Medicare Advantage

Why Medigap and Medicare Advantage work differently, Jacksonville

Duval County has 87 Medicare Advantage plans for 2027. Compared with 2026, 18 plans are not coming back, 15 are new, and 48 continuing plans changed in some way you should check before December 7, 17 of them under a new name. This guide covers what those numbers mean for Jacksonville, not which plan to pick.

JACKSONVILLE, Fla. — When people turn 65 here, they usually land at the same fork in the road: stay with Original Medicare (often paired with a Medigap policy and a stand-alone drug plan) or choose a Medicare Advantage plan that bundles things together. The choice isn't just about doctors and drug lists. It's also about how the costs are shaped — what you pay every month, what you pay at the pharmacy counter, and what happens if a big medical year hits.

For 2027, Jacksonville shoppers have plenty to weigh. Jacksonville sits in Duval County, where 70 Medicare Advantage plans are available for the coming year, offered by 13 carriers, according to CMS Medicare Plan Finder and Landscape data. That's the backdrop. The bigger question is how the pieces of cost fit together on each path.

Two paths, two very different cost shapes

Both paths start with Medicare Part A (hospital) and Part B (medical). Part B has a standard monthly premium set by CMS each year, and higher-income beneficiaries pay more through IRMAA — which in 2026 begins above $109,000 in income for a single filer.

From there, the paths split:

• Original Medicare + Medigap + a stand-alone Part D drug plan. You typically pay three monthly premiums (Part B, Medigap, Part D). In return, Medigap covers much of the cost sharing Original Medicare leaves behind, so your costs at the point of care tend to be more predictable.
• Medicare Advantage (usually with drug coverage built in). You still pay the Part B premium, plus any premium the plan itself charges. Costs then come in the form of copays, coinsurance, and deductibles as you use care, up to the plan's annual out-of-pocket maximum.

Neither path is automatically cheaper. They just move the money around differently — more up front vs. more as you go.

What's set at the program level for 2027

Some cost pieces are the same no matter which path you pick, because Medicare itself sets them:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs reach that amount, you pay $0 for covered drugs the rest of the year.
• Part D deductible: no plan can charge more than $615 in 2026 or $700 in 2027.
• The coverage gap (the old "donut hole") is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs out in monthly installments instead of paying big amounts at the pharmacy.
• IRMAA surcharges for Part B and Part D kick in above $109,000 in income for single filers in 2026.

These rules travel with you regardless of the path.

Where the paths actually feel different

The lived difference tends to show up in three places:

1. Monthly bills vs. per-visit bills. Medigap tends to push more of your cost into a steady monthly premium. Medicare Advantage tends to push more into copays and coinsurance when you use services. 2. Out-of-pocket protection. Medicare Advantage plans are required to have an annual medical out-of-pocket maximum. Original Medicare on its own has no cap, which is why many people add Medigap. 3. Drug coverage. In Duval County, most drug coverage comes bundled into Medicare Advantage plans (MA-PD). If you go the Original Medicare + Medigap route, drug coverage needs its own careful look.

What the Jacksonville numbers tell you (and what they don't)

Ninety Medicare Advantage plans across 12 carriers is a lot to sort through. Volume is not the same as fit. The right question isn't "which plan is best" — it's "which cost shape matches how I actually use health care?" Someone who sees specialists often may value predictability. Someone who rarely goes to the doctor may weigh premiums differently.

Star Ratings, published by CMS, are one signal shoppers can look up. They're a quality measure, not a personalized recommendation — a reminder to look at the underlying details rather than any single number.

Dates to circle

• Oct. 15 – Dec. 7: Medicare Annual Enrollment Period. Join, switch, or drop Medicare Advantage and Part D plans. Changes take effect Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you can switch to another one or return to Original Medicare (and pick up a stand-alone drug plan if one is available).

Medigap has its own rules. The strongest guaranteed rights to buy a Medigap policy generally apply during your six-month Medigap Open Enrollment window when you first enroll in Part B at 65. After that, in most states, insurers can use medical underwriting.

Where to get personalized help

No article — including this one — can tell you which path fits your health, your budget, or your medications. For that, use the official, unbiased sources:

• Medicare.gov — compare plans using the Medicare Plan Finder.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• SHINE, Florida's State Health Insurance Assistance Program (SHIP), offers free one-on-one counseling to Medicare beneficiaries and their families.