How to choose an Advantage plan

Start with the network

With Medicare Advantage, the network comes first, because it determines whether you can keep seeing the doctors you trust. Confirm that your physicians and preferred hospitals are in-network for any plan you’re considering. It also helps to know the plan type: an HMO generally requires you to stay in-network and get referrals to specialists, while a PPO lets you go out-of-network at a higher cost and usually skips referrals. If keeping a specific doctor matters, start there.

Check drug coverage

Most Medicare Advantage plans include Part D drug coverage, which is convenient — but only if the plan covers your drugs. Check the plan’s formulary the same way you would a standalone drug plan: is each medication covered, on what tier, and are there restrictions like prior authorization? Because the drug coverage is baked into the plan, a great-looking Advantage plan with poor coverage of your prescriptions can quietly cost you.

Look at total cost, not the premium

A $0 premium is eye-catching, but it’s only the entry point. With Advantage you pay as you use care — copays for visits, coinsurance for bigger services — up to the plan’s annual out-of-pocket maximum, which is capped at $9,250 for in-network care in 2026. The better comparison is what you’d actually pay for the care you expect to use, plus that worst-case maximum, rather than the premium alone. Two $0-premium plans can differ a lot once you add up copays.

Weigh extras and star ratings

Finally, the extras and the report card. Many plans include dental, vision, hearing, fitness, or over-the-counter allowances — nice to have, but check the actual limits, which are often capped. Medicare also rates plans from one to five stars on quality and service; a higher rating is a reasonable signal of a well-run plan. Take the extras into account, but let network, drug coverage, and total cost lead the decision.