How to Compare Medicare Plan Options

Introduction

Comparing Medicare options can feel overwhelming—especially when benefits, costs, and provider networks change from year to year. Many beneficiaries stick with their current coverage simply because reviewing alternatives seems complicated. But even small changes in premiums or drug formularies can significantly impact your out-of-pocket spending.

The good news: Medicare gives you multiple opportunities each year to review and adjust your coverage. Understanding what you can do during the Annual Enrollment Period (AEP) and the Medicare Advantage Open Enrollment Period (MA OEP) can help you make confident, cost-smart decisions. This guide breaks down how to thoughtfully compare Medicare options using simple, approachable language.

How to Compare Medicare Options

Comparing Medicare options requires more than just checking premiums. You’ll want to evaluate benefits, networks, total costs, and prescription drug coverage. Below are practical steps to follow as you evaluate your choices.

Understand Your Main Medicare Choices

When comparing plans, you’re generally evaluating these options:

Original Medicare (Part A Hospital Insurance & Part B Medical Insurance)

• Nationwide provider access
• No annual out-of-pocket limit
• Option to add Part D for prescription coverage
• Option to add Medigap to reduce out-of-pocket costs

Learn more about Part A and Part B coverage from Medicare.gov.

Medicare Advantage (Part C)

• All-in-one coverage
• Often includes Part D
• May include dental, vision, hearing, and wellness extras
• Annual out-of-pocket maximum
• Network-based coverage (HMO/PPO)
  

Prescription Drug Plans (Part D)

A Prescription Drug Plan (Part D) is standalone coverage that helps pay for your prescription medications when you’re enrolled in Original Medicare.

Medigap (Medicare Supplemental Insurance)

A Medigap policy is optional supplemental insurance that helps cover out-of-pocket costs, such as deductibles, coinsurance, and copayments, that Original Medicare doesn’t fully pay, and it’s available in standardized plan types like Plans A, B, D, G, K, L, M, and N (with Plans C and F limited to those eligible for Medicare before 2020).

Note: Medigap cannot be paired with Medicare Advantage.

If you’re still deciding whether supplemental coverage or an all-in-one plan better fits your needs, you can compare Medicare Advantage vs. Medigap coverage to understand key differences.

What You Can Do During the Annual Enrollment Period (AEP)

AEP runs from October 15–December 7 each year.
This is the main period for making Medicare Advantage and Part D changes.

During AEP, you can:

• Switch from Original Medicare to Medicare Advantage
• Switch from Medicare Advantage back to Original Medicare
• Change from one Medicare Advantage plan to another
• Add, drop, or switch Part D drug plans
• Enroll in Medicare Advantage or Part D for the first time if eligible
  

Why AEP Matters

AEP allows you to update your coverage before the new year begins.

You may want to compare plans if:

• Premiums or deductibles are increasing
• Your doctors may leave the network
• Your medications have been moved to different formulary tiers
• You want more supplemental benefits
  

If you want a deeper breakdown of how to evaluate costs, networks, and supplemental benefits, you can also learn how to compare Medicare Advantage plans in our step-by-step guide.

What You Can Do During the Medicare Advantage Open Enrollment Period (Jan 1 – March 31)

The Medicare Advantage Open Enrollment Period (MA OEP) is only for people already enrolled in a Medicare Advantage plan.

During MA OEP, you can:

• Switch from one Medicare Advantage plan to another
• Return to Original Medicare (with the option to add Part D)
  

Limitations

• You cannot switch from Original Medicare to Medicare Advantage
• You cannot add, drop, or change standalone Part D plans unless you leave Medicare Advantage for Original Medicare
• You get one plan change during this period

Why MA OEP Matters

If you:

• Switched to a Medicare Advantage plan and regret the decision
• Discover your provider isn’t in-network
• Face unexpected copays or prescription rules
• Want different supplemental benefits

How to Compare Medicare Advantage Plans Effectively

When reviewing Medicare Advantage plans, focus on these areas:

1. Review Plan Costs

Compare:

• Premiums
• Deductibles
• Copays/coinsurance
• Out-of-pocket maximum

Even low-premium plans can cost more overall if other expenses are high.

2. Check Provider Networks

To avoid surprise bills, confirm:

• Your primary care doctor participates
• Your preferred hospitals are in-network
• Specialists you regularly see or may need are included

Some plans may contract with limited specialists.

3. Compare Prescription Drug Coverage

Review:

• Drug tiers
• Prior authorization requirements
• Preferred vs. standard pharmacy pricing

Tip: List your medications and check how each plan covers them.

4. Review Extra Benefits

Many Medicare Advantage plans offer extras like:

• Dental and vision
• Hearing aids
• Wellness and fitness benefits
• Over-the-counter allowances

Compare annual allowances and coverage rules carefully.

5. Use Star Ratings

Medicare Star Ratings, provided by the Centers for Medicare & Medicaid Services (CMS), measure plan quality based on:

• Member experience
• Chronic condition management
• Preventive care
• Customer service

For additional context on plan quality and service levels, you can also review some of the best Medicare Advantage plans and companies to see how major insurers stack up.

Quick Reference: Who Should Consider Switching?

You may benefit from comparing new Medicare options if you:

• Expect higher healthcare usage
• Received an Annual Notice of Change (ANOC) showing premium or network changes
• Want better supplemental benefits
• Added new medications
• Moved or plan to move
  

Bottom Line: Compare Medicare Options With Confidence

Every Medicare beneficiary deserves coverage that fits their health needs and budget. Using AEP and MA OEP strategically can help ensure you have the right Medicare Advantage or Part D plan for the upcoming year. Compare benefits, review drug coverage, double-check networks, and use trusted tools to simplify your decision.