Medicare Part D Prescription Drug Coverage in Florida

The Medicare program offers prescription drug coverage to all Medicare beneficiaries, including those in the state of Florida. It is important for all Florida Medicare beneficiaries to sign up for prescription drug coverage when they are first eligible. If any Florida resident enrolled in Medicare ends up without creditable prescription drug coverage for 63 or more days in a row, they would be subject to a late enrollment penalty.

How do Florida Medicare beneficiaries get creditable prescription drug coverage?

Creditable prescription drug coverage can be attained through a prescription drug plan run by a private insurance company approved by Medicare. Florida Medicarebeneficiaries can also get creditable prescription drug coverage through a current or former employer or union, TRICARE, Indian Health Services, or the Department of Veteran Affairs.

A Florida resident can get Medicare drug coverage through one of the following Medicare drug plans:

  1. Medicare Part D Prescription Drug Plans (PDPs)Medicare Prescription Drug Plans, also known as stand-alone Part D plans, can provide creditable Part D coverage for Florida Medicare beneficiaries already enrolled in one of the following:
    • Original Medicare
    • Medicare Supplement Plan
    • Medicare Advantage Cost Plan
    • Medicare Advantage Private Fee-for-Service Plan
    • Medicare Advantage Medical Savings Account Plan
  2. Medicare Advantage Prescription Drug (MAPD) PlanAnother option is to sign up for a Medicare Advantage plan that includes prescription drug coverage in a plan better known as a Medicare Advantage Prescription Drug plan. Florida residents enrolled in this type of plan would receive all of their Part A hospital, Part B medical, and Part D prescription drug coverage through their MAPD plans. Please note that this type of plan is not combinable with any other type of Medicare private insurance plan.

How are Florida residents eligible for Medicare Part D enrollment?

In order to be eligible to enroll in a stand-alone Medicare Part D plan in the state of Florida, residents must be enrolled in either Medicare Part A or Part B. In order to enroll in a MAPD plan, residents must be enrolled in both Part A and Part B. The availability of Medicare plans that offer medication coverage may then depend on the Florida county in which the Medicare beneficiary resides.

When can Medicare beneficiaries enroll in Medicare Part D coverage in Florida?

After eligibility requirements are met, beneficiaries can then sign up for a Medicare drug plan when they first become eligible for Medicare and during a few specific enrollment periods:

  • Initial Enrollment Period when they first become Medicare eligible
  • Annual Enrollment Periods, including Open Enrollment Period for Medicare Advantage and Medicare Part D and Medicare Advantage Disenrollment Period
  • Special Enrollment Periods, when special situations occur, such as moving to another state or changing Medicaid eligibility

How much does Medicare drug coverage cost in Florida?

The cost of Medicare Part D drug coverage is made up of a variety of different payments, which include, but is not limited to: monthly premiums, yearly deductibles, copayments, coinsurance and costs in the coverage gap.

Actual drug costs for Medicare drug coverage in Florida will depend on individual medication needs and prescription drug choices including:

  • Plan chosen to provide drug coverage
  • Choice of pharmacy and whether this provider is in the plan’s network
  • Combination of medications taken
  • Whether the individual is eligible for the Medicare Part D Extra Help program, which provides assistance with Part D costs