Florida Blue Medicare Advantage 2026-2027 Review

CMS maintains its own database of star ratings, which rank each plan from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures.

You can find a plan’s rating with Medicare's plan finding tool.

With any Medicare Advantage plan, you'll still be responsible for paying your Medicare Part B premium, which is $202.90 per month in 2026.

Most people pay this standard Part B amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.

Formulary tiers

We evaluate Medicare Advantage plans based on their prices for the first three tiers on their formulary, the list of covered drugs. Many plans have five-tier formularies:

We evaluate Tiers 1–3 individually based on their out-of-pocket costs and whether a prescription drug deductible applies.

We don't compare plans based on higher tiers because there are fewer significant differences in plan design. Nearly all plans charge coinsurance for Tier 4 and Tier 5 drugs, so what you'll pay depends mostly on the retail price of the drug.

Scoring

Plans get the highest scores for offering the lowest out-of-pocket costs. Plans get a perfect score for the tier if they offer $0 copays.

We evaluate plans that do charge copays or coinsurance based on reference prices:

Using reference prices lets us compare plans with copays and coinsurance. For example, with a copay, you might owe a flat $40 for a Tier 3 drug. An 18% coinsurance could work out slightly cheaper, at $36 for a $200 drug. But a plan with a 25% coinsurance would cost you $50 — and we'd score it lower.

Plans also earn points based on whether a prescription drug deductible applies at each of the first three tiers. We prefer plans that start covering your medications immediately, rather than after you've met a deductible.

Plan details

We give two numbers in the boxes above. First, the percentage of the company's plans with $0 copays for the tier. These percentages are often pretty high for Tier 1, but can drop off sharply afterward. Second, we list averages of what plans that do charge copays or coinsurance would cost. We don't include the plans with $0 copays in these averages because we want to give a realistic sense of what you might actually pay. The averages are estimates based on our reference prices, after you've met your prescription drug deductible, if any.

Medicare Advantage plans that don't include prescription drug coverage don't get scored on these measures. They're not penalized for the lack of coverage, but their scores for other cost factors like premiums and out-of-pocket costs for medical care get higher weight in their overall ratings.

Services

We evaluate Medicare Advantage plans based on the out-of-pocket costs they charge for three services: a visit to the emergency department, an ambulance ride and a seven-day hospital stay.

We chose these services for several reasons:

Emergency and ambulance charges

We extracted plan-level cost information from CMS’ “MPF Benefit Summary,” a giant spreadsheet that lays out whether and how plans cover an array of healthcare services.

Emergency visits and ambulance rides often have coinsurance, which means you owe a percentage of Medicare’s allowed cost. To put plans on a level playing field, we used reference prices for these services. We used $1,200 as a round reference price for an ambulance ride, based on numbers from MedPAC’s June 2026 report to Congress.

For an emergency department visit, we used $800 to represent the allowed amounts for a high-severity visit that doesn’t result in an admission to the hospital for inpatient care. That’s based on the sum of Medicare’s physician payment rate for CPT 99285 and facility fee for APC 5025.

We used these reference prices to calculate out-of-pocket costs for plans that charge coinsurance for either of the services above. That allows us to compare plans with copays against plans with coinsurance on an even playing field.

Hospital stays

Out-of-pocket costs for hospital stays are typically copays per day for a certain number of days. We used a seven-day hospital stay to compare costs. The average length of stay for Medicare Advantage beneficiaries is 7.1 days, according to a study published by the American Medical Association in 2025. Using this reference length of stay allows us to compare plans that charge out-of-pocket costs on a per-day basis against ones that charge per stay, regardless of length.

Scoring

For each service, we score plans more highly when they have lower out-of-pocket costs. Company-level averages are weighted by plan enrollment within the company.