October 10, 2025

Florida Medicare AEP 2025: Your 10‑Step Checklist for Oct 15–Dec 7

Florida Medicare AEP 2025: Your 10‑Step Checklist for Oct 15–Dec 7

If you’re on Medicare in Florida, the Annual Enrollment Period (AEP) runs from October 15 to December 7, 2025. This is your once‑a‑year window to change Medicare Advantage and Part D prescription drug plans for coverage starting January 1, 2026. Use this simple, Florida‑focused checklist to make confident choices and avoid costly surprises.

Who this guide is for

  • Current Medicare beneficiaries in Florida (Original Medicare + Part D or Medicare Advantage)
  • Floridians helping a parent, spouse, or friend with Medicare decisions
  • Those newly eligible for Medicare who want to understand AEP versus other enrollment windows

The 10‑step AEP checklist for Florida

  1. Mark the dates and set two reminders
    1. Add October 15 (start) and December 7 (deadline) to your calendar.
    2. Set one reminder for the week of October 15 to start comparisons and a second for before Thanksgiving to finalize a change, avoiding last‑minute rushes in early December.
  2. List your doctors, hospitals, and preferred pharmacies
    1. Write down every provider you want to keep. Florida networks vary widely by county.
    2. If you prefer certain systems (e.g., Baptist Health, AdventHealth, Cleveland Clinic Florida), note them so you can verify in‑network status when comparing plans.
  3. Make a 90‑day medication list
    1. Include exact names, dosages, and how often you take each medication.
    2. Florida plan formularies can look similar but differ on tiers, prior authorization, and quantity limits—details that affect your costs.
  4. Review what changed for you in 2025
    1. Did your plan add referrals, tighten authorizations, or change your copays?
    2. Look at last year’s out‑of‑pocket costs, any surprise bills, and benefits you didn’t use (e.g., fitness, dental allowances, OTC cards). Keep what works; fix what didn’t.
  5. Read your Annual Notice of Change (ANOC)
    1. Plans mail ANOCs each fall. Scan for premium, deductible, and copay updates and any network or formulary changes for 2026.
    2. If the ANOC shows a doctor or drug is leaving your plan, that’s your cue to shop.
  6. Compare at the county level
    1. Medicare Advantage and Part D options are county‑specific in Florida. A great plan in Miami‑Dade may not be offered—or have different benefits—in Polk or Duval.
    2. Check star ratings, but weigh networks and drug costs first; a 4‑star plan that covers your hospital and medications can beat a 5‑star plan that doesn’t.
  7. Verify networks and drugs with the plan—not just the brochure
    1. Use the plan’s online directory and pharmacy tools to confirm your physicians, hospitals, and medications. Screenshots help if you need to appeal later.
    2. For snowbirds: confirm coverage for out‑of‑area travel and routine care away from home.
  8. Understand your trade‑offs: Original Medicare vs. Medicare Advantage
    1. Original Medicare + Medigap + Part D: Broad access to providers that accept Medicare; predictable costs with Medigap; higher monthly premium; no dental/vision extras.
    2. Medicare Advantage (Part C): Often lower premiums and extra benefits; must use plan networks and rules; costs vary by service; may need referrals.
    3. If you’re considering switching from Advantage back to Original Medicare, check Medigap underwriting rules—Florida has unique protections but not year‑round guaranteed issue for everyone. Know your options before you disenroll.
  9. Check your total cost, not just the premium
    1. Add premium + expected copays/coinsurance + drug costs + potential out‑of‑network expenses + extras you value (dental, hearing, vision, fitness).
    2. Run a best‑case and a “bad‑year” scenario using your actual utilization to avoid surprises.
  10. Enroll correctly and keep records
    1. Submit changes by December 7, 2025, for a January 1, 2026 effective date.
    2. Save confirmation numbers and screenshots; keep your old and new plan ID cards until your new coverage is active.

Florida‑specific tips

  • Hurricanes and special enrollments: If a FEMA‑declared disaster affects your county and disrupts your ability to enroll, you may qualify for a Special Enrollment Period. Keep an eye on official notices during storm season.
  • Dual‑eligible and Extra Help: If you qualify for Medicaid or the Low‑Income Subsidy (Extra Help), you may have additional opportunities to change plans and lower drug costs. Ask us to check your eligibility confidentially.
  • Veteran coordination: TRICARE and VA benefits can pair with Medicare differently than standard retiree coverage. Make sure you’re not duplicating drug coverage.

Key timelines at a glance

  • October 15–December 7, 2025: AEP—change Medicare Advantage (MA) and Part D plans.
  • January 1–March 31, 2026: Medicare Advantage Open Enrollment Period (MA‑OEP)—if you’re enrolled in an MA plan on January 1, you can switch MA plans or go back to Original Medicare once during this window.

Common questions, answered

Is AEP the time to buy a Medigap (Medicare Supplement) plan?
Maybe. You can switch from MA to Original Medicare during AEP and apply for Medigap, but acceptance and pricing can depend on health underwriting. Florida offers some special Medigap rules, including birthday‑month switching for certain standardized plans with equal or lesser benefits, but this is separate from AEP. Ask before you drop coverage.

Do I have to change if I’m happy?
No. If your doctors, drugs, and costs look good for 2026, you can keep your current plan. Still review your ANOC to confirm nothing critical changed.

What if I’m turning 65 after December 7?
Your Initial Enrollment Period (IEP) is different from AEP. It spans the three months before, the month of, and the three months after your 65th birthday month. We can help you coordinate Part A, Part B, Part D or an MA plan so you don’t miss deadlines.

When will my new plan start?
Changes made during AEP take effect January 1, 2026.

Action checklist you can print

  • Calendar reminders: Oct 15 and Nov 25
  • List: doctors, hospitals, pharmacies
  • Medications: names, dosages, 90‑day quantities
  • Documents: ID cards, ANOC, last year’s EOBs
  • Priorities: network access, drug costs, OOP maximum, dental/vision needs
  • Two plans to compare side‑by‑side with total annual cost
  • Enrollment confirmation saved

How we can help (no‑pressure, local support)

We’re an independent Florida brokerage. That means we compare multiple carriers in your county, verify networks and drugs, and explain trade‑offs in plain English.

Free plan reviews by phone, video, or in‑person. We’ll document your doctors and medications, run cost scenarios, and help you enroll before the December 7 deadline.

Light disclaimer: We don’t 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 to get information on all of your options.