Medicare Advantage Plans Florida 2026
Medicare Advantage Plans in
Northeast Florida
Flagler, Volusia, Duval, and St. Johns counties each have different plan options, networks, and carrier availability. I compare every plan in your ZIP code — free, with no obligation.
What Is Medicare Advantage?
Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurance companies approved by Medicare. Instead of getting your Part A and Part B benefits directly from the federal government, you get them through a private plan — and most plans bundle Part D drug coverage as well.
Plans must cover everything Original Medicare covers, but they can also offer extra benefits like dental, vision, hearing, and fitness memberships. In exchange, you agree to use the plan's network of doctors and hospitals.
In Northeast Florida, the most common plan types are HMOs (which require you to use in-network providers and get referrals) and PPOs (which give you more flexibility but typically cost more when you go out-of-network).
2026 Key Numbers
- Part B Premium$202.90/month
- Part B Deductible$283/year
- MA Out-of-Pocket Max (in-network)$9,350
- MA Out-of-Pocket Max (combined)$14,000
- Annual Enrollment PeriodOct 15 – Dec 7
- MA Open EnrollmentJan 1 – Mar 31
Medicare Advantage: Pros & Cons
Advantages
- $0 or low monthly premium on many plans
- Includes Part D drug coverage in one plan
- Extra benefits: dental, vision, hearing, fitness
- Out-of-pocket maximum caps your annual exposure
- Care coordination through a primary care doctor
Disadvantages
- Network restrictions — must use in-network providers
- Referrals required for specialists (HMO plans)
- Plans can change benefits and networks each year
- Prior authorization required for many procedures
- Coverage ends if you move outside the service area
Not sure which side wins for your situation? Schedule a free comparison — I'll walk through both options with your specific doctors and medications.
Medicare Advantage by County
Plan availability, networks, and carrier options vary significantly by county. Here's what you need to know in each area I serve.
Flagler County
Palm Coast, Bunnell, Flagler Beach, Beverly Beach
Flagler County is one of the fastest-growing counties in Florida. Most Medicare Advantage plans here use the Daytona Beach–Palm Coast HMO network. AdventHealth Palm Coast and Halifax Health are the primary hospital anchors. HMO plans often require referrals to see specialists at UF Health St. Johns or Mayo Clinic in Jacksonville.
Local tip: Many Palm Coast retirees are surprised their HMO plan requires a referral to see a cardiologist at AdventHealth — a PPO avoids that friction entirely.
Volusia County
Daytona Beach, Ormond Beach, Port Orange, DeLand, New Smyrna Beach, Deltona
Volusia County has the highest concentration of Medicare beneficiaries in Northeast Florida. Halifax Health, AdventHealth Daytona, and Florida Hospital DeLand are all in-network with most major plans. The county's large retiree population means strong plan competition — more carriers offer $0-premium plans here than in neighboring counties.
Local tip: Volusia residents have more plan choices than almost anywhere in Florida. That's good news, but it also means more confusion. A side-by-side comparison is essential.
Duval County
Jacksonville, Jacksonville Beach, Atlantic Beach, Neptune Beach, Baldwin
Duval County is anchored by Mayo Clinic Florida and Baptist Health — two of the most sought-after hospital systems in the state. Not all Medicare Advantage plans include Mayo Clinic in their network. If keeping Mayo is a priority, you must verify network inclusion before enrolling. UF Health Jacksonville is also a major provider here.
Local tip: Mayo Clinic Jacksonville is NOT in every Medicare Advantage network. If you're a Mayo patient, this is the single most important thing to check before choosing a plan.
St. Johns County
St. Augustine, Ponte Vedra Beach, Nocatee, Fleming Island, St. Augustine Beach
St. Johns County is the wealthiest and fastest-growing county in Northeast Florida. Residents here often prefer PPO plans for the flexibility to see specialists at Mayo Clinic, Baptist Health, or UF Health without referrals. The county's newer communities (Nocatee, Shearwater) have younger retirees who are more likely to be active and want broad specialist access.
Local tip: St. Johns County residents disproportionately choose Medigap over Medicare Advantage — the flexibility to see any doctor nationwide without network restrictions is worth the premium for many here.
Types of Medicare Advantage Plans
Health Maintenance Organization
Lowest premiums. Must use in-network providers. Requires referrals to see specialists. Most common plan type in Volusia and Flagler counties.
Best for: Healthy beneficiaries with established local doctors who rarely need specialists.
Preferred Provider Organization
Higher premiums but no referrals needed. Can see out-of-network providers at higher cost. Popular in St. Johns County and among Mayo Clinic patients.
Best for: Active retirees who travel, see multiple specialists, or want access to Mayo Clinic.
Dual Special Needs Plan
For people who qualify for both Medicare and Medicaid. Coordinates benefits between both programs. Often includes extra benefits like transportation and meal delivery.
Best for: Low-income beneficiaries who qualify for Florida Medicaid.
Frequently Asked Questions
Can I keep my doctor with Medicare Advantage?
Only if your doctor is in the plan's network. Before enrolling, always verify your specific doctors — primary care, specialists, and hospitals — are in-network for the plan you're considering. I run this check for every client at no charge.
What happens if I need care outside the network?
With an HMO, out-of-network care is generally not covered except in emergencies. With a PPO, you can go out-of-network but pay higher cost-sharing. If you travel frequently or split time between states, a PPO or Medigap plan may serve you better.
Can I switch from Medicare Advantage back to Original Medicare?
Yes — during the Annual Enrollment Period (Oct 15–Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1–Mar 31). However, if you want to add a Medigap plan after leaving Medicare Advantage, you may face medical underwriting in Florida unless you have a guaranteed issue right.
Are Medicare Advantage plans the same in every county?
No — plans are county-specific. A plan available in Volusia County may not be available in Flagler County, and the benefits, premiums, and networks can differ significantly even for the same carrier. Always compare plans for your specific ZIP code.
Do Medicare Advantage plans cover care at Mayo Clinic Jacksonville?
Some do, some don't. Mayo Clinic is selective about which plans it accepts. If you're a Mayo patient or want that option, I verify network inclusion before recommending any plan.
Get a Free Medicare Advantage Comparison
I compare every plan available in your ZIP code — checking your doctors, your medications, and your budget. No cost, no pressure, no obligation.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY: 1-877-486-2048) to get information on all of your options.
Not affiliated with or endorsed by the U.S. government or the federal Medicare program. This is an advertisement for insurance. William Gray and affiliated licensed agents are independent insurance agents, not government employees or representatives. Medicare has neither reviewed nor endorsed this information.
Not all plans or types of coverage may be available in your area. Plan availability, benefits, and premiums vary by county and ZIP code. Enrollment in any plan depends on contract renewal. Benefits, premiums, and cost-sharing may change on January 1 of each year.
Independent Agent & Compensation Disclosure. William Gray is an independent licensed insurance agent (FL License #W690237) and is not employed by or exclusively affiliated with any single insurance company. William is compensated by insurance carriers when you enroll in a plan. This compensation does not affect the premium you pay — your premium is the same whether you enroll through a broker or directly with the carrier. Affiliated agents are independent contractors solely responsible for their own conduct and representations.