Everyone has different healthcare needs, including the medications that they take and the pharmacies they use. For this reason, the best Part D plan in Florida depends on your unique situation. 

In this article, we’ll talk about what you need to know about Medicare prescription drug coverage in Florida, so you can enroll in a plan that works for you.

Key takeaways:

  • If you live in Florida, you can choose from 21 prescription drug plans offered by seven insurance carriers. 

  • Florida residents can also choose from Medicare Advantage plans that include prescription drug coverage. Availability of these plans varies by county. 

  • When deciding on the best Medicare Part D plan in Florida, focus on the medications you take and your preferred pharmacies. 

What is Part D?

Medicare has four parts: Part A, Part B, Part C, and Part D. Medicare Part D is your prescription drug coverage. Private insurance companies offer drug plans that are approved by the federal government. 

There are two ways you can get prescription coverage:

  • You can enroll in a prescription drug plan. Usually, people with Original Medicare choose to sign up for a prescription drug plan. 

  • You can enroll in a Medicare Advantage plan that includes prescription drug coverage (often called an MAPD plan). Most Medicare Advantage plans include prescription drug coverage. 

You have a few opportunities to enroll in Part D. You can either choose to sign up during your Initial Enrollment Period or during the Medicare Open Enrollment Period. The Open Enrollment Period occurs every year and is also a good opportunity to review your plan and needs. If there’s a plan available that better suits you, you can switch to it during Open Enrollment.

Aside from the medications you take regularly, Medicare Part D also covers important vaccines recommended by the CDC, like RSV, COVID-19, and Hepatitis B at no cost to you.

Part D costs and coverage

Part D includes the following costs:

  • Monthly premium

  • Monthly IRMAA surcharge, if applicable

  • Yearly deductible

You will also be responsible for out-of-pocket costs (deductibles, copays, and coinsurance).

No drug coverage can have a deductible higher than $545 in 2024. 

Standalone prescription drug plans have varying premiums, and the average premium is $47.71 in Florida. Many Medicare Advantage plans, including those that come with prescription drug coverage, have no monthly premium (keep in mind you still need to pay your Part B premium). If you’re considering a Medicare Advantage plan, there are more things to consider to make sure your plan fits your healthcare needs. 

Drug tiers and formularies

Medicare drug plans and Medicare Advantage plans have unique lists of covered drugs (called formularies). This is the most important component of your coverage. A plan’s formulary states what prescription drugs it covers. If you’re looking for a drug plan, comparing copays, coinsurance, and deductibles can ensure that you find a plan that covers your medications affordably. 

Medicare uses drug tiers to categorize drugs and assign costs. Drugs on a lower tier (Tier 1, for example) are less expensive, generic medications, and drugs on a higher tier (Tier 4, for example) tend to be more expensive, brand-name prescriptions.

Overview of Medicare Part D plans in Florida

In Florida, almost 4 million Medicare beneficiaries are enrolled in Part D. Of those, 35% have a standalone prescription drug plan and 65% have drug coverage through a Medicare Advantage plan. We’ll discuss both options for prescription coverage in Florida below. 

Standalone prescription drug plans in Florida

There are 20 prescription drug plans in Florida, and seven different insurance carriers offer them. These insurance companies are:

  • Aetna Medicare

  • Cigna

  • Florida Blue

  • Humana

  • Mutual of Omaha Rx

  • UnitedHealthcare

  • Wellcare

Premiums for prescription drug plans in Florida range from $0 (Wellcare Value Script) to $181.60 (BlueMedicare Complete Rx by Florida Blue). However, your individual costs for medications will depend on what prescriptions you take and how your plan covers them. When comparing plans, make sure you take a look at the summary of benefits  to understand how much your medications will cost. 

The other factor to consider is your pharmacies. Medicare drug plans have “preferred” pharmacies at which your prescription costs will be lower. So, you’ll also want to pay attention to what prescription drug plans cover your pharmacy of choice.

Medicare Advantage plans with prescription drug coverage

In Florida, more people are enrolled in Medicare Advantage versus Original Medicare. It’s also more common for people to have prescription drug coverage through their Medicare Advantage plan. 

The availability of Medicare Advantage plans varies from one county to the next. Plans and their prescription coverage also vary widely. It’s important to make sure you compare plans and calculate your estimated costs. You should also re-evaluate your plan every year during the Open Enrollment Period, because plans can change and your healthcare needs may change too.

Enrolling in a Part D plan in Florida

Focusing on your priorities will help you choose the Medicare drug coverage that fits your needs best.  The choice between many different Medicare plans in Florida can make enrollment feel overwhelming. A Chapter Medicare Advisor can help you compare and enroll in the best one for your needs. Speak with us today by calling 855-900-2427 or schedule a time to chat.

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