Medicare drug coverage in Florida: 25 drugs, plain English

Quick answers

What is the Part D out-of-pocket cap for 2027?

$2,400. After you pay that much for covered Part D drugs in 2027, you pay nothing more for covered Part D drugs that year.

Which drugs get Medicare negotiated prices in 2027?

The 15 drugs from CMS's second round, including Ozempic, Wegovy, Rybelsus, Trelegy Ellipta, Otezla and Xtandi, plus six of the first 10, such as Eliquis and Jardiance. Stelara, Xarelto, Entresto and NovoLog/Fiasp leave the program on January 1, 2027.

Does Medicare cover weight-loss drugs?

Part D can't cover drugs for weight loss alone, but CMS's Medicare GLP-1 Bridge covers Wegovy, Zepbound KwikPen and Foundayo for eligible people with Medicare drug coverage through December 31, 2027.

How many standalone Part D plans does Florida have for 2027?

CMS lists 11 from 6 companies. Florida is its own Part D region, so each one is sold in all 67 counties.

Does Florida have a state drug program for seniors?

No. Florida doesn't have a state drug-assistance program for seniors. Federal Extra Help is the main help with Part D costs.

How Medicare drug coverage works

Medicare splits drug coverage between two parts:

• Part D covers most prescription drugs you take at home: pills, inhalers and pens or syringes you inject yourself. You get it from a standalone Part D plan (with Original Medicare) or from a Medicare Advantage plan that includes drug coverage. Each plan has its own formulary (drug list), tiers, pharmacy network and rules such as prior authorization.
• Part B covers a limited set of outpatient drugs, mostly ones you don't usually give yourself, such as injections and infusions a clinician gives in a doctor's office or hospital outpatient setting, plus drugs used with equipment like a nebulizer or an insulin pump, and certain injectable osteoporosis drugs.

The same drug can fall under either part depending on how it's given. Stelara is an example: the IV starting dose in a clinic is Part B, and the injections you give yourself at home are Part D. Prolia can be Part B or Part D depending on who gives it. Part A covers drugs only as part of an inpatient stay.

What changes for drug coverage in 2027

The 25 drugs

Each page answers "Does Medicare cover it in Florida?": which part covers it, its negotiation status, generics or biosimilars, the cost protections that apply and how to check a plan.

"Negotiated price" means CMS set a maximum fair price under the Medicare Drug Price Negotiation Program. It's what plans and pharmacies pay, not your copay. In January 2026 CMS selected 15 more drugs, including Trulicity and, for the first time, drugs paid under Part B, for prices that take effect in 2028. See Which drugs have Medicare negotiated prices in 2027?

Common drug questions from Floridians

• Does Medicare cover weight-loss drugs like Wegovy or Zepbound in Florida?
• Is insulin capped for people with Medicare in Florida?
• Which drugs have Medicare negotiated prices in 2027?
• Does Medicare pay for prescriptions bought in Mexico, Canada or Latin America?

Drug coverage in Florida

Florida is its own Part D region (PDP Region 11), so each standalone Part D plan sold here is offered in all 67 counties. For 2027, CMS lists 11 standalone Part D plans from 6 companies. Medicare Advantage choices, most with drug coverage, run from 7 plans in Monroe County to 52 in Hillsborough County. See How many Part D plans are in Florida for 2027? and Florida counties.

• No state drug program for seniors. Florida doesn't have a state drug-assistance program for seniors; Extra Help is the main help with Part D costs. Florida's AIDS Drug Assistance Program (ADAP), run by the Department of Health, helps eligible people with HIV with HIV medication costs, including some people with Medicare. See Does Florida have a state drug assistance program for seniors?
• Full Florida Medicaid and Medicare: your drugs come through Medicare drug coverage with Extra Help built in, not through Florida Medicaid. People with a Medicare Savings Program (QMB, SLMB or QI-1) get Extra Help automatically too. See Florida Medicaid and Medicare.
• Florida state retirees: State Group Insurance health plans that pay secondary to Medicare include prescription drug coverage the State says Medicare approves as creditable, so you don't need a separate Part D plan; the State's group Medicare Advantage (MA-PD) plans include Part D. Ask People First before joining an outside plan. See Florida state retirees and Medicare.
• Snowbirds: a Florida Part D plan's service area is Florida. Ask whether the plan's pharmacy network reaches where you spend the summer. See prescriptions for snowbirds.
• Hurricanes: CMS expects Medicare drug plans to allow early refills after a federal disaster declaration, and Florida's early-refill law (s. 252.358) covers state-licensed insurers and HMOs. See early prescription refills before a hurricane and hurricanes and Medicare.
• If your Medicare Advantage plan ends in 2027, see plans ending in 2027 to choose new drug coverage without a gap.

How to check a plan's coverage for your drugs

1. List every drug. Exact name, strength and how often you take it.
2. Look them up. Enter them with your ZIP code on PlanMatch or Medicare.gov's Plan Finder to see each plan's formulary and rules.
3. Read your 2027 Annual Notice of Change. It lists formulary changes for next year. Open Enrollment runs October 15 to December 7, 2026.
4. Get help if you want it. You can request a call from a licensed insurance agent, who can compare plans from the companies they work with, or call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) for information on all of your options.

If your drug isn't covered or a charge looks wrong

• Ask your plan for an exception. A formulary exception if the drug isn't covered, or a tiering exception if it's on a high tier. Your prescriber supports the request. See Medicare appeals in Florida.
• Medicare questions: 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) or Medicare.gov.
• Suspected billing errors or fraud: the Senior Medicare Patrol national line, 1-877-808-2468, or the HHS Office of Inspector General, 1-800-HHS-TIPS. See Medicare fraud in Florida.
• Extra Help applications: Social Security, 1-800-772-1213 (TTY 1-800-325-0778). See Extra Help in Florida.

Sources

• Medicare.gov — Drug coverage (Part D)
• Medicare.gov — How much does Medicare drug coverage cost?
• Medicare.gov — Prescription drugs (outpatient) under Part B
• Medicare.gov — Insulin
• Medicare.gov — Travel outside the U.S.
• CMS — CY 2027 Rate Announcement (2027 Part D deductible and out-of-pocket threshold)
• CMS — Selected drugs and negotiated prices (including drugs with deselection determinations; updated November 2, 2026)
• CMS — Selected drugs for initial price applicability year 2028 (January 2026)
• CMS — Medicare GLP-1 Bridge
• Medicare.gov — Weight loss drugs (Medicare GLP-1 Bridge)
• Medicare.gov — Medicare Prescription Payment Plan
• Social Security — Extra Help with Medicare prescription drug plan costs
• CMS — Medicare Advantage and Part D Landscape files, 2027 (PDP Region 11: Florida)
• Florida Department of Health — AIDS Drug Assistance Program (ADAP)
• Florida Division of State Group Insurance — Frequently asked questions for retirees
• Florida Statutes — s. 252.358, emergency prescription refills
• CMS — Pharmacy access during a federal disaster declaration: questions and answers for Part D plan sponsors

Every question in this guide

• Does Medicare cover weight-loss drugs like Wegovy or Zepbound in Florida?
• Does Medicare pay for prescriptions I buy in Mexico, Canada or Latin America?
• Is insulin capped for people with Medicare in Florida?
• Which drugs have Medicare negotiated prices in 2027?

Frequently asked questions

Medicare in your Florida county

Plans, local agents and help, county by county: Miami-Dade · Broward · Palm Beach · Hillsborough · Orange · Duval · Pinellas · Lee · Polk · Pasco · Brevard · Volusia · Seminole · Sarasota · Osceola · Manatee · Lake · Marion · Collier · St. Lucie · All 67 counties →