Medicare Advantage Plans in Walton, Okaloosa and Bay Counties

A Medicare Advantage plan is a private plan that delivers your Part A and Part B coverage instead of Original Medicare, usually with drug coverage built in. Each plan has its own service area, network and rules, so the two questions that matter here are whether your doctors are in the plan and which window lets you change.

Medicare Advantage dates and numbers for 2027

• Annual Enrollment Period for 2027 plans: October 15 to December 7, 2026. A plan chosen in it starts January 1, 2027.

• Medicare Advantage Open Enrollment Period: January 1 to March 31, 2027, for people who are in a Medicare Advantage plan on January 1. One change, to another Medicare Advantage plan or back to Original Medicare, with or without a standalone drug plan. It does not let someone on Original Medicare join a Medicare Advantage plan.

• Who can join: anyone with Medicare Part A and Part B who lives in the plan’s service area, including people with end-stage renal disease, who have been able to join since 2021. Outside special needs plans, a plan cannot turn you down because of your health.

• If your 2026 plan is not offered in your county for 2027: a special enrollment period from December 8 through the end of February to choose another plan, and, if you return to Original Medicare, a guaranteed right to certain Medicare Supplement plans from the day you receive your plan’s letter until about March 4, 2027.

• Away from home: Medicare’s rules generally require a plan to disenroll a member who has been outside its service area for more than six months in a row, and each plan’s rules for time away vary.

• Plans on Medicare’s 2027 list, published in September 2026: Walton County 35, Okaloosa 31, Bay 32, from four to five companies, as HMO, HMO-POS, PPO and regional PPO plans. About four in ten are special needs plans that only people in certain situations can join, and about one in four carry no drug coverage.

• Drug coverage inside a Medicare Advantage plan follows Medicare’s 2027 Part D limits: the two thousand four hundred dollar cap on what you pay out of pocket for covered drugs and the seven hundred dollar limit on a deductible.

• Your Annual Notice of Change: your current plan has to get it to you by September 30 each year. It lists what changes on January 1.

• Switching plans during a course of treatment: Medicare’s rule gives you at least ninety days with the new plan before it can require its own prior authorization for that treatment.

We do not offer every plan available in your area. Currently we represent 3 organizations which offer 8 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Who can join a Medicare Advantage plan here, and when can you change?

Anyone with Medicare Part A and Part B who lives in a plan’s service area can join it, and outside special needs plans a plan cannot turn you down because of your health when you apply in a valid window. The service area is the county list in the plan’s documents; a plan sold in Walton County may or may not be sold in Okaloosa or Bay, so the address on your Medicare record is where the comparison starts. The window you are in decides when a change can take effect.

Your first chance: the seven months around your Medicare start

Your first chance to join a Medicare Advantage plan is the seven months around the month you first have both Part A and Part B: three months before, that month, and three months after. Choose before your Medicare starts and the plan starts the same day. If you keep working past 65 with coverage from a current employer and add Part B later, your window is the three months before your Part B starts, and when that employer coverage ends Medicare also gives you two full months after the month it ends to join a plan.

Every fall: October 15 to December 7

Medicare’s Annual Enrollment Period is the one scheduled chance each year for anyone with Medicare to join a Medicare Advantage plan, switch plans, or leave one for Original Medicare, with the change starting January 1. Most of the 2027 comparisons we run happen in these seven weeks.

January 1 to March 31: one change, only for people already in a plan

Medicare’s Open Enrollment Period for Medicare Advantage runs January 1 to March 31. It is only for people who are in a Medicare Advantage plan on January 1, it allows one change, and the change can be to another Medicare Advantage plan or to Original Medicare, with or without a standalone drug plan. Someone on Original Medicare cannot use it to join a Medicare Advantage plan, and a Medicare Supplement client cannot use it to change drug plans.

Other times the door opens

Medicare gives a special enrollment period when you move out of your plan’s service area or into a county with plans you did not have before, when your plan ends or leaves your county (December 8 through the end of February for a plan that is not renewing for 2027), when you lose coverage from a current employer, when you qualify for Extra Help or Medicaid, and in a few other situations, each with its own clock. A plan that Medicare rates five stars can be joined once between December 8 and November 30 of the following year. And if you joined a Medicare Advantage plan when you first became eligible for Medicare at 65, you can return to Original Medicare at any point in your first twelve months in it, with a guaranteed right to buy a Medicare Supplement that our Medicare Supplement page explains.

What Medicare sets, and what each plan sets

Medicare sets the frame. Every Medicare Advantage plan has to cover everything Part A and Part B cover, under Medicare’s own coverage rules, with hospice care still paid by Original Medicare. Medicare sets the enrollment windows above, the rule that a plan can only enroll people who live in its service area, the six-month rule for members who are away, the September 30 deadline for the Annual Notice of Change, and the rule that an approved prior authorization for a course of treatment stays valid for as long as that treatment is medically necessary.

Each plan sets the rest, and the rest is what you feel.

• Its service area: the counties where it sells.

• Its network: which doctors, hospitals and other providers are in it, and whether you can go outside it.

• Its rules for getting care: whether you need a primary care doctor, whether you need a referral to see a specialist, and which services need the plan’s approval first.

• Its drug list, pharmacy network and pharmacy terms, if it includes drug coverage, inside Medicare’s 2027 limits.

• Its own costs, which are in its 2027 documents and can change every January 1.

Nothing about Medicare changes from one plan to the next. The plan’s own choices do, which is why two plans sold in the same county can be a very different fit for two neighbors.

HMO, HMO-POS, PPO and the other plan types on Medicare’s list

Medicare sorts plans by how their networks work, and the type tells you a lot before you read anything else.

• HMO: you use the plan’s network, usually with a primary care doctor and a referral to see a specialist. Outside the network the plan generally pays only for emergency care, urgently needed care away from home, and out-of-area dialysis.

• HMO-POS: an HMO with a point-of-service option that lets you go outside the network for some services under the plan’s terms.

• PPO: a network plus the option to see providers outside it, with the plan’s out-of-network terms applying when you do. A regional PPO’s service area is a whole Medicare region rather than a set of counties; Florida is a region of its own, so a regional PPO sold here is sold statewide.

• Special needs plans: for people who also have Medicaid, who have a qualifying chronic condition, or who live in an institution. Only those people can join, and the plan can check.

• Private fee-for-service plans and a couple of other rare types exist in other parts of the country; none is on Medicare’s 2027 list for Walton, Okaloosa or Bay.

On the 2027 list for our three counties, the plans open to general enrollment are HMO, HMO-POS, PPO and regional PPO, and HMO and PPO plans are both on the list in each county, so the type you prefer narrows the field without settling it.

The network question: your doctors, your hospital, and where you go for the big things

Here the comparison is mostly a network check, and we do it with you, name by name. Your primary care doctor. Each specialist you see. The hospital you would use: for most of our Walton County clients that is Ascension Sacred Heart Emerald Coast in Miramar Beach or North Walton Doctors Hospital in DeFuniak Springs, with the Fort Walton Beach, Niceville and Panama City hospitals for clients in Okaloosa and Bay. Then the harder question: where you would go for the big things, because a lot of specialized care from here happens in Pensacola, Birmingham, Jacksonville, Nashville, Atlanta or Houston, and the plan’s rules for care outside its network and outside its service area decide how that works.

We check each name in the plan’s 2027 provider directory, and because directories lag, we call the office for the doctors who matter most and ask whether they are in the plan for the coming year. A doctor can leave a network during the year, and Medicare requires the plan to tell you when one you see regularly does. We note what we found in your file, so when a letter comes we can read it against your own list.

Snowbirds, sunbirds and the six-month rule

Sunbirds are our neighbors who live in Santa Rosa Beach, Freeport or Inlet Beach on paper and leave for the mountains or the Midwest from June through September; snowbirds come the other way for the winter. Both run into the same rule. A Medicare Advantage plan has a service area, and Medicare’s rules generally require a plan to disenroll a member who has been outside it for more than six months in a row, and each plan’s rules for time away vary. Four months away is inside the six-month rule. Leaving in May and coming home at Christmas runs past it, so we go over the plan’s rules for time away with you before you choose.

How a plan handles routine care while you are away is set by the plan and written in its Evidence of Coverage, and it varies by plan. We read that section with you before you go, and we note the months you expect to be gone, because that number decides more than most people expect. Our Medicare Supplement page covers how the other path handles travel.

Drug coverage inside a Medicare Advantage plan

Most Medicare Advantage plans sold here include drug coverage, and that coverage follows Medicare’s 2027 Part D limits: the two thousand four hundred dollar cap on what you pay out of pocket for covered drugs, the seven hundred dollar limit on a plan’s deductible, and no coverage gap. Inside those limits the plan sets its own drug list, tiers and pharmacy network, so we price your prescriptions in each plan at the pharmacy you use, the same comparison our Part D page walks through.

Two rules trip people up. If your Medicare Advantage plan includes drug coverage, you cannot add a standalone drug plan on top of it; joining one ends your Medicare Advantage plan and returns you to Original Medicare. And a standalone drug plan cannot be added to an HMO or PPO that has no drug coverage either, so the plans on the 2027 list without drug coverage are built for people who get their drugs elsewhere, such as through the VA, TRICARE For Life or an employer or union plan.

Medicare Advantage and a Medicare Supplement do not go together

A Medicare Supplement pays your share of Original Medicare’s bills, so it has nothing to pay while a Medicare Advantage plan is delivering your coverage, and it is illegal for anyone to sell you one while you are in a Medicare Advantage plan unless you are on your way back to Original Medicare. The choice between the two paths comes down to your doctors, how many months a year you are here, and how you would rather absorb a bad year. Our overview of the three paths at 65 lays them side by side, and our Medicare Supplement page covers the other side in the same detail as this one.

If your Medicare Advantage plan is ending December 31

Several Medicare Advantage plans sold in Walton, Okaloosa and Bay counties in 2026 are not offered here for 2027, and most plans that are not renewing mailed their members a letter dated October 2. Read it closely: it says whether your plan is ending in your county or moving you into another of the company’s plans for 2027. If it is ending and you want another Medicare Advantage plan, you can choose one through December 7, and because your plan is not renewing you also have a special enrollment period from December 8 through the end of February; a plan chosen in that period starts the first of the following month, so waiting into January leaves January on Original Medicare alone. If you would rather return to Original Medicare and a supplement, federal and Florida law give you a guaranteed right to certain Medicare Supplement plans from the day you receive the letter until 63 days after your coverage ends, about March 4, 2027. Our guide to what to do when your Medicare Advantage plan is ending puts the dates, the drug plan and the order of steps in one place.

Switching plans in the middle of treatment

If you are in a course of treatment when you switch Medicare Advantage plans, Medicare’s rule gives you a transition of at least ninety days with the new plan before it can require its own prior authorization for that treatment, and that holds even if the provider is outside the new plan’s network. An approval your old plan gave for a course of treatment stays valid with that plan for as long as the treatment is medically necessary. Bring the approval letter to the appointment, and we note the treatment and the dates in your file so we can follow up with the new plan on the transition.

TRICARE For Life, VA care and a Medicare Advantage plan

Around Eglin, Hurlburt and Tyndall we see a lot of TRICARE For Life. It stays with you if you join a Medicare Advantage plan: TRICARE says it pays after your Medicare plan, that you use the plan’s network for care that is not an emergency, and that you may need to file your own claims with the TRICARE For Life contractor when a Medicare Advantage plan is primary. Whether a Medicare Advantage plan fits a TRICARE For Life household is a network question first and a paperwork question second, and we go over both. VA care is separate from Medicare: a Medicare Advantage plan does not pay for care at the VA, and the VA does not pay for care outside its system unless it authorized that care, so many veterans here keep both and use each where it works.

The plans we can enroll you in, and the ones we cannot

We are appointed with some of the companies on Medicare’s 2027 list for our counties, not all of them. We still look at the whole county list with you, because the comparison is about your fit, not ours. If the plan that fits you best is one we cannot enroll you in, we tell you, you enroll yourself at Medicare.gov or by calling 1-800-MEDICARE, and we note it in your file. If it is a plan offered by one of the companies we represent, we enroll you from the office.

What to expect when you call about Medicare Advantage

Medicare Advantage questions go to Chris Jayne, Trista Cordell or Garrett Fuller. All three are licensed and work from our office at 4821 US Highway 98 W, Suite 103, Santa Rosa Beach, FL 32459, open 9 to 4, Monday through Thursday. Before we go over plans with you one on one, Medicare requires a Scope of Appointment form, which takes a minute and can be signed the same day, in the office or by phone.

Call the office at 850-622-5283 and ask for Chris Jayne, Trista Cordell, or Garrett Fuller, Fuller Insurance LLC, Florida license L039483. Bring your Medicare card, the names of your doctors and the hospital you would use, your prescriptions with doses, the months you expect to be away, and any letter from your current plan, and we will go over which window you are in and how each plan sold in your county handles your list for 2027.

When you share your information with us, a licensed Fuller Insurance agent will contact you.

Dates and rules on this page are Medicare’s and apply to every plan; dollar figures are Medicare’s 2027 Part D limits and carry their year. Each plan’s own network, rules and costs are in that plan’s 2027 documents, and your plan’s documents control.

Fuller Insurance is not connected with or endorsed by the U.S. government or the federal Medicare program.