The benefits of Medicare Advantage go beyond low premiums. By February, you’ve seen your copays, your pharmacy bills, and your doctor network in action. I’m Michele Sanchez, and I run Michele Sanchez Insurance Agency in Marco Island. I help residents of Marco Island, FL, review those results every year. The Medicare Advantage Open Enrollment Period opens January 1, and you get one switch before it closes March 31.
Key Takeaways
- Your one-time plan switch runs from January 1 through March 31, and February shows your real costs.
- In 2026, three in four members in drug-covered plans paid no extra premium beyond Part B.
- A February request starts new coverage on March 1.
- Dropping Advantage in Florida puts your Medigap approval at risk.
- Call me at (239) 682-8567 for a plan review in Marco Island.
What Are the Benefits of Medicare Advantage in 2026?
Advantage plans include everything Original Medicare offers, plus extras like dental, vision, and hearing. Private insurers run these plans. I compare them to Marco Island residents. KFF’s 2026 Medicare Advantage analysis reports that 75% of members in plans with drug coverage pay nothing beyond the Part B premium of $202.90 a month in 2026.
Dental benefits reach 98% of individual-plan members. Vision tops 99%, hearing hits 95%, and fitness reaches 91%. Core extras held steady from 2025, but two benefits shrank. Over-the-counter allowances dropped from 79% to 68% of members, and transportation slid from 28% to 22%.
Federal rules set a $9,250 ceiling on 2026 in-network medical costs, and the average plan sets its own limit at $5,421. Original Medicare has no such yearly limit. Part D drug costs carry a separate cap of $2,100. About 32% of individual-plan members get a rebate against Part B costs, and for 39% of them the rebate falls under $10 a month.
| Benefit | 2026 Coverage Rate | Note |
| Dental | 98% | Individual plans |
| Vision | 99%+ | Individual plans |
| Hearing | 95% | Individual plans |
| Fitness | 91% | Individual plans |
| Over-the-counter allowance | 68% | Down from 79% in 2025 |
| Transportation | 22% | Down from 28% in 2025 |
| $0 drug premium (beyond Part B) | 75% | Members in drug-covered plans |
Why Should You Re-Evaluate Medicare Advantage in February?
February is when your plan’s real costs show up. January claims have been posted, and your deductible has started fresh. Marco Island members learn their network limits fast when a Collier County specialist bills out of network.
Call me at Michele Sanchez Insurance Agency in Marco Island for Advantage plan help if a bill surprises you.
Four things surface by February:
- Your first Explanation of Benefits statements arrive.
- Your pharmacy charges the real tier price for each drug.
- Your doctor’s office tells you what needs prior authorization. KFF’s 2026 Medicare Advantage analysis finds 99% of members sit in plans that require it for some services.
- Your referrals show how easy care is to reach.
Check three numbers: what you paid, what you still owe, and how close you sit to your yearly limit. Send your request in February, and coverage starts March 1. Don’t wait for the deadline, because waiting leaves no room to fix a mistake.
What Can You Change Before March 31?
One change is all you get, and only if you already have Medicare Advantage. The Medicare Advantage Open Enrollment Period runs January 1 to March 31 each year. Your options: switch to another Advantage plan, with or without drug coverage, or choose Original Medicare and join a Part D plan.
You can’t use this window to move from Original Medicare into Medicare Advantage. Coverage starts the following month, on the 1st.
| Window | Dates | Who Uses It | What You Can Do |
| Annual Enrollment Period | Oct 15 to Dec 7 | Everyone with Medicare | Join, switch, or drop a plan for the new year |
| Open Enrollment Period | Jan 1 to Mar 31 | Advantage members only | Make one switch or pick Original Medicare |
The fall Annual Enrollment Period sets next year’s plan. For 2027, the Part D cap rises to $2,400 and the deductible climbs to $700.
How Do You Review Your Advantage Plan?
Six checks tell you whether your plan still fits. Write down each answer. I’ll walk you through the same six during a plan review.
- Doctors and hospitals: confirm each one sits in your network, including your specialists.
- Drugs: enter every drug by name and dose in the Medicare Plan Finder at Medicare.gov, then check its tier on your formulary.
- Spending: compare what you paid with your out-of-pocket maximum.
- Approvals: note each service that needed prior authorization or a referral.
- Extras: list the dental, vision, hearing, and fitness benefits you used.
- Notices: read the Annual Notice of Change your insurer sent last fall.
You don’t need special tools, just your statements and your drug list. If every item passes, keep your plan. One failed check on doctors or drugs is reason enough to compare two or three other options together. Watch my Medicare education videos to prepare for your review.
What Is the Medigap Catch in Florida?
Leaving Advantage can cost you Medigap coverage in Florida. Medigap is an add-on policy that helps pay costs Original Medicare leaves behind, like deductibles and coinsurance. Insurers can refuse you or charge more based on your health history. They call this medical underwriting.
Florida has one of the highest Advantage enrollment rates in the country, so this catch reaches many Florida Medicare Advantage members.
The main guaranteed windows are narrow:
- Your six-month Medigap open enrollment, which starts when you’re 65 and enrolled in Part B.
- The first 12 months after you join Medicare Advantage at 65.
- From 60 days before to 63 after your plan leaves Medicare or your service area.
Switching between Advantage plans needs no underwriting.
Before you drop Advantage, ask me at Michele Sanchez Insurance Agency in Marco Island to compare your options. Florida SHINE, the state’s free counseling program, also helps.
What Should Marco Island Residents Check Locally?
Plans on Marco Island differ in three ways: doctor networks, travel rules, and county reach. Carriers change their Collier County service areas every year, so confirm your carrier still serves your address. Collier County has 43 Medicare Advantage plans for 2026, not counting special needs plans.
Plan types follow different rules. Most HMO plans cover in-network care only, and 61% of members have one. PPO plans also cover out-of-network care at a higher cost. HMO members face an average limit of $4,636, while PPO members face $6,592.
If you leave Hideaway Beach or Key Marco for the summer, compare how each type pays when you travel. Ask each plan where your doctors and pharmacy sit. That answer matters whether you live near Tigertail Beach or along San Marco Road. Ask whether your hospital counts as in network, too.
I review Advantage plans across all of Marco Island, 34145. Learn about turning 65 in Naples if you’re new to Medicare.
Medicare Advantage Open Enrollment FAQs
Yes, you can change plans in February, but only once. The answers below cover the rest. For more guidance, visit my Michele Sanchez Insurance Agency homepage.
Can I Change My Medicare Advantage Plan in February?
Yes, one time. February falls inside the window for current Advantage members.
When Is Medicare Advantage Open Enrollment?
The Open Enrollment Period is a three-month window, January through March, when Advantage members can switch plans or leave for Original Medicare.
Can I Switch From Medicare Advantage to Original Medicare?
Yes. Make the move by March 31 and enroll in Part D coverage. Florida insurers can still turn down your Medigap application.
When Does My New Coverage Start After I Switch?
Your new coverage begins the first day of the month after the plan receives your request.
Can I Get a Medigap Plan If I Leave Medicare Advantage?
Medigap approval isn’t guaranteed. Insurers can screen your health history, except in protected windows. Read more about Medicare Supplement Insurance.
What Happens If I Miss the March 31 Deadline?
Your plan stays put until fall enrollment, October 15 to December 7, unless a Special Enrollment Period applies.
How Much Does Medicare Advantage Cost in 2026?
Most members in drug-coverage plans owe only the standard Part B charge of $202.90. Call me at Michele Sanchez Insurance Agency in Marco Island for your exact costs.
Ready to Review Your Medicare Advantage 2026 Benefits?
Start your review in February and finish before March 31. The benefits of Medicare Advantage deserve a check every year, and a short review shows whether your doctors, drugs, and extras still fit.
At Michele Sanchez Insurance Agency, I serve Marco Island, FL 34145, and I’ll compare your plan with the options in Collier County. Have your drug list and doctor names ready, then call me at (239) 682-8567 to book your plan review. Bring the six checks above, and you’ll leave with a clear answer on whether to stay or switch.
Warmly,
Michele Sanchez
