Quick answer: Compare Medicare Advantage plans on Medicare.gov’s official plan comparison tool (and with 1-800-MEDICARE or a SHIP counselor), not from a “best plans” list. Look at whether your doctors, hospitals and pharmacies are in the plan’s network, whether your prescriptions are on the plan’s formulary and at what tier, the premium (you generally still pay the Part B premium as well), deductibles, copays or coinsurance, the plan’s out-of-pocket maximum, and prior authorization or referral rules. CMS star ratings are an official quality summary, not a promise that a plan will be the right fit for you. Fall Open Enrollment (October 15–December 7) is the main time most people can switch for January 1; some people also have the January–March Advantage Open Enrollment Period or a Special Enrollment Period. This guide belongs in our Medicare guide and complements Medicare Advantage vs Medigap rather than repeating that choice.
Sources: Medicare.gov plan comparison and Medicare Advantage materials; CMS star-rating program as an official quality measure (confirm current methodology on Medicare.gov); Medicare.gov enrollment-period pages; CMS 2026 Part B standard premium of $202.90 announced November 14, 2025, for people who pay the standard amount — IRMAA can raise that amount, as discussed in our IRMAA article. Plan premiums, networks and drug lists vary and must be checked for your ZIP code and the coverage year. Official URLs fetched 2026-11-10: https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles ; https://www.medicare.gov/basics/costs/medicare-costs Checked November 2026, with live-page confirmation the same day.. This is general consumer information, not legal, tax, medical or benefits advice. Medicare rules, plan designs and dollar amounts change. Confirm current details on Medicare.gov, with CMS, Social Security, your plan, and a State Health Insurance Assistance Program (SHIP) counselor before you rely on a figure or a deadline.
Start With Official Tools, Not a Ranked List
This site will not publish a ranked list of “best” Medicare Advantage plans. Plans change every year, networks and drug lists are local, and a five-star summary is not the same as your cardiologist being in network. The official comparison starts at Medicare.gov (plan compare), where you can enter your location, your current coverage, your doctors, and your prescriptions. 1-800-MEDICARE can help you use the same information. A State Health Insurance Assistance Program counselor can go through the results with you at no cost.
Have this in front of you before you compare: your Medicare Number, your doctors and the facilities you actually use, your pharmacies, a current medication list with doses, and any equipment or specialists you expect to need. A plan that looks inexpensive on premium can be expensive if a regularly used drug is non-formulary or a hospital is out of network.
Medicare Advantage Plans are still Medicare. They must cover the services Original Medicare covers, though they can use networks, prior authorization, and different cost-sharing. Hospice is often still provided through Original Medicare even if you have an Advantage plan; confirm current official language on Medicare.gov if that service is relevant. You generally must have Part A and Part B, and you generally still pay the Part B premium. For 2026, CMS announced a standard Part B premium of $202.90 per month for people who pay the standard amount. Higher-income people may pay more because of IRMAA. The Advantage plan may charge its own premium on top of that, or it may have a $0 plan premium; either way, “zero premium” does not mean zero cost.
Decide first whether Medicare Advantage is the structure you want, using our Advantage vs Medigap guide. Then compare specific plans in your area for the coverage year you are buying, which during the 2026 fall Open Enrollment period means 2027 plans. Confirm the year on the tool.
Networks, Drugs, Prior Authorization and Costs
Network rules are often the make-or-break item. An HMO-style Advantage plan typically expects you to use network providers and may require referrals. A PPO-style plan may allow out-of-network care at a higher cost. “In network” must be verified with the plan for each doctor, not assumed from a directory screenshot. Ask the provider’s office whether they will participate in that specific plan next year, because directories can lag.
Drug coverage is the second make-or-break item if the plan includes Part D. Enter every prescription in the official tool and look at tier, utilization management (prior authorization, step therapy, quantity limits), and the pharmacy you actually use, including mail-order if you rely on it. Formulary design is explained more fully in our Part D formularies and tiers article. A plan can be a poor fit even if its premium is low, if one specialty drug is not covered or is much more expensive than under another plan.
Prior authorization and referral rules should be read in plain language, not skipped. If you have upcoming surgery, infusion, imaging, or a skilled-nursing stay, ask how the plan handles it. Official comparison tools and plan documents (Evidence of Coverage, Annual Notice of Change) are the sources; a sales flyer is not.
Costs to line up, all from official or plan documents for the correct year:
- The plan premium, if any, plus the Part B premium you already owe.
- Deductibles, copays and coinsurance for primary care, specialists, emergency care, hospital stays and other services you use.
- The plan’s annual out-of-pocket maximum (this is a Medicare Advantage cost-sharing cap for covered Part A and B services; it is not the same number as the Part D drug out-of-pocket cap).
- Drug deductibles and copays, and how they interact with the Part D out-of-pocket cap described in official Medicare.gov Part D materials.
Do not invent a “typical” premium or a national out-of-pocket figure as if every plan used it. Compare the numbers on the official tool for your ZIP code.
Extra benefits — dental, vision, hearing, transportation, meals — can be useful and should be read carefully. Original Medicare’s limits on dental, vision and hearing are discussed in our dental, vision and hearing article; an Advantage extra benefit is not automatically comprehensive. Check annual caps, networks and waiting periods in the plan documents.
Star Ratings, Enrollment Timing and a Fair Process
CMS publishes star ratings for Medicare Advantage and drug plans. They are an official quality summary built from clinical quality, member experience and similar measures, and they can help you compare. They are not a personal guarantee, and a high-rated plan can still be wrong for your doctors or drugs. A lower-rated plan is not automatically a bad idea if it is the one that actually covers your care, though very low ratings can have official consequences at the CMS program level. Read the current year’s stars on Medicare.gov and what they measure, rather than a third-party “award.”
Enrollment timing still governs whether you can change. Fall Open Enrollment, October 15–December 7, is when most people can switch Advantage plans for a January 1 start, as our AEP checklist describes. If you are already in an Advantage plan, the January 1–March 31 Medicare Advantage Open Enrollment Period allows one additional change, with coverage starting the first of the month after the plan gets your request. Special Enrollment Periods apply in defined situations such as a move. Do not enroll from pressure on a phone call if you have not compared official results.
When you are ready, enroll through Medicare.gov or the official plan process, keep the confirmation, and review the first notices of coverage. If a salesperson’s pitch does not match the official plan listing, pause and call 1-800-MEDICARE or SHIP. You can also ask a trusted person to sit with you during the comparison, as long as they are not choosing a plan for a commission you do not understand.
Revisit the comparison every fall. Formularies, premiums, provider networks and your own prescriptions can all change. The plan that fit last year is a starting point, not a final answer.
Documents to Read Before You Enroll, and After January 1
The official comparison tool is the start, not the entire file. After you shortlist two or three plans, open each plan’s Annual Notice of Change (if you already have Medicare) and the Evidence of Coverage for the coverage year. Those official documents explain prior authorization, referral rules, the out-of-pocket maximum, and how emergency care works when you are away from home. A summary card that lists only the premium and primary-care copay leaves out the rules that often cause problems later.
Call the plan to ask about a specific doctor or drug only after you have the official listing in front of you, and ask the provider’s office the same question. When the two answers disagree, wait for a written plan confirmation rather than enrolling on a verbal “we should be fine.” Save the names of the people you spoke with and the date. That log is useful if a directory error has official consequences.
After coverage starts, the first Explanation of Benefits and the first pharmacy receipt are a practical audit. If a specialist visit or a refill is billed as out of network or non-formulary, contact the plan promptly. Official appeal and coverage-determination rights exist for a reason, and earlier contact is easier than a mid-year surprise. Switching again will still require an official enrollment period, so a January problem may be fixable inside the Advantage Open Enrollment Period if you are already in an Advantage plan and have not yet used that one change.
People who receive Medicaid or Extra Help should compare with that official status entered correctly, because plan availability and payments can differ. SHIP counselors are used to those cases. Broker compensation is not an official quality measure and should not replace the Medicare.gov listing.
Re-run the official comparison whenever your drug list or your specialists change, even if you are not required to pick a new plan. Staying with a plan is easiest when the plan still matches the care you actually use.
Frequently Asked Questions
Is a $0-premium Advantage plan free?
No. You generally still pay the Part B premium (the standard 2026 amount announced by CMS is $202.90, and IRMAA can raise it). You may also have copays, coinsurance and drug costs.
Can I keep all of my current doctors?
Only if they participate in that plan’s network (or you use an out-of-network benefit that the plan actually offers and you can afford). Verify with the official tool and the provider’s office.
Should I pick the plan with the highest star rating automatically?
No. Use stars as one official data point, then check doctors, drugs and costs for your situation.
Where do I compare plans?
Medicare.gov’s plan comparison tool is the official starting point. 1-800-MEDICARE and SHIP can help you use it.
Do I have to choose a new plan every year?
No, but you should review the Annual Notice of Change and official listings every fall, because staying put is still a decision.
What if a plan is leaving my area?
Follow official non-renewal notices and Medicare.gov Special Enrollment Period rules. That is a qualifying situation, not a reason to use an unofficial replacement list.
