Compare Medicare Advantage plans against the care you actually need, using the exact plan offered in your area for the correct year. There is no single plan that is best for everyone. Start with providers and expected costs, then examine additional benefits and enrollment rules.
Use the same worksheet for every option
| Compare | Write down for each plan |
|---|---|
| Identity | Plan name, plan ID, county or service area, and year. |
| Providers | Whether each doctor, hospital and preferred location is in the exact network and accepting patients. |
| Regular costs | Plan premium, applicable Medicare premiums and medical deductible. |
| Care costs | Primary care, specialist, hospital and other expected medical cost sharing. |
| Medical spending limits | Annual limit and whether separate in-network and combined limits apply. |
| Part D | Whether included, pharmacy network and coverage rules for your needs. |
| Extra benefits | What is covered, who qualifies, participating providers, frequency and dollar limits. |
| Access rules | Referrals, prior authorization and routine care away from home. |
Verify your providers twice
Ask the plan about the specific provider and practice address. Then ask the provider’s office whether it accepts that exact plan and is taking new patients. A company logo on a practice website is not enough to confirm every plan sold by that company.
For planned hospital care, ask whether separate clinicians or facilities will bill you. If you travel, check routine out-of-area coverage as well as emergency and urgently needed care.
Look beyond a $0 premium
A plan with no additional monthly premium can still have copayments, coinsurance and other costs. You generally continue paying the Part B premium. Compare a year of predictable premiums and expected care, then consider what your responsibility could be in a year with more medical services.
Medicare Advantage’s medical spending limit does not replace the separate Part D rules. Do not treat a dental allowance or other extra as unrestricted cash or assume it offsets every expense.
Read the documents and record answers
The Evidence of Coverage explains benefits, costs and plan rules. The Annual Notice of Change explains changes effective the following January. Use the documents for the year you are choosing, and keep written answers or call reference numbers for unresolved questions.
Before switching, confirm the enrollment period, start date and effects on employer or union coverage. If the alternative is Original Medicare with Medigap, check Medigap purchase rights separately. SHIP offers free counseling independent of insurers; a Licensed Insurance Agent can explain the plans the agent represents.
Related coverage questions
- Medicare Advantage: Eligibility, Benefits and Plan Rules
- Medicare HMO and PPO: Networks, Referrals and Costs
- How to Verify Your Medicare Coverage and Plan Enrollment