Medicare Plan Finder: How to Compare Plans Step by Step

Comparing Medicare plans can feel overwhelming.

There are many plans, each with its own premium, deductible, copays, drug list and network.

Reading brochures one by one rarely gives a clear answer, and advertisements make every option sound like the best.

The official Medicare Plan Finder on Medicare.gov is built to cut through that.

When you enter your own drugs and pharmacy, it estimates what each plan in your area would cost you over the year.

This guide walks you through using it step by step and shows what to look at besides the price.

What the Plan Finder does

The Plan Finder lets you compare Medicare drug plans, Medicare Advantage plans and Medigap policies available where you live.

Its most useful feature is the drug cost estimate: it uses your actual prescriptions and pharmacy to estimate your total yearly costs,

including premiums and what you would pay for drugs.

It is an official government tool, and using it is free.

You can browse as a guest or log in to a Medicare account, which can save your drug list for next time.

Before you start: gather your information

• Your ZIP code. Plans are offered by area, so results depend on where you live.
• A complete list of your prescriptions, with the exact name, dose, form and how often you take each one.
• Your preferred pharmacies, including any mail-order pharmacy you use.
• Your doctors and hospitals, if you are considering a Medicare Advantage plan.
• Your current plan's name, so you can compare it with the alternatives.

Step by step

1. Choose the type of coverage you want to compare: a drug plan to go with Original Medicare, a Medicare Advantage plan, or Medigap.
2. Enter your ZIP code and any help you already receive with costs, such as Extra Help.
3. Add every drug on your list, carefully selecting the right dose and quantity.
4. Select up to a few pharmacies you would actually use.
5. Sort the results by estimated total yearly cost, not by premium alone.
6. Open the details of the top plans to see drug coverage, restrictions and other benefits.
7. Compare your current plan with the two or three best alternatives side by side.

Why the lowest premium is not always the cheapest

A plan with a very low premium can still cost you more over the year if it charges higher copays for your drugs or does not cover one of them.

That is why the estimated total cost, which combines premiums and drug costs, is the number to watch.

Look too at how costs are spread through the year.

Some plans have a deductible that you pay first, so January and February can be more expensive even when the yearly total is lower.

What to check besides cost

• Drug restrictions: prior authorization, step therapy or quantity limits on any of your drugs.
• Pharmacy network: whether your pharmacy is in network and whether it is a preferred pharmacy with lower copays.
• Doctor and hospital network for Medicare Advantage plans, which you should confirm with the plan and your doctors directly.
• Out-of-pocket limit for Medicare Advantage plans, which caps what you pay for covered medical services in a year.
• Star ratings, which summarize quality and member experience.

Common mistakes to avoid

• Leaving out a drug you take only occasionally, which can change the results.
• Choosing the wrong dose or form, such as tablets instead of capsules.
• Comparing only premiums and skipping the total estimate.
• Forgetting to check doctors before choosing a Medicare Advantage plan.
• Waiting until the last days of the enrollment period, when help lines are busiest.

An example of a careful comparison

Imagine someone who takes three regular medicines and fills them at a neighborhood pharmacy.

They enter all three drugs with the exact doses, add their pharmacy and a mail-order option, and sort by estimated yearly cost.

The cheapest plan by premium turns out to be third on the list, because one of their drugs sits on a high tier there.

The plan at the top has a slightly higher premium but much lower drug costs, and their pharmacy is preferred in its network.

Before switching, they open the plan details and see that one drug needs prior authorization.

They call their doctor's office to ask whether that is a problem, confirm it is routine for them, and enroll before December 7.

That is the whole process: complete list, total cost, details, one phone call, decision.

Save your work for next year

If you create a Medicare account, your drug list can be saved, which makes next year's comparison much faster.

Even without an account, keep a printed or written copy of your list and the plans you compared, with their estimated totals.

Next fall, you can start from that page instead of from scratch.

When to use it

The best time to compare is the fall enrollment period, from October 15 to December 7, when changes take effect on January 1.

It is also useful when you first join Medicare, when you move, or when your prescriptions change significantly during the year.

Getting help with the Plan Finder

If you prefer not to do it alone, you have free options.

You can call Medicare and ask a representative to help you compare, or contact your State Health Insurance Assistance Program for free one-on-one counseling.

Many family members also help older relatives by sitting together with the drug list in hand.

Frequently Asked Questions

Do I have to enroll through the Plan Finder?

You can enroll in many plans directly through the Plan Finder, but you can also enroll by contacting the plan.

Either way, compare first.

Are the cost estimates exact?

They are estimates based on the information you enter and on plan prices.

Your real costs can differ if your prescriptions or pharmacy change.

Is my information shared with insurance companies?

Browsing and comparing do not enroll you or send your details to plans.

Information goes to a plan only when you choose to enroll.

This guide is general information and is not affiliated with Medicare or any insurance plan.

Sources and Further Reading

• Medicare.gov: the official site, home of the Medicare Plan Finder.
• Medicare.gov — Drug coverage (Part D): how drug plans and their costs work.
• Medicare.gov — Talk to someone: how to reach Medicare for help.
• SHIP — State Health Insurance Assistance Programs: free counseling to compare plans.