Medicare Guide

How to compare Medicare Advantage plans (complete guide)

To compare Medicare Advantage plans, start with your doctors and prescriptions. Then check each plan's network, drug coverage, yearly out-of-pocket limit and total yearly cost, not just the premium. Medicare's Plan Finder or a licensed agent can show you the plans in your ZIP code. You can change plans during open enrollment, October 15 to December 7.

Reviewed by Calvin Bagley, Licensed Insurance Agent since 2011 · Published October 30, 2026 · Last updated October 30, 2026

Quick answer

Medicare starts with Parts A and B. Your real decision is how you want the rest of your coverage to work.

Most people compare Original Medicare with add-ons against Medicare Advantage. The right path depends on local plan availability, doctors, prescriptions, budget, travel, and timing.

Key takeaways

Your doctors and drugs decide which plans are worth a closer look. Check them before you compare prices.
A $0 premium plan can still cost you more over a year once you add copays, drug costs and the out-of-pocket limit.
Plans are sold by ZIP code, so a plan your neighbor in Phoenix has may not exist in Las Vegas or McAllen. Availability varies by location.
Network rules differ by plan type. HMOs and PPOs handle out-of-network care in different ways.
Comparing once isn't enough. Plans change their costs and benefits every year, so review yours every fall.
Medicare Advantage open enrollment runs October 15 to December 7 each year (Medicare.gov).
From January 1 to March 31, if you're already in a Medicare Advantage plan, you can switch to another one or go back to Original Medicare once (Medicare.gov).
Medicare Advantage plans have a yearly limit on what you pay out of pocket for covered Part A and Part B services (Medicare.gov).
Medicare rates plans on a scale of 1 to 5 stars (Medicare.gov).

What this means in plain English

A Medicare Advantage plan is a Medicare-approved plan from a private company that replaces Original Medicare for your Part A and Part B coverage. Most include drug coverage, and many add extras like dental or vision. Comparing plans means lining them up side by side to see which one covers your care at a cost you can live with.

What to look for when you compare Medicare Advantage plans

Look first at whether your doctors and hospitals are in network. Then check whether each of your prescriptions is on the plan's drug list and what tier it sits in. After that, compare the out-of-pocket limit, specialist copays and the star rating. Extras like dental matter less than they seem if the plan doesn't cover the doctor you see every month.

Top options compared

HMO plans usually require you to stay in network and get referrals for specialists. In exchange, they often have lower costs. PPO plans let you see out-of-network providers for a higher price, which suits people who travel or split time between states. Special Needs Plans are for people with Medicaid or certain chronic conditions. Which type fits depends on how often you see specialists and how much freedom you want.

HMO vs PPO example

Here's a direct comparison. Say you live in Reno and spend winters near family in Phoenix. With an HMO, the plan generally won't pay for a routine checkup with a Phoenix doctor outside its network, though it still covers emergency and urgent care (Medicare.gov). With a PPO, you could see that Phoenix doctor and pay more than you would in network. If you rarely leave town, the HMO's lower costs may matter more than that freedom.

How to choose after you compare Medicare Advantage plans

Add up a full year. Take the premium times 12, plus your expected copays and drug costs, and then picture your worst year by adding the out-of-pocket limit. For example, picture two plans in the same ZIP code. We made up these numbers to show the math. Plan A has a $0 premium and a $50 specialist copay. Plan B costs $40 a month with a $20 specialist copay.

Run the numbers

If you see a specialist twice a month, Plan A's copays come to $1,200 a year. Plan B costs $480 in premiums plus $480 in copays, or $960. So the $0 plan costs $240 more. But if you see a specialist once a month, Plan A wins by $120. Run this math with each plan's real figures.

Pick the plan that fits

Pick the plan that covers your current doctors and holds up in that bad-year math. If two plans tie, the higher star rating is a fair tiebreaker. This is general information, so confirm the details with a licensed Medicare agent before you enroll.

What to do next

Today, write down your doctors, your prescriptions with doses, and your pharmacy. Then call or text a licensed local agent at The Medicare Store at 888-333-5853, or schedule a free meeting. An agent compares plans across multiple carriers, checks your doctors and drugs, handles enrollment at no cost to you, and checks in six times in the first year. Meet by phone, at an office in Las Vegas, Reno, Phoenix, Albuquerque, McAllen or Laredo, or at home on request. Help is available in English and Spanish.

Common questions

Questions people usually ask next

These answers are a starting point. Medicare details can change based on timing, other coverage, and where you live.

Can I compare Medicare Advantage plans on my own?

Yes. Medicare's Plan Finder lists plans by ZIP code and estimates drug costs. A licensed agent can also check your doctors directly with each carrier, which the tool doesn't always do.

Does a $0 premium plan cost nothing?

No. You still pay your Part B premium. You also pay copays or coinsurance when you get care, plus what you owe for drugs. Compare total yearly cost, not the monthly premium alone.

When can I switch Medicare Advantage plans?

You can switch during open enrollment, October 15 to December 7. Certain life events, like moving, can also give you a Special Enrollment Period.

Do plans change every year?

Yes. Premiums, networks, drug lists and copays can change each January. Your plan sends a notice of changes each fall, so compare again before December 7.

Does my VA or Medicaid coverage work with these plans?

Often, yes. Insurance companies design some plans to work with Medicaid, and veterans can keep VA care alongside a plan. How they fit together depends on your situation.

Official references

Sources checked for this guide

These guides are written in plain English, but the 2026 cost figures and coverage rules should stay tied to official Medicare and CMS source material.

Medicare's Plan Finder open enrollment, October 15 to December 7 Medicare Advantage plan schedule a free meeting

About the reviewer

Calvin Bagley · Licensed Insurance Agent since 2011 · Nevada license #820948

Calvin Bagley is the founder and president of The Medicare Store and has been a licensed insurance agent since 2011 (Nevada license #820948). He built The Medicare Store around free, unhurried Medicare guidance from local agents, and still works with clients and agents across every Medicare Store market.

Need help applying this?

Talk with The Medicare Store before you choose.

Medicare decisions depend on your doctors, prescriptions, location, timing, and budget. We can help you compare the options that fit your situation.

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