Medicare AdvantageCoverageHigh impact
Florida Blue 2026 Medicare Health Plan Changes
Florida Blue·FL·Medicare
Effective date
Jan 1, 2026
We identified it
Jun 16, 2026
Summary
Florida Blue Medicare is eliminating several supplemental benefits for 2026 including caregiver services, transportation, chronic illness programs, and OTC benefits. Drug formulary changes will shift from copays to coinsurance for brand-name medications on HMO plans, and Medicare Part D out-of-pocket maximums will be capped at $2,100.
Action Required
Before January 1, 2026: Billing team must update patient benefit verification processes to reflect elimination of Carallel caregiver services, Modivcare transportation, Special Supplemental Benefits for Chronically Ill, and OTC benefits for Premier HMO/Value PPO plans. Update staff training on new Part D $2,100 out-of-pocket maximum and coinsurance structure for tiers 3-4 brand drugs on HMO plans. Verify patient eligibility more frequently as over 1 million Medicare beneficiaries may lose coverage due to new immigration restrictions.