Medicare Advantage enrollment continues to grow each year, and millions of Americans now depend on these plans for their healthcare. As enrollment rises, insurers have expanded their offerings, leading to more choices but also more variation in coverage, networks, and out-of-pocket costs.
Because Medicare Advantage plans are allowed to change their premiums, benefits, and provider networks every year, the plan you relied on in 2025 may look very different in 2026. That makes it critical to compare Medicare Advantage plans with fresh eyes rather than renewing based on familiarity.
Understanding the Key Elements When You Compare Medicare Advantage Plans
Comparing plans is not about checking a single box—it requires reviewing several parts of the plan to get a complete picture. Here are the core areas that matter most:
- Plan Type: HMOs require network use and referrals, PPOs offer more flexibility, and SNPs serve beneficiaries with specific needs.
- Costs: Beyond the monthly premium, examine deductibles, copays, coinsurance, and the annual out-of-pocket maximum.
- Provider Network: Your preferred doctors and hospitals may not appear in every plan.
- Prescription Drug Coverage: Formularies vary, and drug tier placement can influence cost significantly.
- Extra Benefits: Dental, vision, hearing, transportation, meal support, and wellness programs may be included.
- Star Ratings: CMS evaluates plans on quality, service, and patient outcomes using a one-to-five-star system.
- Geographic Availability: Not all plans are offered in every ZIP code.
When you compare Medicare Advantage plans with these factors in mind, you gain a much clearer understanding of which options truly meet your health needs and budget.
Latest Updates Affecting Medicare Advantage Plans for 2026
The 2026 plan year introduces meaningful changes that can influence how beneficiaries select coverage. Here are the most notable updates:
- A payment increase of just over 5% will take effect for Medicare Advantage plans in 2026. This adjustment may help stabilize benefits in some plans.
- Supplemental benefits will face tighter oversight to ensure that what is offered provides actual, measurable value to members.
- Improved plan comparison tools will make it easier for beneficiaries to access provider directories, view drug pricing, and evaluate extra benefits.
- Widespread availability: Nearly all Medicare-eligible individuals will continue to have access to multiple Medicare Advantage plan choices in 2026.
- Out-of-pocket protections remain in place, keeping annual limits on consumer spending within Medicare Advantage plans—something Original Medicare does not offer on its own.
These updates aim to improve transparency, raise plan quality, and help beneficiaries make more informed choices when comparing Medicare Advantage plans.
How to Effectively Compare Medicare Advantage Plans Step by Step
Comparing plans becomes much easier when you break the process into simple, reliable steps.
1. Identify Your Priorities Before Comparing Plans
What matters most to you will guide your entire comparison process. Ask yourself:
- Do you want your current doctors included in your plan’s network?
- How important is flexible access to specialists?
- Do you take medications that require consistent coverage?
- Are dental, vision, or hearing benefits essential to your budget?
- Do you prefer plans that include transportation or wellness benefits?
Knowing your priorities helps narrow dozens of plans into a manageable group.
2. Take Advantage of Official Tools for Comparing Plans
Medicare’s official plan-finder tool allows you to review:
- Premiums, deductibles and copays
- Prescription drug costs
- Provider network details
- Star Ratings
- Extra benefits
- Year-to-year changes in coverage
Tools like these can give you a side-by-side view of plans, allowing a clear and unbiased comparison.
3. Look Beyond the Premium When Evaluating Costs
A $0 premium may catch your eye, but the premium alone doesn’t reflect the full cost of care.
To compare Medicare Advantage plans accurately, review:
- Annual out-of-pocket maximum
- Primary and specialist visit copays
- Emergency room and hospital costs
- Prescription drug copays by tier
- Access to in-network vs. out-of-network care
A plan with a higher premium but lower out-of-pocket costs may save money long-term if you use healthcare frequently.
4. Examine Provider Networks Carefully
Provider networks change each year, which is why checking your doctors is essential.
Look at:
- Primary care providers
- Specialists you visit regularly
- Hospitals and outpatient facilities in your area
- Whether referrals are required
One of the biggest surprises many beneficiaries face is learning that their doctor is no longer covered—something that can be avoided with careful comparison.
5. Evaluate Prescription Drug Coverage Line by Line
Medication costs vary dramatically depending on a plan’s formulary.
When you compare Medicare Advantage plans, review:
- Whether each of your medications is covered
- Which drug tier they fall into
- Pricing for 30-day and 90-day fills
- Preferred pharmacies versus standard ones
- Mail-order options
These details can significantly change your annual prescription costs.
6. Compare Extra Benefits Thoughtfully
Extra benefits can be popular, but they also differ widely between plans. As you evaluate options, consider:
- Dental (cleanings, dentures, root canals, implants)
- Vision (eye exams, glasses, contacts)
- Hearing (exams, hearing aids)
- Over-the-counter allowances
- Meal assistance
- Transportation to medical appointments
- Fitness memberships
These benefits can help you save money—if they align with your needs.
7. Consider Star Ratings as Part of Your Decision
Star Ratings offer insight into a plan’s quality and reliability. Higher-rated plans may offer:
- Better customer service
- More dependable drug coverage
- Stronger preventive care performance
- Higher member satisfaction
- Better health outcomes
While ratings should not be the only deciding factor, they are a helpful guide.
A Helpful Comparison Table for Medicare Advantage Plans
| Feature | What to Review | Questions to Ask Yourself |
|---|---|---|
| Monthly Premium | $0 or higher, depending on the plan | “Does this fit my budget and needs?” |
| Out-of-Pocket Maximum | Annual limit on spending | “What’s the worst-case scenario for my costs?” |
| Provider Network | Doctors, hospitals, specialists | “Are my providers included?” |
| Prescription Coverage | Drug formulary, tier costs | “How much will my medications cost each month?” |
| Extra Benefits | Dental, vision, hearing, fitness, transport | “Will I use these benefits?” |
| Star Rating | Plan quality based on CMS performance measures | “Is this plan known for strong service and outcomes?” |
Why Failing to Compare Medicare Advantage Plans Can Be Costly
Skipping the comparison process may lead to:
- Higher out-of-pocket expenses
- Losing access to your preferred doctor
- Unexpected prescription costs
- Reduced extra benefits
- Enrollment in a plan that doesn’t fit your lifestyle
- Difficulty switching later if you miss enrollment windows
A careful comparison now can prevent regret later.
Timing Matters: Key Enrollment Dates to Remember
- October 15 – December 7: Annual Enrollment Period (AEP)
- January 1: Coverage begins for the new plan year
- January 1 – March 31: Medicare Advantage Open Enrollment Period (MA-OEP)
Effectively comparing Medicare Advantage plans before these dates ensures you choose the plan that truly fits your needs.
Final Thoughts
The changes coming in 2026 make this an important year to sit down, review your options and compare Medicare Advantage plans carefully. With more transparency, improved benefits and wider access, you have the opportunity to select a plan that brings confidence and control to your healthcare. The more thorough your comparison, the stronger your choice will be.
We’d love to hear your thoughts — what matters most to you when you compare Medicare Advantage plans? Share your perspective below and stay informed as updates continue.
Disclaimer: This article is for general informational purposes only. It does not provide personalized financial, medical or insurance advice. Always consult licensed Medicare professionals or official Medicare resources before making coverage decisions.