Florida’s 2026 Stand-Alone Part D Drug Plans: Ten Choices, None Rated Four Stars

“I’ve been on a Part D plan for a while, and I’m wondering why my generic prescriptions suddenly cost more. Did something change?” That is a question posted publicly on a consumer Medicare Q&A site, and it is close to word-for-word what people ask us in Jacksonville every January. Something did change. It almost certainly was not the drug.

A stand-alone Medicare drug plan is re-filed with CMS every year. The premium, the deductible, the list of covered drugs and the tier your particular drug sits on are all set for one calendar year at a time, and the plan you are in on 31 December becomes a different product on 1 January unless you look. Auto-renewal is the default, so most people inherit next year’s terms having chosen under last year’s. That is the mechanism behind the January phone call, and it is not your fault.

What the Florida stand-alone drug plan market actually looks like in 2026

There are ten of them. Not hundreds, not the sixty-odd envelopes that arrive in October — ten stand-alone Part D plans, from five parent organizations, for the whole state of Florida in the 2026 plan year. Stand-alone Part D is sold by region rather than by county, and Florida is PDP region 11, so every one of these ten records carries the county name “All Counties.” A retiree in Jacksonville and a retiree in Fort Lauderdale are choosing from the identical menu.

That matters because the mail does not tell you this. Marketing volume makes the choice feel enormous, and the actual choice is a table you can read in two minutes. Here is that table, exactly as CMS publishes it in the CY2026 landscape file.

We are an independent agency, and we do not represent every plan in that table. We publish it because CMS publishes it, and because a person deciding in October deserves to see the whole board rather than the three plans whose advertising reached them. McDowell Business Resources is not a carrier, and we are not affiliated with or endorsed by the U.S. government, CMS or the federal Medicare program.

Why did my generic prescriptions suddenly cost more?

Four things move independently inside a Part D plan, and only one of them shows up in the advertising. The premium is the number on the envelope. The deductible is what you pay yourself before the plan starts paying — no plan may set it above $615 for CY2026, and most Florida plans use every dollar of that allowance. The formulary is the list of drugs the plan covers. The tier is where your specific drug sits inside that list, and a drug moving from one tier to the next is invisible until you stand at the pharmacy counter.

Once you are through the deductible, CMS sets the structure: for CY2026 you pay 25% coinsurance for covered Part D drugs until your out-of-pocket spending reaches the annual threshold. A generic that cost you a fixed few dollars last year can cost 25% of a higher negotiated price this year if the plan moved it off a flat-copay tier. Nothing about your health changed. The paperwork did.

Not one Florida drug plan reached four stars for 2026

CMS rates stand-alone drug plans on a Part D summary star rating. Across all ten Florida plans for the 2026 plan year, the mean is 3.0 and the range is 2.0 to 3.5. Zero of ten reach 4.0. Two of the ten sit at 2.0.

Read that carefully, because it cuts both ways. It is not a reason to panic and it is not a reason to switch — a star rating measures things like customer service, complaints, appeals handling and medication adherence metrics, not whether your particular prescription is covered. What it does tell you is that in this market there is no obvious quality winner to auto-renew into. If you were holding out for the four-star option to declare itself, it does not exist in Florida this year. That is the sharpest argument we know of for reading your Annual Notice of Change each autumn instead of letting the plan roll.

It also travels badly as a headline. We have seen the “no four-star plans” fact used to sell people out of stand-alone Part D and into something else entirely. That is not what the number says. It says compare on your own drug list, because the ratings will not do the sorting for you.

The spread is $2,604 a year, before a single prescription

The lowest published monthly premium in the Florida stand-alone market for 2026 is $0.00 and the highest is $217.00. Over twelve months that is a $2,604 difference in premium alone, paid whether you fill one prescription or forty. The median premium is $98.45 and the mean is $86.62. Two of the ten plans carry a $0.00 premium.

A $2,604 annual gap in a single line item is unusual in Medicare. It is roughly what the standard Part B premium costs for a year, and it sits inside a product most people pick in ten minutes from a mailer. Whether the higher premium is worth paying depends entirely on which drugs you take and where they sit on each plan’s formulary — which is a sentence you can only finish with your own list in front of you.

Is the lowest premium also the lowest yearly cost?

Not automatically, and the 2026 Florida data makes the point better than any argument could. Seven of the ten plans charge the full $615 statutory maximum deductible for CY2026, including both of the $0.00-premium plans. The one plan in the state with a $0 annual deductible carries the second-highest premium in the market at $115.90 a month. The mean deductible across the ten is $503.60.

That last block is the part nobody markets. The ceiling on your drug spending, the coinsurance rate that gets you there, and the geography are identical across all ten. The competition happens in the first $615 and in whether your drug is on the list at all.

The $4.82 figure is the low-income premium subsidy amount CMS publishes alongside every Florida plan record for 2026. If you qualify for Part D Extra Help, what you actually pay is not the premium printed in the table above. Checking whether you qualify is free, and you can do it through Medicare.gov or by calling 1-800-MEDICARE.

The $2,100 cap is the same whether the plan costs $0 or $217

For CY2026, CMS set the annual out-of-pocket threshold at $2,100. Once your out-of-pocket spending on covered Part D drugs reaches it, Medicare.gov states you pay $0 for each covered drug for the rest of the calendar year. Every one of Florida’s ten stand-alone plans carries that same $2,100 ceiling. It is not a feature one plan offers and another does not. It is the statute.

People still say “the $2,000 cap,” and they are not wrong so much as a year behind — $2,000 was the 2025 figure. The verified 2026 number is $2,100, and if you are budgeting for this year, use $2,100. We wrote the mechanics of the cap up in detail in our Part D cap guide, including what counts toward it and what does not.

What the cap is actually protecting you from

Abstractly, $2,100 sounds like a lot to spend on prescriptions. Set against what Part D drugs actually cost, it is a very low ceiling — and that is the point. In calendar year 2025, apixaban (Eliquis) accounted for $24,047,711,043 in gross Part D spending across 4,806,752 beneficiaries, an average of $5,002.90 per person taking it. Semaglutide (Ozempic) ran $16,153,040,297 across 2,044,798 beneficiaries, or $7,899.58 each. Empagliflozin (Jardiance) was $15,087,584,932 across 2,977,956 beneficiaries, $5,066.42 each.

Those are gross Part D figures — plan payments, beneficiary payments and government payments added together, before manufacturer rebates. They are not what Medicare paid and they are not what you would pay. They are the size of the bill the system is handling on your behalf, and against a $2,100 personal ceiling they show you exactly which readers the cap was built for.

The last bar is the other half of the story. In 2025, 7,260,387 Part D beneficiaries filled albuterol sulfate HFA at an average of $71.82 each for the entire year. Common drugs are cheap. If your list is four generics and an inhaler, the cap will never come near you and the deductible is the number that decides your year. If your list includes one specialty drug, the cap is the only number that matters and the premium is almost noise. Most people do not know which of those two readers they are until somebody adds it up.

What happens if you skip a drug plan because you do not take drugs?

This is the most expensive mistake available in Part D, and it is permanent. Medicare.gov states the late-enrollment penalty is an extra 1% for each month — 12% a year — that you go without creditable drug coverage after you were first eligible, or after any gap of 63 or more days. The penalty is calculated on the national base beneficiary premium, which is $38.99 for 2026, and it is added for as long as you have Medicare drug coverage.

Medicare.gov’s own worked example: a 14-month delay produces a 14% penalty, which on the 2026 base of $38.99 is $5.50 a month. That is small. It is also forever, it grows as the base premium grows, and it buys you nothing. For 2027 the base beneficiary premium rises to $41.33, so the same 14% costs more next year than it does this year.

If you have drug coverage through an employer, a union, the VA or TRICARE, ask the plan administrator in writing whether it is creditable. That single sentence, asked before you retire, is what keeps the 63-day clock from starting without you knowing.

Insulin, and the one price that does not move

If you use insulin, one figure is fixed regardless of which of the ten plans you hold. Medicare.gov states that a one-month supply of each Part B- and Part D-covered insulin product costs no more than $35, that you do not pay a deductible for insulin, and that a three-month supply generally costs no more than $105.

That is worth saying plainly because the $615 deductible dominates so much of this conversation. Insulin sits outside it. Somebody comparing plans on “the deductible is lower here” can be comparing a number that does not apply to their largest prescription.

Does the Medicare Prescription Payment Plan save you money?

No, and Medicare.gov says so in those words: it “doesn’t save you money or lower your drug costs.” What it does is spread your out-of-pocket drug costs across the calendar year instead of hitting you all at once at the pharmacy counter. CMS describes it as capped monthly payments rather than paying everything up front.

The practical details: anyone with a Medicare drug plan or a Medicare health plan with drug coverage can use it, there is no cost to participate, participation is voluntary, and you opt in through your own plan rather than through Medicare. Once you are in, you keep paying your plan premium if you have one, and you get a bill from the plan for your prescriptions instead of paying the pharmacy.

It is a cash-flow tool for people whose drug costs land in January and February. If your January refill would put $900 on a credit card, it is worth a call to your plan. If your yearly drug spend is $200, it changes nothing.

What changes for 2027, and when you would feel it

CMS published its Part C and D announcement on 28 July 2026, and three figures in it matter for anyone holding a Florida drug plan. The CY2027 Part D national average monthly bid amount is $296.05, up from $239.27 for 2026. The Part D base beneficiary premium goes from $38.99 to $41.33, calculated by CMS as $38.99 × 1.06. And the Part D Premium Stabilization Demonstration, which has been dampening stand-alone plan premiums, is being discontinued: CMS states it will end the demonstration at the end of CY 2026 “to return the program to operating under traditional market conditions in CY 2027.”

None of that is a 2027 premium for any specific plan, and we will not guess at one. Bids are not premiums. What it does mean is that the 2027 landscape is being built on different footing than the 2026 one, which makes the autumn review less optional than usual. Read your Annual Notice of Change when it arrives in September.

How to run your own drug list against the plans each October

You can do all of this yourself, for free, without talking to anyone. It takes about forty minutes the first time and fifteen minutes every year after. Medicare’s Annual Enrollment Period runs 15 October to 7 December, with coverage starting 1 January, and the plan must have your enrollment request by 7 December.

1. Write down every drug, with the dose and the frequencyExact names, exact strengths, including the ones you take occasionally and the ones a specialist prescribes. Generic names help. A photograph of each bottle is faster than typing and harder to get wrong.
2. Add your pharmacy, by name and locationPreferred-pharmacy status changes what you pay on the same plan. The chain on the corner and the chain two miles away are not always in the same tier for the same plan.
3. Open the Plan Finder at Medicare.gov and enter the listUse the official tool at Medicare.gov, not a comparison site you found in an ad. Enter your ZIP code, then your drugs, then your pharmacy, in that order.
4. Sort on estimated total annual cost, not on premiumThe tool will show premium, deductible and estimated yearly drug cost separately. The premium is the one number that tells you the least. For 2026 in Florida the premiums alone span $2,604 a year, and the deductibles span $615.
5. Check every drug shows as covered, not “not on formulary”A plan that excludes one of your five drugs is not a cheaper plan. It is a different plan. Note any drug that requires prior authorization or step therapy, because that is a phone call in January you did not budget for.
6. Check the star rating, then put it in perspectiveFor 2026 no Florida stand-alone plan is above 3.5, so the rating cannot break a tie for you. Use it to notice a 2.0 you were about to auto-renew into, then go back to your drug list.
7. Ask about Extra Help if money is tightThe low-income premium subsidy amount published for Florida plans in 2026 is $4.82, and qualifying changes your premium, deductible and copays. Call 1-800-MEDICARE, or Florida’s SHIP program SHINE on 1-800-963-5337, and ask them to screen you. Both are free and neither sells anything.
8. Enrol by 7 December and keep the confirmation numberWrite down the date, the confirmation number and the name of whoever you spoke to. If the January pharmacy visit goes wrong, that record is what fixes it in one call instead of four.

Bring your current plan and your prescription list; we’ll do the comparison with you. If you would rather do it alone, the steps above are the whole method, and we would rather you did it alone than not at all.

Before and after: what the review actually changes

Illustrative example only. Marguerite is 72, lives in Mandarin, and takes five medications: three long-standing generics, a blood thinner and an inhaler. She has been in the same stand-alone drug plan since 2021 and has never changed it, because nothing ever seemed to be wrong.

Before. She is in a plan carrying the $615 statutory maximum deductible for 2026 and a premium near the market median of $98.45 a month. Her premium alone is $1,181.40 for the year. She pays the first $615 of her covered drug costs herself, then 25% coinsurance after that. She has never read her Annual Notice of Change, and she does not know that one of her generics moved up a tier in January, which is why her February refill cost more than her December one.

After. She spends half an hour with her bottles and the Plan Finder. She learns three things. Her blood thinner is on the formulary of every plan she checks, but not on the same tier. Two plans in the Florida market carry a $0.00 premium and both use the full $615 deductible, while a third charges $25.90 a month with a $601 deductible. And the plan she has been in is rated 3.0, which is the mean for the state — neither a reason to leave nor a reason to stay. She now picks on estimated annual cost with her own five drugs entered, and she knows what she is buying.

The point of the example is not that she saves money, because we cannot promise that and nobody should. The point is that she made a decision instead of inheriting one. In a market where the premiums span $2,604 a year and the deductibles span $615, an inherited decision is expensive far more often than it is lucky.

How this fits with the rest of your Medicare

A stand-alone Part D plan is what you buy when you have Original Medicare, usually alongside a Medicare Supplement policy, because Medigap does not include drug coverage. If you have a Medicare Advantage plan instead, drug coverage is normally built into it and these ten plans are not your menu. In Duval County for the 2026 plan year, CMS lists 46 Medicare Advantage and MA-PD plan rows, and 80% of the MA-PD plans there carry a $0 monthly premium — which is why so many Jacksonville readers assume drug coverage is free and are surprised by a stand-alone premium.

The two paths are not interchangeable, and the choice between them has consequences that outlast a drug plan. We laid out that comparison in Medicare Advantage vs Supplement, and the windows in which you are allowed to move between them in our 2026 enrollment periods guide. If you are new to all of this, start with the Medicare in Florida guide and come back here.

Where to get help that has nothing to sell you

Three free options exist before you talk to any agent, including us. Medicare.gov runs the Plan Finder and is the only tool with the authoritative formulary data. 1-800-MEDICARE will answer questions about your own enrollment and screen you for assistance programs. And Florida’s SHIP program, SHINE, provides free unbiased counselling through the Department of Elder Affairs and your local Area Agency on Aging on 1-800-963-5337.

We list those because they are genuinely useful and because we do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area, so a second opinion from a source with no commercial interest is a reasonable thing to want.

How we help

We take your exact drug list — names, doses, frequencies — and your pharmacy, and we run it against the plans we represent, then show you estimated total annual cost rather than premium. We flag any drug that is off-formulary or needs prior authorization before you enrol, not after. We check whether you might qualify for Extra Help. And we do it again every autumn, because the plan changes every January whether or not you do.

We will tell you honestly if this isn’t the right fit for you. That includes telling you to stay where you are, which happens often, and telling you when Medicare.gov or SHINE can answer your question faster than we can. McDowell Business Resources is an independent agency in Florida — we are not a carrier, and we are not connected with or endorsed by the federal Medicare program.

What you get out of doing this once a year

You stop being surprised in January. That is the whole benefit, and it is worth more than it sounds. The person who checks their formulary in October knows in advance that a drug moved tiers, and has a month and a half to do something about it. The person who does not check finds out at the counter, in front of a queue, with a pharmacist who cannot change anything.

The Florida numbers for 2026 make the case without any help from us: ten plans, a $2,604 spread in annual premium, a $615 spread in deductible, star ratings that top out at 3.5, and one identical $2,100 ceiling underneath all of it. Nothing in that picture rewards auto-renewal. All of it rewards forty minutes with your own bottles on the kitchen table.

Whatever you decide, decide it on the numbers. If you want help getting to them, we’re here — and you can always start on our Medicare page to see how we work before you call.