoints:
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September 2025: Insurers mail the Annual Notice of Change (ANOC) to explain what’s different about your plan.
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October 15–December 7, 2025: Medicare Open Enrollment — your main chance to switch plans for 2026.
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January 1–March 31, 2026: Medicare Advantage Open Enrollment — a second window where you can make one change if you need to.
If your plan is ending, you’ll also qualify for a Special Enrollment Period (SEP). SEPs are designed for major changes such as plan cancellations, moving to a new county, or losing employer coverage.
Acting early gives you more breathing room. Instead of scrambling in December, you can compare networks, review drug lists, and confirm costs well ahead of time. Waiting too long often means fewer choices and higher stress. Our Medicare penalty calculator is a handy tool to see what delays could cost you financially.
Medicare Advantage vs. Medicare Supplement in 2026
Medicare Advantage is popular because it bundles medical and drug coverage in one plan. But with the changes ahead, some seniors may find Medicare Supplement plans in Florida — often called Medigap — more appealing.
Supplements work alongside Original Medicare. They usually have higher monthly premiums but fewer surprise costs, and they let you see any doctor who accepts Medicare.
For example, if you want the freedom to keep your specialist in Orlando and still see a provider in Tampa, Medigap can make that easier.
Advantage plans, on the other hand, tend to have lower premiums but stricter provider networks and changing extras. If you’re unsure which route is best, see our guide on comparing Medicare Supplement vs. Advantage.
How Medicare Information Project Helps
Sorting through Medicare options on your own can feel overwhelming. That’s why so many Florida seniors turn to the Medicare Information Project. We’ve helped residents across Tampa Bay — from Brandon and Riverview to Sun City and Plant City — make confident choices about their coverage.
Here’s how we help:
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Personalized comparisons: See plans side by side, with costs and benefits explained in plain language.
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Guidance on Supplements and Part D: If you’re exploring alternatives to Advantage, we’ll walk you through your options.
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Enrollment support: We handle the details so you don’t miss deadlines or paperwork.
Because we’re independent, we don’t push one insurer over another. Our only goal is to find the plan that fits you best. For example, we recently worked with a Riverview retiree whose Advantage plan dropped her cardiologist. By switching to another local plan, she kept her doctor and saved $90 per month.
If you’re in Hillsborough County, we also offer direct Medicare assistance in Tampa and can connect you with a local Medicare agent in Brandon.
Take the Next Step
Medicare Advantage changes for 2026 don’t have to leave you guessing. With the right guidance, you can protect your coverage, manage your costs, and head into the new year with confidence.
Medicare Information Project is here to guide you step by step, making the process simple and stress-free. Schedule a free consultation with one of our local advisors today.
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FAQs
When do the 2026 Medicare Advantage changes take effect?
Most changes begin January 1, 2026, but plan details are available starting October 1, 2025.
What happens if my plan ends?
You’ll qualify for a Special Enrollment Period to pick a new plan. See our guide on switching Medicare Advantage in Florida for the steps.
Can I return to Original Medicare?
Yes. During open enrollment, you can return to Original Medicare. Many seniors add a Supplement and Part D plan for more complete coverage. Our guide on choosing Medigap Plan G explains why it’s popular in Florida.
Will my prescriptions still be covered?
Coverage depends on the formulary, or drug list, each plan uses. These lists change annually. If your medication is dropped, you may face higher costs — but an advisor can help you find a plan that still covers it. See our resource on how Medicare Part D works for details.
What if I move to another county in Florida?
Moving can qualify you for a Special Enrollment Period. Plans available in Brandon may differ from those in Plant City, so reviewing options right away is key.
How do Medicare Star Ratings affect my plan choices?
Plans with higher ratings generally offer better benefits and more stability. Choosing a highly rated plan can reduce the risk of sudden changes or cuts.
What happens if I miss the enrollment window?
If you miss both the fall and early 2026 enrollment periods, you may have to wait until the next cycle unless you qualify for a Special Enrollment Period. This could leave you paying higher costs or going without needed coverage.