Medicare

2026 Medicare Changes Every South Florida Senior Should Know

Viva Insurance Group · Updated July 2026 · 6 min read

Older Florida couple reviewing 2026 Medicare changes with a licensed agent

Medicare changes a little every year, but 2026 brings a few updates worth paying attention to, especially here in Miami-Dade and Broward, where more than half of people on Medicare use a private Advantage plan. Here is what actually changed, in plain language, with the numbers you can check yourself.

The Part D drug cap gets better

The single biggest change helps anyone who takes expensive medications. For 2026, your out-of-pocket spending on covered Part D prescription drugs is capped at $2,100 for the year (up slightly from $2,000 in 2025). Once you hit that amount, you pay nothing more for covered drugs for the rest of the calendar year. The old "donut hole" coverage gap is gone for good.

There is a companion program worth knowing about: the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across monthly installments instead of paying a large amount all at once. If a high-cost prescription used to wreck your budget early in the year, ask us whether this helps you.

Part B costs went up

The other side of the coin: the standard Part B premium rose to about $202.90 per month for 2026 (from $185 in 2025), and the annual Part B deductible increased to roughly $283. Higher earners pay more through IRMAA surcharges. These are set by the federal government, so they are the same with any agent, and you can confirm the current figures at Medicare.gov.

In plain English: your drug protection got stronger, but your Part B premium and deductible went up. Whether you come out ahead depends on your prescriptions and which plan you are in, which is exactly the math to run before the deadline.

Lower prices on 10 common drugs

For the first time, Medicare-negotiated prices took effect on January 1, 2026 for 10 widely used medications, including treatments for diabetes, blood clots, heart failure, and certain autoimmune conditions. If you take one of these, your plan must make the negotiated price available. It is worth checking your specific drugs against your 2026 plan's formulary, because tiers and pharmacies can still change.

Advantage plans: read the fine print this year

Florida has one of the largest, most competitive Medicare Advantage markets in the country, with hundreds of plans available statewide. For 2026:

Some plans left certain counties. If your plan is discontinued and you do nothing, you can be moved back to Original Medicare, which does not include drug coverage. Do not ignore a discontinuation notice.
Networks changed. Even if your plan continues, your doctor or hospital may no longer be in-network for 2026. The Medicare Plan Finder now shows provider networks, but always confirm directly with your doctor's office.
Extra benefits shifted. Dental, vision, hearing, and grocery or over-the-counter allowances vary a lot by county and can change year to year. Do not pick a plan for a perk you will not use.

Advantage plans also have a yearly cap on your in-network medical spending (the maximum out-of-pocket, or MOOP). The federal maximum for 2026 is in the ballpark of $9,250, but most South Florida plans set theirs well below that. A lower MOOP protects you in a bad health year; verify the exact number on each plan's Summary of Benefits.

What you should actually do before December 7

✓Read your Annual Notice of Change (ANOC). It arrives in the fall and spells out how your plan changes for 2026. Do not set it aside.
✓List your doctors and every medication. Check both against your 2026 plan before you renew.
✓Compare total yearly cost, not just premium. A $0 premium plan can cost more once copays and drug tiers are counted.
✓Use the Annual Enrollment Period (October 15 – December 7) to switch if your plan no longer fits. Advantage members also get January 1 – March 31 for certain changes.

Not sure whether Advantage or a Supplement is right for you as costs shift? Our plain-language comparisons and the turning-65 checklist walk through it, or we can just do the math with you.

Want your 2026 plan reviewed against your doctors and drugs? We do it free, for your county.

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Viva Insurance Group does not offer every plan available in your area. Any information we provide is limited to the plans we offer in your area. For all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day, 7 days a week. Figures cited are 2026 amounts published by CMS and Medicare.gov and may be updated; confirm current numbers before enrolling.