Short answer: Start with the healthcare you actually use. Compare doctors, prescriptions, pharmacies, total annual costs, network rules, prior authorization, and quality—not just the premium or extra benefits.
Step 1: Confirm your deadline
Read the ending date and reason in your notice. A plan non-renewal, contract termination, move, and individual disenrollment can create different deadlines. Confirm the applicable Special Enrollment Period before shopping.
Step 2: Build a personal coverage list
• Doctors, specialists, hospitals, laboratories, and medical suppliers. • Every prescription, dosage, frequency, and preferred pharmacy. • Scheduled procedures and ongoing treatment. • Expected travel or time spent in another state. • Dental, vision, hearing, transportation, and other benefits used regularly.
Step 3: Compare the two main paths
Another Medicare Advantage plan may combine Part A, Part B, and usually Part D, with a provider network and annual out-of-pocket maximum. Original Medicare offers broad provider access but generally requires separate decisions about Part D and Medigap and has no annual Part A/Part B out-of-pocket limit by itself.
Step 4: Estimate total cost
Compare the Part B premium, any plan or Medigap premium, deductibles, drug costs, office and hospital cost sharing, maximum out-of-pocket limit, and services not covered. A $0-premium plan is not a $0-cost plan.
Step 5: Verify, do not assume
Search results and provider offices can be outdated. Check the plan’s current directory and formulary, then call the plan and provider. Record the date, representative, and reference number. Ask about the exact plan name and contract—not merely the insurer.
Step 6: Examine restrictions and quality
Review HMO versus PPO rules, referrals, prior authorization, out-of-network coverage, drug tiers, quantity limits, step therapy, pharmacy networks, and Medicare Star Ratings. Extra benefits should be evaluated only after core medical and drug needs are satisfied.
Frequently asked questions
What is the most important comparison? - There is no universal best plan. For many people, provider access, prescriptions, total cost, and maximum financial exposure matter most. Can I rely on an agent’s verbal statement? - Verify important claims in official plan materials and directly with the plan. Where can I get free help? - Use Medicare Plan Compare, call 1-800-MEDICARE, or contact SHIP. Official resources - Medicare Plan Compare (https://www.medicare.gov/plan-compare/) · Compare Medicare Advantage plan types (https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options/compare)