How to Actually Compare Medicare Plans During Open Enrollment

Every year, Medicare sends the same message during Open Enrollment: compare your options, you might save money. That is true. But the email does not tell you how to do it, what actually matters, or how to tell a real improvement from a plan that just looks better on paper.

This is the practical version.

When Open Enrollment Runs

Medicare Open Enrollment, also called the Annual Enrollment Period, runs October 15 through December 7 each year. Any changes you make take effect January 1. If you miss the window, your next chance to switch is the Medicare Advantage Open Enrollment Period, which runs January 1 through March 31, but with more limited options.

The October 15 to December 7 window is your broadest opportunity. You can switch between Medicare Advantage plans, drop Medicare Advantage and return to Original Medicare, change your Part D drug plan, or add a Part D plan if you do not have one.

Start With Your Annual Notice of Change

Before comparing anything else, read the Annual Notice of Change (ANOC) that your current plan mailed to you in late September. It lists every change your plan is making for next year: premium increases, changes to your deductible, drugs removed from formulary, and benefit reductions.

Plans change significantly from year to year. A plan that was right for you in 2026 may have cut its dental benefit, raised its out-of-pocket maximum, or removed a drug you take from its preferred tier. The ANOC tells you what changed. If you have not opened it, find it now.

If you cannot find it, call the number on the back of your Medicare card and ask for your plan's changes for next year.

Check Your Prescriptions First

Drug coverage is the single most variable part of any Medicare plan. The same medication can cost $10 per month on one plan and $200 on another. Formularies change every year, and a drug that was on Tier 2 last year may have moved to Tier 4.

To compare drug costs properly, use the Medicare Plan Finder at Medicare.gov/plan-compare. Enter every prescription drug you take, the dose, and how often you take it. The tool calculates your estimated annual drug costs for each plan in your area. This is the most useful number in the comparison.

Three things to verify before enrolling in any plan: - Your specific drugs are on the formulary (not just a similar drug) - The pharmacy you use is in-network (preferred network pharmacies charge less) - No prior authorization requirements will delay your first fill

Check Your Doctors

If you are switching from Original Medicare to Medicare Advantage, or switching between Medicare Advantage plans, verify your doctors are in-network before you enroll. Not after.

Go to the plan's website or call member services. Ask specifically: is Dr. [name] contracted with this plan for next year? Directories are sometimes outdated. Calling directly takes five minutes and avoids a significant problem.

If your doctors are not in-network, you have two options: find a plan that covers them, or switch to a plan with a broader network and accept that any doctor you see will be covered. Out-of-network care in an HMO-style Medicare Advantage plan is typically not covered at all, except for emergencies.

If keeping your specific doctors matters, a PPO-style plan or Original Medicare with a Medigap supplement gives you the most flexibility.

Check Extra Benefits

Many Medicare Advantage plans offer dental, vision, hearing, and fitness benefits beyond what Original Medicare covers. These are worth factoring into your comparison, but with some skepticism.

Dental coverage in Medicare Advantage varies widely. Some plans cover preventive care only. Others offer up to $2,000 or $3,000 in annual dental benefits including crowns and major restorative work. The difference between these two types of coverage is significant if you have ongoing dental needs.

Vision benefits typically cover one annual eye exam and an allowance toward glasses or contacts, often $100 to $200. Hearing benefits may include a discount on hearing aids or an allowance toward a fitting.

Fitness benefits are usually included as a gym membership network (like SilverSneakers). These have real value if you use them.

When comparing extra benefits, calculate what you would actually use in a year. A plan with a $2,000 dental allowance you need is worth meaningfully more than one with a $150 vision allowance you do not.

Compare Total Costs, Not Just Premiums

A $0 premium Medicare Advantage plan is not necessarily cheaper than one with a $60 monthly premium. The plan with a lower or no premium often has higher copays, a higher deductible, or a higher out-of-pocket maximum.

The out-of-pocket maximum is the most important cost number in Medicare Advantage. In 2026, plans can set this as high as $9,350 for in-network care. If you have a hospital stay or need surgery, you will pay costs up to that cap. A plan with a $4,500 out-of-pocket max costs more per month but could save you thousands if you have significant medical needs.

For a side-by-side look at the tradeoffs between Medicare Advantage and Original Medicare with a supplement, see our [Medicare Advantage vs. Supplement comparison](/medicare-advantage-vs-supplement).

One Scenario Where Staying Put Makes Sense

If nothing in your ANOC changed significantly, your drugs are all still covered at the same tier, your doctors are still in-network, and you have not had unexpected costs, you do not need to switch. Switching plans for a marginal benefit can disrupt existing authorizations for ongoing treatments.

The goal is not to switch every year. It is to check every year so you know what you have.

What to Do Before December 7

1. Read your Annual Notice of Change 2. Check Medicare.gov/plan-compare with your full drug list 3. Verify your doctors are in-network for any plan you are considering 4. Compare out-of-pocket maximums, not just premiums 5. Make any change before December 7

If you want help comparing plans in your area, the SHIP program (State Health Insurance Assistance Program) offers free, unbiased counseling in every state. Find your local SHIP at shiphelp.org.