How to Compare Medicare Advantage Plans Without Getting Overwhelmed
Every fall, Medicare Advantage plans flood the market with new benefits, flashy mailers, and fine print that seem to speak a foreign language. But, comparing plans doesn’t have to feel like learning a new language. At Harbor Health Insurance Services, we help you cut through the clutter and focus on what actually matters to your health and wallet.
Start with your Doctors & Prescriptions
- Your preferred doctors and specialists are in-network, or that you have coverage for out-of-area care if you travel. Staying in-network is one of the biggest cost savers for beneficiaries (KFF, 2025).
- Your prescriptions are included on the plan’s formulary, and your preferred pharmacy is considered in-network or preferred. Formularies and pharmacy networks are updated each year, so reviewing this annually is essential (NerdWallet, 2025).
Why it matters: Even highly rates plans can become expensive if your medications fall into higher tiers or your doctor drops out of the network.
Look Beyond the Monthly Cost
- Medical and Part D deductibles (KFF, 2025)
- Copays and coinsurance for primary care, specialists, diagnostics, and hospital visits.
- In-network vs out-of-network changes, especially on PPO plans (KFF, 2025)
- Out-of-Pocket maximums: In 2025, most Medicare Advantage plans increased these limits, with averages rising again into 2026 (CMS, 2026)
Check The Extra Benefits, But Weigh Them Wisely
Many Medicare Advantage plans now offer additional benefits like:
- Dental & Vision
- Hearing aids
- Fitness memberships
- OTC Benefit cards
- Transportation
- Meal delivery after a hospital stay
These supplemental benefits expanded further in 2-25, with more plans offering flexible allowances and “bundled” benefits (KFF, 2025).
But, here’s the key:
- Extra perks should never outweigh core coverage
- A strong doctor network and predictable medication costs should come first
- If you won’t use the perks, consider whether a simpler plan with stronger medical coverage may be a better value.
Ask for Help Reviewing the Fine Print
Medicare Advantage plan include nuances like prior authorizations, tiered drug formularies, referral rules, network restrictions, and mid-year cost changes (NCOA, 2025). These details matter more than most people realize.
How Harbor Health Insurance Services Helps You
- Reviewing your doctor list, prescriptions, and anticipated care needs.
- Comparing plan Summaries of Benefits in plain language
- Calling providers and pharmacies when needed
- Looking for hidden costs many people miss–like higher specialist copays, restrictive authorizations, or shrinking networks.
- Ensuring the plan you choose supports your actual lifestyle and care patters
Enrollment Reminder:
The Annual Enrollment Period (AEP) for Medicare Advantage runs every year from
October 15 to December 7 (NCOA, 2025).
Schedule your 2026 Medicare review now: Schedule Your Consult Here!
References:
Centers for Medicare and Medicaid Services (CMS). (2026). 2026 Medicare Advantage and Part D Rate Announcement. Retrieved from https://www.cms.gov
Kaiser Family Foundation (KFF). (2025). Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization.
KFF. (2025). Medicare Advantage 2025 Spotlight: A First Look at Premiums and Benefits.
National Council on Aging (NCOA). (2025). What You’ll Pay in Out-of-Pocket Medicare Costs in 2025.
NerdWallet. (2025). Best Medicare Advantage Plans in 2025.
Medicare Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
