There is no single "best" Medicare Advantage plan — the right one depends on your doctors, medications, and budget
Medicare Advantage plans vary by county, by insurer, and by the specific coverage they offer. A plan that works well for someone in one zip code may not be available in another, or may cover different doctors. The "best" plan is the one that covers your current doctors, keeps your out-of-pocket costs low for the care you actually use, and fits your budget. This means you need to compare plans based on your own situation, not on rankings or reviews from other people.
The comparison tool on Medicare.gov lets you enter your doctors and medications to see which plans cover them and what you would pay. This is the most direct way to find plans worth considering. You can also call 1-800-MEDICARE to speak with someone who can walk you through the comparison, or contact your State Health Insurance information Program (SHIP), which offers free one-on-one counseling.
Key Takeaways
- The best plan for you covers your doctors and medications at a cost you can afford — not the plan with the lowest premium or highest star rating.
- Use Medicare.gov's plan comparison tool and enter your actual doctors and current medications to see real costs and coverage for each plan in your area.
- Plans change every year, so a plan that worked in 2024 may have different costs, coverage, or doctors in 2025.
- Your State Health Insurance information Program offers free counseling to help you compare plans without pressure to buy.
- Open enrollment runs from October 15 to December 7 each year, and changes take effect January 1.
How to compare plans using your doctors and medications
Start by gathering two pieces of information: a list of your current doctors (including their full names and whether they are in-network for each plan) and a list of your current medications with the exact dosages. Medicare.gov's plan comparison tool asks for both.
Go to Medicare.gov, click "Find Care Providers and Suppliers," and search for each of your doctors by name. The tool will show you which plans in your area include that doctor. Then go to the "Prescription Drug Coverage" section and search for each medication. The tool shows you the copay or coinsurance for each drug under each plan. Write down the total out-of-pocket cost for a year of your medications under each plan — this number often matters more than the monthly premium.
Once you have narrowed the list to plans that cover your doctors and medications, compare the deductibles, copays for office visits and specialist visits, and any limits on services like physical therapy or mental health visits. Some plans cover dental, vision, or hearing aids; if you use those services, check whether the plan covers them and at what cost.
What changes from year to year in Medicare Advantage plans
Every January 1, Medicare Advantage plans can change their premiums, deductibles, copays, and the doctors and hospitals they include. A plan you chose in 2024 may cost more or cover fewer doctors in 2025. This is why you should not assume your current plan is still the best choice — you need to re-compare every year during open enrollment.
Insurers also add and drop doctors and hospitals from their networks. If your main doctor leaves the plan's network, you may need to switch plans or find a new doctor. When you compare plans, check whether your doctor is listed as "accepting new patients" — some doctors in a plan's network are not taking new patients, which means you cannot see them even though they are technically in-network.
Drug formularies (the list of medications a plan covers) also change. A medication your plan covered in 2024 may move to a higher cost tier in 2025, or may no longer be covered at all. Always re-check your medications during open enrollment.
Understanding premiums, deductibles, and out-of-pocket costs
The monthly premium is only one part of what you pay. You also pay a deductible (the amount you pay before the plan starts sharing costs), copays (a fixed amount per visit or prescription), and coinsurance (a percentage of the cost). Some plans have a $0 premium but high copays; others have a higher premium but lower copays. The plan with the lowest premium is not always the cheapest overall.
Medicare Advantage plans have a yearly out-of-pocket maximum — once you reach it, the plan pays 100% of your covered costs for the rest of the year. In 2025, this maximum varies by plan but is capped by Medicare at a certain amount. If you expect high medical costs, a plan with a lower out-of-pocket maximum may save you money even if the premium is higher.
Use the Medicare.gov tool to calculate your total estimated cost under each plan based on your doctors' visits and medications. This number — premium plus deductibles plus copays for a year — is what you should compare, not the premium alone.
Star ratings and plan reviews: what they do and do not tell you
Medicare publishes star ratings for each plan based on customer satisfaction, quality measures, and claims processing speed. Plans are rated from 1 to 5 stars. A higher star rating suggests the plan has fewer complaints and faster service, but it does not mean the plan covers your doctors or keeps your costs low.
Online reviews from other people can be helpful for learning about customer service or claim denials, but they do not tell you whether the plan will work for your situation. Someone's complaint about a plan may not affect you — for example, a review criticizing a plan's mental health coverage does not matter if you do not use mental health services. Focus on whether the plan covers your doctors and medications at a cost you can afford.
When to use your State Health Insurance information Program
Your State Health Insurance information Program (SHIP) is a free counseling service funded by Medicare. Counselors are trained to help you compare plans, understand your coverage, and file complaints. They do not work for any insurance company and do not earn commission, so they have no reason to steer you toward one plan over another.
SHIP counselors can help you if you are confused by the Medicare.gov tool, if you have a complicated medical situation and need help understanding which plans might work, or if you have a problem with a plan after you enroll. You can find your state's SHIP by calling 1-800-MEDICARE or visiting the SHIP locator on Medicare.gov.
Many SHIPs offer in-person appointments as well as phone counseling. If you prefer to talk to someone face-to-face, ask whether your local SHIP office has appointments available during open enrollment.
What to do if your current doctor is not in any plan's network
If your main doctor does not participate in any Medicare Advantage plan in your area, you have two options: switch to a different doctor who is in-network with a plan that otherwise fits your needs, or stay on Original Medicare (Part A and Part B) instead of choosing a Medicare Advantage plan.
Before you decide to leave Medicare Advantage, ask your doctor whether they accept Medicare Advantage patients at all. Some doctors do not participate in any Medicare Advantage plans but do accept Original Medicare. If your doctor accepts Original Medicare, you can keep seeing them by staying on Original Medicare and adding a Medigap or Part D plan.
If you want to stay with Medicare Advantage, ask your doctor's office for a referral to another doctor in the plan's network who specializes in the same area. Your SHIP counselor can also help you find in-network doctors in your specialty.
Open enrollment dates and how to enroll
Medicare Advantage open enrollment runs from October 15 to December 7 each year. Any changes you make during this period take effect on January 1. If you miss the important date, you cannot change plans until the next open enrollment period unless you have a may have access to life event (such as moving to a new state, losing other health coverage, or getting married).
You can enroll in a plan through Medicare.gov, by calling 1-800-MEDICARE, by calling the plan directly, or by working with an insurance agent. If you use an agent, make sure they are licensed and ask whether they are paid commission — this does not mean they are dishonest, but it means they have a financial incentive to enroll you in a particular plan.
Once you enroll, the plan will send you a welcome packet with your member ID card, a list of in-network doctors and hospitals, and instructions for ordering prescriptions. Read the welcome packet carefully and call the plan's customer service number if you have questions before January 1.
Frequently Asked Questions
Can I switch Medicare Advantage plans in the middle of the year?
No, unless you have a may have access to life event such as moving out of state, losing your current coverage, or getting married. If you have a may have access to event, you have 60 days to make a change. Call 1-800-MEDICARE to report the event and ask whether you are may be able to access to switch.
What happens to my coverage if my plan leaves the market?
If your plan stops offering coverage in your area, Medicare will send you a notice and you will have the option to switch to another plan without waiting for open enrollment. You will have at least 30 days to choose a new plan. During this time, your current plan continues to cover you.
Do I need a Medigap plan if I have Medicare Advantage?
No. Medicare Advantage and Medigap are separate products — you cannot have both at the same time. Medicare Advantage includes coverage for out-of-pocket costs, so you do not need Medigap. If you switch from Medicare Advantage to Original Medicare, you can then buy a Medigap plan.
What if I cannot afford the monthly premium?
Some Medicare Advantage plans have a $0 premium. If you have low income, you may also be may be able to access for Extra Help, a program that pays part of your Medicare costs. Call 1-800-MEDICARE or your SHIP to learn whether you may have access to.
How do I know if a plan covers my medications at the pharmacy I use?
Use Medicare.gov's prescription drug tool and search for each medication. The tool shows you the copay under each plan and tells you which pharmacies are in-network. You can also call the plan directly and ask whether your pharmacy is in-network and what the copay would be for your specific medications.