Medicare Supplement

Part D's $2,100 Drug Cap and Medicare in Jacksonville

JACKSONVILLE, Fla. — If you're turning 65 soon or just taking a fresh look at your Medicare coverage, you have plenty to sort through this year. Between a new out-of-pocket cap on prescription drugs and dozens of Medicare Advantage options in the metro, it's worth understanding the landscape before you make a choice.

Here's a plain-language look at what's available near Jacksonville, plus the key 2026 program changes every local beneficiary should know.

Plan availability around Jacksonville

Jacksonville sits in Duval County, where Medicare plan choices are set at the county level. According to CMS Medicare Plan Finder data, Duval County has 90 Medicare Advantage plans available for 2026, offered by 12 different carriers providing Medicare Advantage with prescription drug coverage (MA-PD).

Stand-alone Part D drug plans are counted separately by CMS. Florida has 10 stand-alone Part D plans for 2026, sold statewide, so if you're staying on Original Medicare and want drug coverage in Jacksonville, you can join any of them — and you can review the current listings directly on medicare.gov.

For context, Duval County is home to about 156,682 residents age 65 and older, so it's a sizable Medicare market with a lot of moving parts.

What Star Ratings mean (and don't mean)

CMS assigns Star Ratings to Medicare plan contracts each year, from 1 to 5 stars, based on things like customer service, member complaints, and how well plans manage chronic conditions. Under CMS's 2026 Star Ratings, 13 of the 21 rated contracts offering plans in Duval County are rated 4 stars or higher — but ratings shift each year, and a rating alone doesn't tell you whether a specific plan fits your doctors, medications, or budget.

Think of Star Ratings as one data point among many, not a shortcut for choosing coverage.

Big 2026 changes to know

A few program-wide updates take effect in 2026 that will matter for almost every Medicare beneficiary:

• New $2,100 out-of-pocket cap on Part D drugs. Once your covered prescription costs hit $2,100 for the year, you pay $0 for covered drugs the rest of the year.
• Part D deductible maxes out at $615. Plans can charge less, but not more.
• No more "donut hole." The old coverage gap phase was eliminated in 2025. Part D now has three simpler phases.
• Medicare Prescription Payment Plan. This optional program lets you spread your drug costs across monthly payments instead of paying big lump sums at the pharmacy counter.
• IRMAA thresholds. Higher-income beneficiaries pay extra for Part B and Part D. In 2026, the surcharge begins above $109,000 in income for a single filer.

Enrollment dates to circle

Two windows drive most Medicare decisions each year:

• Annual Enrollment Period (AEP): October 15 – December 7. This is when anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan.
• Medicare Advantage Open Enrollment Period: January 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance during this window to switch to a different MA plan or return to Original Medicare.

Missing these windows usually means waiting until the next year, unless you qualify for a Special Enrollment Period (for example, if you move or lose other coverage).

How to compare plans without getting overwhelmed

With 90 Medicare Advantage plans in Duval County, comparing every option one-by-one isn't realistic. A few practical steps can narrow it down fast:

1. List your doctors and preferred hospitals. Then check whether each plan you're considering includes them in-network. 2. List your prescriptions with exact dosages. Plan Finder on medicare.gov will show your yearly drug costs under each plan's formulary. 3. Think about how you use care. Do you travel a lot? See specialists often? Need dental or vision? Those needs point you toward different plan types. 4. Ask for help. Free, unbiased counseling is available — see below.