How to Choose a Medicare Advantage Plan: A 6-Step Checklist
The right plan isn't the one with the flashiest ad — it's the one that covers your doctors, your prescriptions, and your budget. Here's the order to check them in.
Most people choose a Medicare Advantage plan backwards. They start with a brand they saw on TV, then hope their doctors and prescriptions fit. Flip it. Start with your life, and let the plan prove it fits. Here’s the exact order to work through.
Step 1 — List your doctors first
Before premiums, before extras, before anything: write down the doctors and hospitals you want to keep. Then check each plan’s network for them. A plan with a great drug benefit and a gym membership is no bargain if your cardiologist is out of network.
Network first. Everything else is a tiebreaker. This is the step people skip and regret.
Step 2 — Check the drug formulary against your prescriptions
Every plan publishes a formulary — its list of covered drugs, sorted into pricing tiers. Two plans can both “cover” your medication and charge wildly different amounts for it. List your prescriptions and check each one’s tier and cost on every plan you’re considering. Our Part D guide explains how tiers work.
Step 3 — Add up the real cost, not the premium
The premium is the headline; it’s rarely the story. Build a rough yearly estimate:
| Cost to add up | Why it matters |
|---|---|
| Monthly premium × 12 | The number the ad shows you |
| Typical copays | Primary care, specialists, labs |
| Drug costs | From the formulary tiers in Step 2 |
| Out-of-pocket maximum | Your worst-case ceiling for a bad year |
A $0-premium plan with high copays can easily cost more than a low-premium plan with better cost-sharing. Compare the totals.
Step 4 — Match the plan type to your life
HMO plans are cheaper but lock you to a network and often require referrals. PPO plans cost a bit more but let you go out of network. If you travel or split the year between states, that flexibility may be worth the price. Our Medicare Advantage basics guide breaks down the plan types.
Step 5 — Weigh the extras honestly
Dental, vision, hearing, OTC allowances, gym memberships — these are real value, but only if you’ll use them. A generous dental benefit you never touch shouldn’t outweigh a network gap you’ll feel every month. Value the extras you’ll actually use; discount the rest.
Step 6 — Use Star Ratings as a tiebreaker
Once two plans look close on network, drugs, and cost, Medicare’s 1-to-5 Star Rating is a fair way to break the tie. It reflects quality and member experience. Just don’t let a star count override a plan that genuinely covers your doctors and drugs better.
Put it together
Work the steps in order and the right plan usually reveals itself — it’s the one that covers your doctors, prices your drugs reasonably, and keeps your total cost in check. Our scored reviews rate the major carriers on exactly these dimensions, so you can shortlist fast and then verify availability in your ZIP code on Medicare.gov.
This guide is educational and independent. It is not insurance advice and does not recommend any specific plan for your situation. Verify networks, formularies, and costs at Medicare.gov, by calling 1-800-MEDICARE, or with your free State Health Insurance Assistance Program (SHIP).
Our picks
Top-rated Medicare Advantage plans for this
Based on our independent scoring. We may earn a commission — it never affects the ranking.
- See Kaiser Permanente plans in your ZIP
Kaiser Permanente Medicare Advantage
The gold standard for coordinated care — if you live in its footprint.
- See Humana plans in your ZIP
Humana Medicare Advantage
The best all-around pick for most people on Medicare.
- See UnitedHealthcare plans in your ZIP
UnitedHealthcare (AARP) Medicare Advantage
The biggest network in the country, wrapped in the AARP brand.
- See Aetna plans in your ZIP
Aetna Medicare Advantage
A strong value play with a CVS pharmacy edge — if your local plan rates well.
Frequently asked questions
Should I pick the plan with the lowest premium?
Not by default. A $0-premium plan can cost you more than a $40 plan once you add up copays, drug costs, and out-of-network charges. Compare your likely total yearly cost — premium plus expected out-of-pocket — not the premium in isolation.
How do I know if my doctor is in the plan's network?
Check the plan's provider directory directly, and confirm by calling your doctor's office — directories can be out of date. Do this before anything else. The best plan on paper is worthless if your doctor isn't in it.
What is a Star Rating?
Medicare publishes a 1-to-5 Star Rating for each plan based on quality and member experience. It's a useful tiebreaker, but it's a blunt instrument — a 4-star plan that covers your doctors and drugs beats a 5-star plan that doesn't.
About the author
Eleanor Hartley
Independent Medicare Analyst
Eleanor has spent over a decade analyzing Medicare Advantage and Medigap markets — comparing plan networks, drug formularies, and out-of-pocket costs across all 50 states. She sells no insurance and holds no carrier affiliation; her only loyalty is to the reader trying to pick a plan.
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