How do snowbirds get prescriptions filled in Florida and up north?

One plan, two homes

Whether your drug coverage is a standalone Part D plan or part of a Medicare Advantage plan, you have one plan, and it's tied to your permanent residence. Florida is its own Part D region, so a Florida standalone plan's service area is Florida; CMS lists 11 standalone Part D plans in Florida for 2027, from 6 companies. The plan pays at its network pharmacies. Whether a plan's network reaches pharmacies in other states varies by plan, so check before you choose.

• Standalone Part D: the plan must disenroll you only after more than 12 months in a row out of its service area (42 CFR 423.44).
• Medicare Advantage with drug coverage: your drug coverage ends with the plan if you're away more than 6 months in a row without a visitor or traveler program (42 CFR 422.74(d)(4)).

The out-of-network rule

Under 42 CFR 423.124, plans must give you access to out-of-network pharmacies when you can't reasonably be expected to use a network pharmacy and don't use out-of-network pharmacies routinely. Plans may charge you the difference between the pharmacy's price and the plan's allowance, and must set reasonable limits. A winter of refills at an out-of-network pharmacy near your Florida condo isn't what the rule covers.

Before you travel

1. Look up network pharmacies near both addresses. Use your plan's pharmacy directory, or compare plans' networks and formularies before Open Enrollment ends on December 7.
2. Transfer your prescriptions. Ask your pharmacy to move refills to a network pharmacy near where you'll be, and back again when you return.
3. Ask about mail order and travel supplies. Ask whether the plan offers mail order to a seasonal address and whether you can get a longer supply before a trip.
4. Bring a medication list. Include drug names, doses and your prescribers' contact information.

To check how your drugs are covered under plans for your ZIP code, compare drug coverage by plan.

Help with costs

Florida doesn't have a state drug-assistance program for seniors, so Extra Help, the federal program that lowers Part D costs for people with limited income and resources, is the main help. You apply through Social Security, and it follows you between states. Income and resource limits apply; see Extra Help in Florida. You can also spread costs over the year with the Medicare Prescription Payment Plan.

Related questions

Sources

• eCFR — 42 CFR 423.124, Out-of-network access to Part D drugs
• eCFR — 42 CFR 423.44, Involuntary disenrollment by the Part D plan
• eCFR — 42 CFR 422.74, Disenrollment by the MA organization
• CMS — Medicare Advantage and Part D Enrollment and Disenrollment Guidance, contract year 2027
• Medicare.gov — Getting drugs in a disaster or emergency
• Medicare.gov — Help with drug costs (Extra Help)

More questions in this guide

• Does my Medicare Advantage plan cover me when I'm in Florida for the winter?
• Does Original Medicare work in every state for snowbirds?
• What happens to my Medicare Advantage plan if I stay in Florida more than 6 months?
• Does Medicare cover me if I live part of the year in Florida and part in Puerto Rico?
• Can snowbirds keep a Medigap policy bought in another state while in Florida?
• Which state should I use for Medicare if I split my time between Florida and New York?

Part of the guide: Snowbirds and Medicare in Florida · All questions

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