How to Compare Medicare Advantage Plans Side by Side

Medicare Advantage plans often lead with the same headline: low or $0 premium. That number alone doesn't tell you much. Here's a practical way to compare plans beyond the sticker price.

1. Start with your doctors and pharmacy

Before looking at anything else, check whether your current doctors, specialists, and pharmacy are in-network for each plan you're considering. This single factor causes more post-enrollment regret than any other. A plan with a great premium is a poor deal if it means leaving a doctor you've seen for years.

2. Check the drug formulary against your actual prescriptions

Every plan has its own list of covered drugs and its own cost tiers. Pull your current prescription list and check each medication against the plan's formulary — not just whether it's covered, but which tier it falls into, since that determines your actual copay.

3. Add up total costs, not just the premium

Premium is only one piece. Also compare:

• Annual deductible (medical and drug, if separate)
• Copays for primary care visits, specialist visits, and urgent care
• Coinsurance percentages for hospital stays or major procedures
• The plan's maximum out-of-pocket limit — the most you'd pay in a worst-case year

4. Compare the extra benefits — but check the actual limits

Dental, vision, hearing, and fitness benefits vary enormously in generosity between plans, even when both advertise "dental coverage." Check the actual annual dollar allowance or covered services, not just whether the benefit exists.

5. Look at the star rating — as one factor, not the deciding one

A higher star rating reflects stronger performance on quality and service measures, and it's worth weighing. But it shouldn't override a mismatch on network or drug coverage — a lower-rated plan that covers your specific doctors is often the more practical choice.

6. Confirm the plan type: HMO vs. PPO

HMO plans generally require using in-network providers and often need referrals to see specialists. PPO plans usually offer more flexibility to see out-of-network providers, typically at a higher cost. Which structure fits depends on how much flexibility you want versus how much you're willing to pay for it.

Where to actually compare

Medicare's official Plan Finder at medicare.gov/plan-compare lets you enter your medications and see personalized cost estimates across available plans in your area. It's a good starting point — pairing it with a conversation with a local licensed agent can help translate the numbers into what they mean for your specific situation.