Start With What You Actually Use
Comparing Medicare Advantage plans during AEP can feel overwhelming — there are often a dozen or more options in a given county. The comparison gets much more manageable if you start from your own actual usage rather than trying to evaluate every plan feature in the abstract.
Step 1: List Your Doctors and Facilities
Before looking at a single plan detail, write down every doctor, specialist, and hospital you actually use. Then check each plan’s provider directory for all of them — not just your primary care doctor. A plan can look great on paper and still be a poor fit if a specialist you see regularly is out-of-network.
Step 2: List Your Medications
Pull up your current prescription list and check each plan’s formulary — the list of covered drugs and which cost tier each one falls into. The same medication can sit on a low-cost tier in one plan and a high-cost tier in another, which can mean a meaningful cost difference over a year.
Step 3: Compare Total Expected Costs, Not Just Premium
A $0-premium plan isn’t automatically the cheapest option once you factor in copays, coinsurance, and your specific medication costs. Add up what you’d realistically expect to pay across the year — premium plus your typical copays and drug costs — for a more accurate comparison than premium alone.
Step 4: Check the Extra Benefits That Matter to You
Many Medicare Advantage plans include dental, vision, hearing, or fitness benefits that Original Medicare doesn’t. If these matter to you, compare the actual benefit amounts and any network restrictions attached to them — an allowance that’s hard to use because of a limited provider network isn’t worth as much as it looks.
Step 5: Confirm the Out-of-Pocket Maximum
Every Medicare Advantage plan has an annual out-of-pocket maximum, but the amount varies by plan. This cap is your worst-case scenario for the year, so it’s worth knowing even if you don’t expect to hit it.
Give Yourself Enough Time
AEP runs October 15 through December 7, but the comparison above takes real time to do carefully. Starting early in October, rather than in the last week, gives you room to actually compare rather than guess.
Have questions? Schedule a free review with Kayla Price, a licensed insurance agent at Price Services Group. Call 866-648-1578 or visit priceservicesgroup.com/schedule.
Price Services Group, LLC is not affiliated with or endorsed by the U.S. government or the federal Medicare program. NPN: 18530055 | Agency NPN: 20387435