If you’re on Medicare in Florida, 2026 is a year you don’t want to ignore. Significant changes are coming to Part B and Part D, and they will affect more than just your monthly bills. You’ll notice differences in premiums, deductibles, and how much you pay for prescription medications.
Some updates are a win, especially if you take expensive medications. Others could quietly stretch your budget, particularly if you rely on a fixed income.
These adjustments are part of nationwide changes that will roll out in 2026. Knowing what’s ahead can help you avoid surprises and make smarter choices about your healthcare coverage.
Read on as we explore 2026 Medicare changes in Florida.
Part B: The Cost of Outpatient Care
Medicare Part B helps cover doctor visits, diagnostic tests, and preventive services. For 2026, Medicare has updated the costs for most beneficiaries:
- Standard Monthly Premium: The Part B premium rises to $202.90 per month, up from $185 in 2025.
- Annual Deductible: The Part B deductible increases to $283, up from $257 in 2025.
The hold harmless rule may protect some Social Security beneficiaries from seeing their net benefits drop. It applies when the Part B premium increase exceeds their cost-of-living adjustment (COLA).
This protection does not apply to everyone. People new to Medicare or subject to income-related monthly adjustment amounts (IRMAA) are generally not covered.
Knowing these limits helps you plan for how the 2026 Part B premium changes may affect your Social Security benefits.
Part D: A New Prescription Drug Structure
Medicare Part D no longer uses the old “donut hole” system. It now uses a simpler benefit structure. The goal is to limit out-of-pocket costs and reduce exposure to catastrophic drug expenses.
$2,100 Out-of-Pocket Cap
Starting in 2026, Medicare Part D sets a firm $2,100 annual out-of-pocket cap for covered prescription drugs. Once you reach that amount, your cost-sharing drops to $0 for the rest of the year. This change is part of the Inflation Reduction Act and offers relief to people who rely on high-cost medications.
First Negotiated Drug Prices
2026 also marks a significant milestone for Medicare. For the first time, negotiated prices will apply to 10 high-cost Part D drugs. These medications treat conditions such as diabetes, heart failure, blood clots, and autoimmune diseases. The lower prices take effect January 1, 2026, and could deliver meaningful savings for beneficiaries who rely on these drugs.
Plan Beyond Medicare
Medicare provides health insurance, but it isn’t a long-term care solution. It doesn’t cover assisted living or extended nursing home stays. For many families, rising Medicare premiums can even affect eligibility for state-funded programs.
To protect your home and savings, it’s essential to look at the bigger picture. Our step-by-step guide to long-term care planning explains how medical costs fit into your overall estate plan. It also provides practical steps to help you make smart, informed decisions for the future.
Strategic Planning Checklist for 2026
2026 brings crucial Medicare changes, and a little planning now can prevent stress later. This checklist covers key financial, medical, and legal steps to protect your health, budget, and wishes.
Financial
- Update your budget to reflect the $202.90 Part B premium.
- Review supplemental coverage (Medigap) or Medicare Advantage plans for 2026 changes.
- Check eligibility for state or federal programs that can help offset premiums or drug costs.
Medical
- Review your Part D formulary to ensure your medications remain covered at the lowest tier.
- Schedule preventive screenings and annual wellness visits.
- Track changes in drug tiers or copays that could affect your out-of-pocket costs.
Legal/Planning
- Ensure your healthcare power of attorney and living will are up to date.
- Designate a healthcare surrogate to uphold your medical wishes.
- Review your estate plan, trusts, and beneficiary designations.
- Document any advanced care preferences beyond standard forms.
FAQS About 2026 Medicare Changes in Florida
Do Medicare changes apply automatically?
Yes. Most updates take effect automatically, but you should review your plan yearly to ensure it meets your needs.
Should Florida seniors expect higher healthcare costs in 2026?
Some costs may rise, depending on your income, coverage, and prescription needs.
How often should I review Medicare plans?
You should review your Medicare plan every year during enrollment periods. Checking annually helps ensure it still fits your health needs and budget.
Does Medicare cover long-term care?
No. Medicare generally does not cover assisted living or long-term nursing home care.
Who can help with planning around Medicare updates?
Professionals with expertise in healthcare, financial, and legal planning can provide guidance and help you make informed decisions.
Planning For Your Medical and Long-Term Care Needs
As Medicare changes, early planning is more critical than ever. Reviewing your coverage now can reduce surprises, support smarter decisions, and help protect your long-term financial and healthcare stability.
The Scott Law Offices can help you understand how these Medicare changes affect your overall planning. Schedule a consultation today to explore your options and plan with confidence.
