Medicare Plans: Compare Coverage and Get Help Choosing

Start by comparing two paths: Original Medicare (Parts A and B), with optional Medigap and a standalone Part D drug plan, or Medicare Advantage (Part C), which usually includes drug coverage. Choose based on your doctors, prescriptions, travel and total yearly budget.

If you already have employer, retiree or other health coverage, check how it works with Medicare before buying a plan. Existing coverage may change what you need, and joining a separate plan can affect employer or union benefits.

Understand what each part does

• Part A helps cover inpatient hospital care, eligible skilled nursing facility care, hospice and some home health care.
• Part B helps cover doctor visits, outpatient care, preventive services and medical equipment.
• Part C is Medicare Advantage: a Medicare-approved private plan providing your Part A and Part B benefits, usually with Part D.
• Part D covers prescription drugs through a standalone plan or a Medicare Advantage plan that includes it.

Original Medicare is Parts A and B together.

Medicare Supplement insurance and Medigap are the same product. Medigap helps pay specified Original Medicare deductibles, copayments and coinsurance. It cannot pay Medicare Advantage cost sharing. Medigap policies sold after 2005 do not include prescription drug coverage.

Compare the two coverage paths

The Medicare Supplement versus Medicare Advantage decision should come before choosing an insurer. Start with the doctors you want to keep, the monthly premium you can sustain and where you expect to receive care.

Give Original Medicare with Medigap serious consideration if nationwide provider access and predictable covered medical expenses are priorities. Consider Advantage if its network fits and its combination of premiums and service costs works for your budget.

Within Advantage, HMOs generally keep routine care in network; PPOs allow covered out-of-network care, usually at higher cost. Check referrals and prior authorization—approval required before certain services are covered.

If you spend winters elsewhere, ask about routine care at both addresses. For international travel, check emergency coverage separately; neither coverage path should be assumed to cover all overseas care.

Compare a full year of costs

In 2026, the standard Part B premium is $202.90 a month, with higher amounts for some people based on income. The annual Part B deductible under Original Medicare is $283. For many Part B services, you generally owe 20% after the deductible unless other coverage pays your share. Most people pay no Part A premium; if you owe one, include it in either coverage budget. Original Medicare alone has no annual out-of-pocket ceiling.

For each option, add a year of premiums to estimated medical and prescription expenses. Then test a year with a hospital stay, repeated specialist visits or outpatient treatment. For Advantage, examine both in-network and applicable out-of-network limits. Its medical limit covers Part A and B cost sharing; budget separately for premiums, drugs and uncovered care.

For 2026, Part D has a $2,100 annual out-of-pocket limit for covered drugs, after which covered Part D drugs cost you nothing for the rest of the year. Keep premiums separate from that drug-spending figure.

These are 2026 amounts. For coverage beginning in 2027, compare the published 2027 premiums, benefits and plan documents. If you already have a plan, review its Annual Notice of Change and Evidence of Coverage.

Get comparable quotes

For Medigap, request the same plan letter, effective date and deductible option from each insurer. Ask for the actual premium, applicable discounts, pricing method and underwriting requirements. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.

For Advantage and Part D, use your ZIP code, exact prescriptions and preferred pharmacies in Medicare’s tools. Compare estimated yearly costs, then confirm details with the insurer. This page does not provide a personalized quote.

Check that the plan’s drug list covers each prescription, and review restrictions such as prior authorization, quantity limits or step therapy, which can require trying another drug first. Ask the plan and each provider to confirm participation in the exact plan for your coverage year.

Match enrollment to your situation

Your Medicare coverage choices at 65 involve two decisions: when to start Parts A and B, and which additional coverage to choose. Confirm your Medicare enrollment status and effective dates before submitting private-plan applications. If you need to enroll in Parts A and B, start with Social Security’s Medicare application guidance.

Your initial enrollment period generally includes the three months before your 65th birthday month, that month and the three months after. A birthday on the first of a month changes the timing. Enrolling before your birthday month generally lets Part B start that month; enrolling during it or later generally means a next-month start.

If you miss initial enrollment and have no special enrollment period, the Part B General Enrollment Period runs January 1–March 31. Coverage starts the next month after enrollment, and late penalties may apply.

With qualifying coverage through your or your spouse’s current employment, you may be able to delay Part B. Generally, you can enroll while that coverage continues or within eight months after employment or coverage ends, whichever happens first. Confirm your situation with Social Security and the benefits administrator. COBRA does not extend that deadline, and retiree coverage is not current-employment coverage.

Drug coverage has a separate clock: after your initial enrollment period, 63 or more consecutive days without Part D or other creditable prescription coverage can trigger a late penalty. Do not use the eight-month Part B deadline as your drug-plan deadline.

Later changes have different rules

• October 15–December 7: change Medicare Advantage or Part D coverage, or switch between Advantage and Original Medicare, for January 1. The fall 2026 window is for 2027 coverage.
• January 1–March 31: people already in Advantage can make one change to another Advantage plan or return to Original Medicare and add Part D.
• Special enrollment periods: certain moves, coverage losses and other qualifying events may allow changes outside those windows.

These periods have specific eligibility and effective-date rules. Advantage requires both Parts A and B; standalone Part D requires Part A or Part B. You must also meet the plan’s service-area requirements.

Protect your opportunity to buy Medigap

Your federal Medigap open enrollment lasts six months, starting the first month you are both 65 or older and enrolled in Part B. During that period, insurers cannot deny an available policy because of your health.

Annual fall enrollment does not generally create another right to buy Medigap without medical underwriting. Outside your protected enrollment period or another guaranteed right to buy coverage, an insurer may decline your application or charge more because of health history. State protections can add opportunities, and under-65 access varies. Confirm your rights before leaving Advantage in expectation of buying Medigap.

Prepare for a useful comparison

Build your Medicare enrollment preparation checklist around:

• Your Medicare card, if issued, and Part A/B effective dates.
• ZIP code, planned coverage start date and seasonal addresses.
• Doctors, hospitals, prescriptions, dosages and pharmacies.
• Current insurance details, termination dates and creditable drug-coverage notices.
• A sustainable premium budget and an amount you could handle in medical bills.

For employment-based Part B enrollment, gather employment and coverage records; Medicare identifies CMS-L564 as the employment-information form used with the applicable Part B application.

If costs are difficult to manage, check Medicare Savings Programs and Extra Help before ruling out coverage. Eligibility depends on the program and your circumstances.

Choose how you want to shop

When considering using a Medicare broker versus buying direct, ask what each channel can compare. An insurer’s sales team discusses its own offerings; an agent’s selection depends on the companies and plans they represent. Compare that selection with Medicare’s tools.

Insurers generally pay agents and brokers for Medicare health and drug-plan enrollments. Medicare prohibits charging a fee to process enrollment into these plans. Ask how the agent is compensated and request a written explanation of the recommendation.

Help a parent make the decision

When helping a parent choose Medicare coverage, organize the medication list, appointment schedule, budget and comparison notes. Let your parent set priorities and approve the choice. Before speaking or applying on their behalf, ask Medicare and the insurer what authorization they require.

Medicare’s information-release authorization lets a chosen person discuss claims and health records. Do not treat permission to discuss records as permission to sign an enrollment application.

Get a comparison you can act on

For individual help comparing Medicare coverage, take your checklist to a licensed agent or a State Health Insurance Assistance Program counselor. SHIP provides free personalized counseling and is independent of insurers and health plans.

Request a written comparison showing provider access, prescription costs, premiums, potential medical bills and enrollment timing. Ask the person helping you to identify the strongest fit and explain the tradeoffs. Confirm the coverage year, effective date and unresolved doctor or drug questions before applying.