The method

Comparing Advantage plans: seven checks, in this exact order

Short answer: compare Medicare Advantage plans in the order that matches how they can hurt you: your doctors first, your drugs second, the out-of-pocket maximum third, star ratings fourth, prior-authorization burden fifth, your hospital sixth, and the shiny extras dead last. Premiums didn’t make the list because a $0 premium tells you nothing; the checklist below prices what actually varies. Run it against 2027 plans starting October 15, when new prices and star ratings go live.

By the Medicare Decoder team · Updated September 14, 2026 · 4-minute read · Figures are official CMS amounts

Key takeaways

Check in harm order: doctors, drugs, out-of-pocket max, stars, prior auth, hospital, extras. Premium last, if at all.
Verify doctors by calling offices with the exact 2027 plan name; online directories overstate networks routinely.
Run your exact drug list through the official Plan Finder and compare total annual cost, never the premium line.
The out-of-pocket maximum is the price of a bad year; treat differences of $1,000+ as real money, because they are.
Value extras at their caps ($500 dental allowance = $500, not "free dental"), and give 5-star plans their tiebreaker due.

Jump to The 7 checks The total-cost math Three comparison traps When and where to run it FAQ

The seven checks, in harm order

#	Check	How, concretely	Disqualifying answer
1	Your doctors	Call each must-keep office: "Are you in-network for [exact plan name] for 2027, and taking new patients?" Directories lag; offices know.	Any must-keep doctor out of network
2	Your drugs	Enter every prescription and your pharmacy in the official Plan Finder; open the plan’s detail page for tier placements and restriction flags.	A current drug off-formulary, or on a tier you can’t sustain
3	Out-of-pocket maximum	Read the in-network OOP max (and combined in/out for PPOs). This is your bad-year price.	A max thousands above an otherwise-equal rival
4	Star rating	Shown on every Plan Finder listing; 4+ is the comfort zone, 5-star plans allow year-round switching in.	Under 3 stars, or a multi-year slide
5	Prior authorization	Read the Evidence of Coverage for which services need approval, especially any care you already receive.	Heavy PA on your existing treatments
6	Your hospital	Confirm the hospital you’d actually use is in-network, not just any hospital.	Your hospital out-of-network in an HMO
7	The extras	Dental/vision/hearing allowances, gym, cards: value each at its printed annual cap.	Never disqualifying; extras are tiebreakers only

Order reflects financial and medical downside: a broken network or formulary costs more than any extra pays. Star ratings and 2027 details post on Plan Finder October 15.

The total-cost math, on one line

For each finalist, price a normal year and a bad year: normal year = 12 premiums + your predictable copays (primary visits, specialists, drugs from the Plan Finder’s annual estimate); bad year = 12 premiums + the out-of-pocket maximum + your drug cap exposure ($2,400 in 2027). Two plans that look identical at the premium line routinely diverge by thousands on the bad-year line, and the bad year is the one insurance exists for. This is the same discipline as the Part D method, widened to medical care, and it’s why the $0-premium framing deserves permanent suspicion: the premium is the one number every plan can afford to make pretty.

Three comparison traps

The directory trap: plan directories list doctors who left, retired, or stopped taking new patients. The phone call with the exact 2027 plan name is the only verification that counts, and offices answer it all day in the fall.
The extras headline trap: "$3,000 in dental, vision, and hearing benefits!" is usually three separate capped allowances summed at their theoretical maxima across services you may not use. Price each at its cap against your actual needs; the flex-card article covers the aggressive end of this genre.
The this-year trap: you’re shopping the 2027 plan, not the 2026 one you’ve experienced. Networks, formularies, and maxima reset in January; the ANOC discloses your current plan’s changes, and every competitor’s Plan Finder page shows theirs. Compare futures, not memories.

When and where to run it

The checklist takes about 45 minutes for two or three finalists, entirely on the official Plan Finder plus a few phone calls, from October 15 to December 7 for January 1 coverage. Free, unbiased help exists: your SHIP counselor runs this exact comparison with you by phone at no charge, with no commission at stake, which is more than can be said for the season’s advertising. And if the comparison keeps ending in a tie, remember the tie itself is information: pick on the out-of-pocket max and the star trend, the two numbers that predict how the plan behaves when you need it most. The season’s full calendar and the 30-minute version of all of this live on the open enrollment page.

Questions people also ask

What should I look for when comparing Medicare Advantage plans?

In order: whether your doctors are in the 2027 network (verified by phone), how your exact drugs price on each plan’s formulary, the out-of-pocket maximum, star ratings, prior-authorization requirements, your hospital’s network status, and only then the extra benefits, valued at their annual caps.

Is a $0 premium Medicare Advantage plan really free?

No; $0 is the premium, not the price. You still pay the Part B premium, plus the plan’s copays and coinsurance up to its out-of-pocket maximum, which commonly runs $4,000–$5,500+ in-network. Total annual cost across your actual usage is the honest comparison.

What is a good out-of-pocket maximum for Medicare Advantage?

Lower is better and differences are real dollars: the max is what a serious health year costs you on top of premiums. Between otherwise-similar plans, a max $1,500 lower is worth roughly $1,500 in bad-year protection, which usually outweighs any package of extras.

Do Medicare Advantage star ratings matter?

Yes, as a quality signal and a practical lever: ratings summarize member experience, care quality, and service, 4+ stars is the comfort zone, and 5-star plans accept enrollment year-round through a special enrollment period, not just during the fall window.

When can I compare and switch plans for 2027?

October 15 through December 7, 2026, with new coverage starting January 1. 2027 prices, networks, and star ratings post on Medicare’s Plan Finder on October 15, and your current plan’s changes arrive in September’s Annual Notice of Change.

Sources for this article

Medicare.govMedicare Plan Finder: plan details, drug pricing, star ratings, and enrollment.
Medicare.govMedicare.gov: how Advantage plans, networks, and prior authorization work.
CMS.gov2027 Part D bid announcement: the 2027 drug-side parameters used in the math.

Figures checked against these sources in September 2026. We update within weeks when CMS publishes new amounts.

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