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choosing a medicare advantage plan

11 Tips For Choosing The Right Medicare Advantage (Part C) Plan

Shopping for a Medicare plan is not as fun as shopping for a new TV, clothes or toys for the grandkids. But it’s arguably way more important (though your grandkids may disagree!).

The Medicare plan you choose can have a very meaningful impact on your health, bank account balance and life. With plans changing each year (sometimes quite significantly), it pays to stay on top of things.

Quite literally. It can end up costing you $100s or $1000s if you choose a plan that isn’t a good fit for your situation.

So, while not fun, shopping for a new Medicare plan is something most seniors should consider doing each year. Why every year? Because not only can the plans change a lot each year, but your health needs can as well.

The first decision to make is to decide if you’re going to stick with Original Medicare (Part A & Part B) or choose a Medicare Advantage (Part C) plan. While Original Medicare coverage is (quite literally) a life saver for many, it’s not amazing healthcare coverage in and of itself. It leaves people with a lot of gaps in their coverage.

This is why many people (over 40% of everyone on Medicare) opt to get a Medicare Advantage plan. And it’s Medicare Advantage plans that we’re going to focus on in this article.

With so many choices, how do you find the plan that’s the best fit for your situation? Below we have 11 tips on choosing the right Medicare Advantage plan for you.

11 Tips For Choosing The Right Medicare Advantage Plan

Prioritize What’s Most Important

When it comes to your health care, what are the things that are most important to you?

Getting the lowest possible costs? Making sure you have coverage for certain prescription drugs? Being able to go to your favorite doctor(s) / medical facilities? Having coverage for dental, vision and/or hearing aids?

You probably won’t be able to find a perfect plan. Because there really is no such thing.

But you can list out your priorities. Then keep this list close by as you’re shopping for plans so you can find the plan that checks the most important boxes for you as far as coverage and costs.

Use The Medicare Plan Finder

The Medicare website has a very helpful tool to help you find plans in your area. You can find it here –

Just enter some information about what you’re looking for (you can even request to get costs for specific prescription drugs) and you’ll get a list of plans to compare. This is a great way to at least gather some initial information about the plans available to you.

Check The Ratings

The Centers for Medicare & Medicaid Services (CMS) publishes a list each year that measures the quality of Medicare Advantage plans. These star ratings “reflect the experiences of beneficiaries and assist beneficiaries in finding the best plan for them.”

Each plan gets a star rating from 1 to 5 stars. Plans are graded based on the following:

  • Keeping their beneficiaries healthy
  • Customer service
  • Managing chronic conditions
  • Overall satisfaction with the plan
  • Complaints and members leaving the plan

These ratings are definitely more helpful than Amazon star ratings… CMS does not hand out 5 star ratings very easily. So it pays to look them over and factor them into your decision.

Talk With Your Current Healthcare Providers

Another part of this process should involve talking to your current doctor(s) / healthcare providers. You want to make sure they accept Medicare. And also make sure they are in the network of any Part C plan you are considering. (This is assuming you like them, of course 🙂

Look At The Drug Formularies

Do you regularly take any prescription drugs? If so, you want to make sure they are covered. On the Medicare site you can check the specific drugs each Part C plan covers. And you can compare how much they’ll cost you under the different plans you’re looking at.

(Medicare Part D is prescription drug coverage for those who have Original Medicare. You cannot have Part C and Part D at the same time.)

What Additional Services Do You Need?

Dental, vision and hearing aids are three major areas not covered by Original Medicare that many senior need. Many (though not all) Advantage plans offer coverage for some, or all of these.

Factor this into your decision. If you know you’ll need a lot of dental work in the coming year, then pay closer attention to plans that offer good dental benefits.

Extra Savings For Healthy Lifestyle?

Some plans may offer savings based on your lifestyle choices. So, especially if you eat well and exercise regularly, look for a plan that rewards those with a healthy lifestyle.

Some plans even offer gym memberships for free to their members.

What’s More Important – Lower Premiums Or Lower Out-Of-Pocket Costs?

There are different costs you may incur under a Medicare Advantage plan. Yes, there are the premiums – the monthly amount you pay for the plan (though there are many Part C plans that have $0 premiums).

But there are also deductibles, copays and coinsurance, as well as in and out of network out-of-pocket maximums.

Generally, the lower your premiums, the higher your out-of-pocket costs will be and vice versa. It’s worth some time to figure out, based on your financial situation, which option is the best one for you.

What Can You Anticipate About Your Healthcare Needs Over the Next Year?

You have the chance to enroll in a new plan each year. So, before you enroll, think about what healthcare services you think you’ll need in the year ahead.

Obviously, there will be things you can’t predict. But if you know you’ll need surgery and/or other specific treatments, see how the plans you’re considering will handle them.

Travel much?

If you often travel to other states and/or internationally, make sure you have a plan that will cover you wherever you are.

Talk To A Medicare Insurance Agent

We get it. This is all very confusing. And there are many factors to consider.

Thankfully, there are people out there whose job it is to help people evaluate different Medicare plans and choose the right plan for them.

Medicare Insurance agents specialize in doing just that. You can use the free search tool on our site to find a Medicare Insurance agent near you.

The Bottom Line

We hope you found the above tips helpful as you consider the different Medicare Advantage plans out there. While costs are definitely a big part of it, your health needs are a big one too. By balancing these two you can find a plan that is the right fit for you.

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