10 Steps to Compare Medicare Advantage Plans

How to Compare Medicare Advantage Plans

Find Cheap Medicare Plans in Your Area

Currently insured?

By comparing Medicare Advantage plans and changing your coverage, you could save up to $302 each month.

That's just the savings for the actual plan. Enrollees could also save thousands of dollars a year by having a plan's benefits match their current medical and prescription needs.

Comparing Medicare Advantage plans to choose the best option isn't easy, and researchers have found that most people buying a Medicare plan will choose the wrong coverage for their situation.

However, this guide will show you the big picture of how some Medicare Advantage plans offer the ideal combination of good quality and affordable costs. We'll also walk through the steps on how to compare Medicare Advantage plans so you can methodically eliminate plans that aren't a good fit and identify the best coverage for you.

Why compare Medicare Advantage plans?

  1. Save money: After comparing plans, you'll understand which plans are the best deal for you. This is the result of balancing the cost of a plan with your expected out-of-pocket costs for medical care.
  2. Get access to your preferred doctors and hospitals: A plan's network can include different health care providers, and by comparing plans, you can find the plan that gives you the best access to the medical professionals you prefer.
  3. Protect yourself from high medical costs: A Medicare Advantage plan also provides a cap to your medical costs to give you financial protection. Comparing policy details can help you choose the best option for your financial situation and comfort with risk.
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Side-by-side comparison of Medicare Advantage plans

Before we jump into the steps of how to compare plans, let's look at an industry overview to see how Medicare Advantage providers stack up. The average cost of Medicare Advantage plans ranges from $1 to $96 per month depending on the company you choose.

Consider your current provider below to see how its overall prices and quality ratings compare to those of other insurers. For example, if you currently have Oscar, switching to Aetna could give you a plan that's much better quality for only a few more dollars per month.

Company
Star rating
Cost
Molina logo
Molina3.5$1
Oscar logo
Oscar2.5$3
Aetna logo
Aetna/CVS3.9$7
Bright HealthCare logo
Bright Health3.4$8
Cigna Medicare logo
Cigna HealthSpring4.2$9
Show All Rows

Average monthly cost and Medicare star rating for Medicare Advantage plans

Find Cheap Medicare Plans in Your Area

Currently insured?

If you're stuck and need an easy place to start, check out our compilation of the best Medicare Advantage plans to learn more about the insurance companies we recommend this year.

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1. Start with a list of Medicare Advantage plans and providers in your area

In 2022, each eligible person has an average of 39 Medicare Advantage plans to choose between, but the list of plans changes by county. This means you could have access to different plan options than those living nearby.

To discover what plans are available, use the Medicare Plan Finder or request personalized quotes from insurers or brokers.

It's not just the insurance companies that change by location. The cost of plans and their benefits can change too. For example, Medicare Advantage plans in Florida cost an average of $23 per month, and we recommend AARP/UnitedHealthcare to residents because of its widely available free plans and large network of medical providers in the state. On the other hand, it costs an average of $44 per month for a Medicare Advantage plan in New York, and there, the data shows that Humana provides the best combination of low cost and good quality.

State
Average cost
Florida$23/month
New York$44/month
Ohio$47/month
Texas$34/month

2. Exclude any plans that don't include prescription drug coverage

Start narrowing down your options by only looking at Medicare Advantage plans that cover prescription drugs.

With Medicare Advantage, most people can't add on a stand-alone prescription drug plan through Medicare Part D. To get prescription drug coverage, you usually need to bundle it with your medical coverage.

Prescription drugs can be expensive, costing hundreds or thousands of dollars per month. Therefore, we recommend only looking at plans that include prescription drug coverage. On average, this will eliminate about four plans from your available options, helping you to start focusing on the best plans.

3. Determine if you qualify for a Special Needs Plan (SNP)

A Special Needs Plan (SNP) is a type of Medicare Advantage plan designed for people in specific situations such as those who live in a nursing home, have a medical condition like cancer or have a low income. If you qualify for an SNP, this plan will usually give you the best coverage for your situation.

The three types of Special Needs Plans are:

  • Dual Eligible SNP (D-SNP): For those enrolled in both Medicare and Medicaid.
  • Institutional SNP (I-SNP): For those living in an institution like a nursing home or those requiring nursing care at home.
  • Chronic Condition SNP (C-SNP): For those with chronic conditions such as cancer, diabetes, heart disease, dementia, autoimmune disorders, severe blood disorders, HIV/AIDS, neurological disorders, end-stage liver disease, end-stage renal disease (ESRD), severe blood disorders, chronic lung disorders, chronic and disabling mental health conditions, stroke or chronic alcohol and other dependence.

An SNP will cover all of the same Medicare services as other plans, but there could be expanded coverage based on the type of plan.

For example, all Medicare Advantage plans cover some level of skilled nursing facility care, but an Institutional SNP will provide better coverage for these services. Similarly, all Medicare Advantage plans will cover treatments for heart disease. But those who meet the criteria for a Chronic Condition SNP (C-SNP) could have access to more providers who specialize in the condition and have better coverage for relevant medications.

4. Compare monthly costs for the plan to your expected medical costs

On average, a Medicare Advantage plan costs $33 per month in 2022. But you'll usually be able to find plans for less. Most people in the country have access to $0 Medicare Advantage plans. With these plans, you won't pay anything on top of the cost of Original Medicare.

The goal is to find a Medicare Advantage plan that meets your needs with the right balance of monthly costs and medical benefits.

Remember the health insurance rule of thumb — more expensive plans usually have better benefits, making them a good choice for those with significant health care needs. A cheaper plan will save you money each month, but you could pay more each time you need medical care.

When comparing plans, look at the copayments for the treatment you expect to need such as the cost for specialist visits, MRIs or joint replacement surgery. Also, compare plans by their structural benefits including the deductible and out-of-pocket maximum to see how much you could have to spend during the policy year.

Let's look at two situations to compare how an expensive or cheap Medicare Advantage plan would function.

Scenario: Significant health care needs

For someone who expects to need frequent medical treatment or expensive medical procedures, paying more for a plan can help them save overall.

In this example, let's assume you need an expensive surgery that costs $30,000 in total, and your portion of the medical bill would be $6,000. Plan A, a typical cheap plan, costs $0 per month, has a $500 deductible and has an out-of-pocket maximum of $5,000. Plan B, which is more expensive, costs $25 per month, has a $250 deductible and has an out-of-pocket maximum of $3,000.

Plan A
Plan B
Annual cost of plan$0$300
Amount paid to reach deductible$500$250
Addl. copays for hospital bills before the out-of-pocket max.$4,500$2,750
Total annual cost$5,000$3,300 (a savings of $1,700)

Here, you can see that by paying $25 more per month with Plan B, you would pay less overall, saving $1,700 that year. That is because the more expensive plan has a lower out-of-pocket maximum, which caps the amount you pay for in-network health care, an important benefit for those who expect to need expensive procedures.

Scenario: Low health care needs

On the other hand, if you expect to only need routine or moderate amounts of health care, a cheaper plan could be a better deal. In this situation, choosing the more expensive plan would mean being over-insured with more coverage than you need.

Below we compare the same two plans for a scenario where you go to the doctor five times a year and have $100 in miscellaneous health care costs for tests or treatment.

Plan A
Plan B
Annual cost of plan$0$300
Copays for doctor appointments (five visits at $25 each)$125$125
Addl. out-of-pocket health care costs$100$100
Total annual cost$225 (a savings of $300)$525

In this situation, paying more for a health plan wouldn't be worth it because you wouldn't spend enough on health care to reach the deductible.

Remember that you'll choose your coverage based on the amount of care that you expect to need. If you end up needing more or less medical care than you expect, you'll still have coverage. The difference is that you won't be getting the best possible deal.

5. Consider the cost of prescription drugs

In addition to comparing plans by their medical benefits, you should also compare plans based on the cost of the medications that you currently take.

The prescription drug portion of your Medicare Advantage plan will usually have its own set of benefits. This can include a drug deductible, which is separate from the medical deductible, and drug copayments for different tiers of medication. You'll also have to consider the plan's drug formulary to find out which drugs are covered.

Remember to compare coverage based on total annual costs. The insurance rule of thumb applies here too, and those who spend a lot for prescription drugs may be able to get a better deal overall by paying more for a policy that has better benefits.

6. Choose your plan type based on your network preferences

The type of plan you choose will affect your coverage and your costs.

For example, an HMO plan will usually be a cheaper option, but your coverage is limited to the doctors and facilities that are in the plan's network. In contrast, paying more for a PPO plan will give you the option to get out-of-network health care if you're willing to pay a higher rate.

By comparing the plans by their type of coverage, you'll see how much more you'll have to pay if you want access to out-of-network providers. This can help you decide if it's worth it.

HMO
Local PPO
HMO-POS
Average cost$23$43$47
In-network coverage
Out-of-network coverage
(costs more than in-network)
(rules vary by provider)
Out-of-network coverage during an emergency
Can see specialists without referrals
(rules vary by provider)

Monthly costs based on Medicare Advantage plans that include prescription drug coverage

7. Check the list of in-network doctors and providers

No matter what type of plan you choose, it will usually cost more to get medical care from providers that are outside of the plan's network. This means you can save money if the Medicare Advantage plan has a network that includes the doctors and hospitals that you intend to use and live nearby.

While Original Medicare has a very large network that includes most of the doctors in the country, Medicare Advantage plans have a network that's determined by the insurance company.

For example, Blue Cross Blue Shield has one of the largest networks overall and has affiliations with 90% of the country's doctors and hospitals. In contrast, Kaiser Permanente's network is focused on Kaiser health facilities, with a network of just 80,000 physicians and nurses.

If you often spend time out-of-state or traveling, consider how a plan would cover your care during these situations. Emergency care is covered in most situations, but some HMO-POS plans may also cover routine services even when you're out of the area. Otherwise, choosing a PPO plan will ensure that you'll have some coverage no matter which provider you use.

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8. Look at the extra included benefits

A Medicare Advantage plan bundles coverage across the standard categories of hospital care, medical care and prescription drugs. However, many Medicare Advantage plans also include extras. Options can include:

  • Add-on insurance such as dental or vision insurance.
  • Add-on benefits such as hearing aid coverage, telemedicine or routine chiropractic adjustments.
  • Perks such as gym memberships, discount programs, medical alert systems or SilverSneakers subscriptions.

The value of these add-ons can add up. For example, rather than spending an extra $25 per month on dental insurance, those benefits could be included in your Medicare Advantage plan. That could save you $300 per year because you wouldn't have to enroll in a separate plan.

These add-ons provide tangible value to the bundle of coverage that you get through Medicare Advantage. However, we recommend that you first narrow down your plan options based on health benefits before weighing the add-ons.

Many insurance marketing materials will push these add-ons. However, the financial benefit from the add-ons is usually much less than the value of having good benefits for medical care and prescription drugs. In other words, make sure the plans you're considering have good coverage for medical situations like a heart attack or a stroke. Then let perks like an included gym membership tip the scales with their extra value.

9. Compare Medicare star ratings

Medicare star ratings that display on Medicare.gov provide useful insight into a plan's overall quality. Star ratings do not consider a plan's benefits such as deductibles or copayments. Instead, Medicare star rating calculations reveal more about the experience of having the plan.

The 40 measurements combined into the overall star ratings include customer satisfaction, the number of complaints, the appeals process, access to preventive care, if common prescriptions are affordable and more.

A plan with a good star rating is not necessarily more expensive, and there are 5-star Medicare Advantage plans that cost $0 per month. In fact, if a 5-star plan is available in your area, you can switch to it at any time, even if it's not open enrollment.

10. Consider provider reviews and trade-offs

With most Medicare Advantage plans, there's a trade-off with a plan having some great qualities while falling short on others.

Insurance reviews can help you to quickly understand these trade-offs so that you can choose the best coverage for your needs and priorities. For example, consider some of the pros and cons of Medicare Advantage plans from these top companies.

Insurer
Pros
Cons
Kaiser PermanenteBest-ratedExpensive and small network
Aetna/CVSCheap plansHigh rate of complaints
UnitedHealthcare/AARPPopular and middle-of-the-roadPoor customer satisfaction
Cigna HealthSpringOverall lower costsWorse average star rating
Blue Cross Blue ShieldLarge provider networkCan be expensive
HumanaGreat for prescription drugsPoor customer service

Frequently asked questions

How do you compare Medicare Advantage plans?

Start by finding the plans that are available in your area. Then, methodically start eliminating plans based on their coverage, medical benefits, provider network and quality. This process will ultimately reveal the Medicare Advantage plan that's the best match for your needs.

Is there a website to compare Medicare Advantage plans?

The Medicare Plan Finder on Medicare.gov is currently the most comprehensive tool for comparing Medicare Advantage plan benefits, prescription drug coverage and costs. However, most people also use insurance company reviews to get insight into the best Medicare Advantage plans and what the trade-offs are with each company.

What is the best way to compare Medicare Advantage plans?

One of the most important steps when comparing plans is to discover how well a plan's medical benefits match your health care needs. This process means balancing monthly costs for the plan with the out-of-pocket costs for medical care. In general, those with higher medical needs will get an overall better deal by paying more for a policy that has better coverage. Those with fewer medical expenses will usually get the best deal with a cheap plan, but they may have to pay more each time they get medical care.

Do all Medicare Advantage plans have the same benefits?

No, Medicare Advantage plans have different deductibles and copayments, which means how much you pay for medical care will differ based on the plan. However, the list of covered services in a Medicare Advantage plan needs to be at least as good as Original Medicare, providing coverage across a range of essential treatments. For example, all plans would cover an MRI, but one plan could charge $50 and another could charge $150.


Methodology and sources

Medicare Advantage cost data and star ratings were sourced from the Centers for Medicare & Medicaid Services (CMS) public use files. Average costs are based on plans that include prescription drug coverage. Our analysis excludes employer-sponsored plans, Special Needs Plans, PACE plans, sanctioned plans and Health Care Prepayment Plans (HCPPs). The rate of savings is based on the inflation-adjusted average savings as a percentage of the average plan cost. Additional sources include Medicare.gov and the Kaiser Family Foundation.

Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.