Medicare Advantage
Navigating Medicare Options in Orlando & Altamonte Springs for 2026
By IM65 Editorial Team · July 8, 2026 · 9 min read
Quick Answer: For Orlando seniors in 2026, the standard Medicare Part B premium is $202.90/month. Medicare Supplement (Medigap) plans offer predictable costs with no network restrictions, while Medicare Advantage plans often have $0 premiums but require in-network providers. Key changes include a $2,100 Part D out-of-pocket cap and new drug price negotiations.
As we head further into 2026, many seniors across Central Florida, from the bustling streets of Orlando to the peaceful communities of Altamonte Springs and even nearby Winter Park, are thinking about their Medicare coverage. With changes to costs, benefits, and plan availability, it’s more important than ever to understand your options.
Florida is home to a significant senior population, with 183,681 residents aged 65 and over in Orange County and 77,479 in Seminole County, according to the U.S. Census Bureau ACS 2023 5-Year Estimates. This means a lot of our neighbors are navigating these same decisions, whether they are long-time residents or snowbirds enjoying our sunny climate.
What are the key Medicare changes for 2026?
Yes, 2026 brings several important updates to Medicare that will affect beneficiaries in Orlando and across the country. These changes include adjustments to premiums and deductibles, significant improvements for prescription drug costs, and shifts in plan offerings by major carriers.
We've found that most seniors in Florida focus on two main areas: how much they'll pay out of pocket and what their drug coverage looks like. Good news on the prescription front! A major win for Orlando seniors in 2026: No matter which Medicare path you choose, your total out-of-pocket cost for prescriptions is now capped at $2,100 per year under the Inflation Reduction Act. This makes the Medigap + Part D combo much more attractive than in previous years.
2026 Medicare Part B Costs
The standard Medicare Part B premium has increased to $202.90 per month in 2026, up from $185.00 in 2025. Additionally, the annual Part B deductible is now $283. For some higher-income beneficiaries, known as IRMAA (Income-Related Monthly Adjustment Amount) recipients, Part B surcharges can be as high as $689.90 per month, impacting those with single incomes above $109,000 per year. These increases primarily affect those on Original Medicare and those with Medicare Supplement (Medigap) plans, as Medicare Advantage plans often offer ways to offset these costs.
Part D Prescription Drug Coverage Updates
Beyond the $2,100 out-of-pocket cap, the Inflation Reduction Act also introduced drug price negotiations. As of January 1, 2026, the first 10 negotiated drug prices took effect, including for common medications like Eliquis, Jardiance, and Xarelto. Seniors taking these drugs on their Part D drug plans will see the negotiated Maximum Fair Prices at the pharmacy. This is a significant step towards making prescription drugs more affordable for our community in Central Florida.
What Medicare plans are available in Orlando and Altamonte Springs for 2026?
Many options are available for seniors in Orlando and Altamonte Springs (32714) for 2026, with both Medicare Advantage and Medicare Supplement plans widely offered. We've found that local seniors have a robust selection to choose from, though market changes are impacting choices.
According to the CMS Medicare Monthly Enrollment Dataset (2025 Annual), Orange County, Florida, had 222,901 Medicare beneficiaries, with 135,487 (60.8%) enrolled in Medicare Advantage. In Seminole County, where Altamonte Springs is located, there were 89,174 Medicare beneficiaries, with 47,833 (53.6%) enrolled in Medicare Advantage. These numbers show a strong preference for Medicare Advantage plans in our area.
Medicare Advantage in Central Florida
For 2026, Orange County offers 59 Medicare Advantage plans, with 53 of them having a $0 premium. In Seminole County, there are also 59 plans available, with 51 offering a $0 premium. These plans often include extra benefits not covered by Original Medicare, such as dental, vision, and hearing coverage.
However, it's important to be aware of network restrictions. While Medigap allows you to see any doctor at AdventHealth or Orlando Health, some Medicare Advantage HMOs may restrict you to one network or the other. We recommend checking your 2026 provider directory before switching plans.
Here's a look at some notable Medicare Advantage plans available in Orange County for 2026:
| Plan Name (Carrier) | Premium (Monthly) | MOOP (Max Out-of-Pocket) | Drug Deductible |
|---|---|---|---|
| Humana Gold Plus Giveback (HMO) | $0 | $6,750 | N/A |
| HumanaChoice Florida (HMO-POS) | $0 | $4,700 | $615 |
| AARP Medicare Advantage from UHC FL-0018 (HMO) | $0 | $6,700 | $600 |
| AARP Medicare Advantage from UHC FL-0031 (PPO) | $62 | $9,250 | $600 |
| BlueMedicare Select (HMO) | $154 | $6,750 | $615 |
| Aetna Medicare Eagle Giveback (HMO) | $0 | $6,750 | N/A |
| Aetna Medicare Signature (HMO) | $0 | $6,750 | $615 |
These are examples, and readers should verify current availability and benefits with an IM65 Approved Advisor.
It's worth noting that in ZIP codes like 32714 (Altamonte Springs) and 32801 (downtown Orlando), we are seeing 'Giveback' amounts as high as $125 per month on select 2026 Medicare Advantage plans. This can effectively lower your Part B cost from $202.90 down to just $77.90 per month.
Medicare Supplement (Medigap) Plans
Medicare Supplement plans work differently. They help cover the gaps in Original Medicare, such as deductibles, copayments, and coinsurance. While they typically have a monthly premium, they offer the flexibility to see any doctor or specialist nationwide who accepts Medicare, without network restrictions. Many seniors in areas like Kissimmee and Sanford prefer Medigap for its predictable costs and broader access to care, especially if they travel frequently.
How do Medicare Advantage and Medicare Supplement plans compare for Central Florida seniors?
Choosing between Medicare Advantage and Medicare Supplement can be one of the most important decisions for a 65-year-old in Orlando. Both options have distinct advantages and disadvantages, especially when considering the specific healthcare landscape of Central Florida.
Florida has a high rate of Medicare Advantage enrollment, with 56.7% of its 5,240,142 total Medicare beneficiaries enrolled in MA plans, according to the CMS Medicare Monthly Enrollment Dataset (2025 Annual). This trend is even stronger in Orange County, with 60.8% of beneficiaries choosing MA. This speaks to the popularity of these plans, often due to their $0 premiums and additional benefits.
| Feature | Medicare Advantage (Part C) | Medicare Supplement (Medigap) |
|---|---|---|
| Monthly Premium (Avg.) | Often $0 (in Central Florida) | Varies by plan & carrier (in addition to Part B) |
| Provider Network | Typically HMO or PPO, with network restrictions | Any doctor/hospital that accepts Medicare |
| Out-of-Pocket Costs | Copays/coinsurance for services, annual MOOP limit (e.g., Average MOOP in Orange County: $5,126) | Few to no out-of-pocket costs for Medicare-eligible services after premium |
| Extra Benefits | Often includes dental, vision, hearing, gym memberships, OTC allowances | Does not include extra benefits (must purchase separately) |
| Prescription Drugs | Usually includes Part D coverage (MAPD) | Requires separate Part D drug plan |
| Referrals | Often required for specialists (HMOs) | Generally not required |
2026 Market Changes in Florida
It's crucial for Central Florida seniors to be aware of recent market shifts. AvMed is exiting all Medicare Advantage plans statewide effective January 1, 2026, impacting thousands of Florida seniors who must select new coverage during AEP or a Special Enrollment Period. Aetna is also reducing its Medicare Advantage footprint in select Florida counties, leading to some county-level plan terminations. UnitedHealthcare, Humana, and Aetna have all reduced the number of states and counties served for 2026, which could mean narrower networks or higher cost-sharing in some plans to recover margins. If you're in Clermont or Apopka, these changes could affect your local plan choices.
What are the 2026 CMS Star Ratings for Medicare Advantage plans?
The 2026 CMS Star Ratings are an important tool for evaluating Medicare Advantage plans, reflecting their quality and performance. We encourage seniors in Lake Nona and Oviedo to pay close attention to these ratings when making enrollment decisions.
Nationally, the weighted average for Star Ratings increased slightly to 3.98 stars in 2026, up from 3.96 in 2025. Approximately 73% of MA members nationally are in 4-star or higher plans. In Orange County, 73% of plans are rated 4 stars or higher, giving local seniors access to high-quality options.
Key Carrier Performance:
- UnitedHealthcare (AARP): 77% of members are in 4+ star plans, remaining stable despite market contraction.
- Humana: Saw a decrease, with 20% of members in 4+ star plans (down from 25% in 2025).
- Aetna (CVS Health): Still leads peers with 81% of members in 4+ star plans, though down from 89% in 2025.
- Elevance Health: Showed significant improvement, with 53% of members in 4+ star plans, up from 40% in 2025.
- Centene (WellCare): Experienced a dramatic improvement, with 18% of members in 4+ star plans, up from just 1% in 2025. WellCare is a major player in Florida.
- Kaiser Permanente: Consistently top-rated, with nearly 100% of members in 4+ star plans, though their presence is limited to specific markets.
- Clover Health: Saw a major decline, with 0% of members in 4+ star plans, potentially costing them tens of millions in bonus payments.
CMS has also raised the bar for achieving 4+ stars and is proposing to remove 12 administrative process measures from Star Ratings starting in the 2027 measurement year, shifting focus more towards clinical outcomes. This means plans that drop below 4 stars may lose bonus payments, potentially leading to fewer supplemental benefits like dental insurance, vision, hearing, and OTC allowances in future years.
Making informed decisions about your Medicare coverage is essential. An IM65 Approved Advisor can help you navigate these complex changes and find a plan that best fits your healthcare needs and budget. We are here to serve our Central Florida community, from Orlando to Altamonte Springs (32714) and beyond.
Frequently Asked Questions
Is Medicare Part B $202.90 for everyone in Orlando?
No, the standard Medicare Part B premium of $202.90/month applies to most beneficiaries. However, higher-income individuals (single filers with incomes above $109,000) will pay an Income-Related Monthly Adjustment Amount (IRMAA) surcharge, which can increase their Part B premium significantly, up to $689.90 per month in 2026.
Can I switch Medicare plans in 2026?
Yes, you can typically switch Medicare plans during the Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year, for coverage effective January 1 of the following year. Additionally, certain events, like a plan leaving your area (e.g., AvMed's exit from Florida), may trigger a Special Enrollment Period (SEP), allowing you to make changes outside of AEP. An IM65 Approved Advisor can help you determine your eligibility for an SEP.
What is the Part D out-of-pocket cap for 2026 in Central Florida?
For 2026, the Medicare Part D annual out-of-pocket cap is $2,100 for all beneficiaries nationwide, including those in Central Florida. Once you reach this amount in covered prescription drug costs, you will pay $0 for your covered medications for the remainder of the year. This is a significant benefit, especially for seniors with high prescription drug expenses.
Ready to explore your 2026 Medicare options in Orlando, Altamonte Springs, or elsewhere in Central Florida? Speak with an IM65 Approved Advisor today at no cost. We can help you compare plans, understand benefits, and ensure you have the coverage that's right for you.
*We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.*
This article was researched and drafted with AI assistance and screened for accuracy before publication. It is general education, not a recommendation about any specific plan. For advice about your own situation, speak with a licensed advisor.