Best Medicare Choices Right Now

Here’s how to evaluate your options for the coming year. Check in with your pharmacy and doctor to make sure that your pharmacy will still accept your Part D plan or that your physician will take your Medicare Advantage plan next year. If the answer is no, consider switching to one of the plans they will be participating in. Next, take these steps:

Create an account at medicare.gov, if you don’t already have one. That will allow you to compare coverage options, monthly premiums, and deductibles among the different Part D and Advantage plans in your area. It also lets you save and access important information, including your current plan details, medications you take, and your preferred pharmacy.

Get free help comparing and choosing plans. Your state’s SHIP (State Health Insurance Assistance Program) counselors will provide free, unbiased advice on the best plans for you, says Jack Hoadley, PhD, a Medicare expert and research professor emeritus at the Health Policy Institute at Georgetown University in Washington, D.C. To find a SHIP counselor, go to shiphelp.org and select the "SHIP Locator" button. You can also get free help from a Medicare Rights Center counselor.

Locate a local, independent insurance broker licensed to sell health policies. They can also help you find your best Medicare Advantage, supplemental insurance, and Part D options and get you signed up (which the counselors described above can’t do). You can search for local brokers at nabip.org, the website of the National Association of Benefits and Insurance Professionals. NABIP members have committed to making their recommendations with the consumer’s best interest in mind. That is important because three large online brokers—eHealth, GoHealth, and SelectQuote—are under investigation by the Department of Justice for allegedly receiving improper payments from major insurance companies to steer people into their plans.

Even with guidance from the pros, it helps to be familiar with the various coverage options. Here, we’ve laid out some common preferences and situations to help you choose the plan that’s best for you.

Traditional Medicare is the government-run health plan most folks are eligible for once they turn 65. It generally gives people the most choice in where to receive their healthcare, but understanding what it covers can be challenging, and the cost of what’s not covered can be steep. So when is sticking with—or switching to—traditional Medicare the best move?

You want access to a wide network of doctors and hospitals with no referrals or preapprovals needed. Traditional Medicare is accepted by 98 percent of all physicians and most hospitals in the U.S. and lets you visit any doctor who accepts Medicare—including top specialists—anywhere in the country, without a referral. Doctors can generally order tests without the hassle of getting a preapproval from Medicare, says Hoadley. A recent analysis in the journal Health Affairs found that the top reason people switched from Advantage plans to traditional Medicare was because they had trouble getting needed care.

You can get a supplemental, or Medigap, plan that provides the coverage you want at a price you can afford. The 20 percent of healthcare costs not covered by traditional Medicare can quickly add up. Supplemental plans, offered by private insurance companies, cover some—or even all—of what Medicare doesn’t. (Typically, the higher the premium, the more robust the coverage.) According to the Kaiser Family Foundation, only 11 percent of people on traditional Medicare go without this additional coverage. "If you become ill and don’t have supplemental coverage, you could face thousands of dollars in out-of-pocket costs," says Hoadley. You’re automatically re-enrolled each year and can switch to a different supplemental plan at open enrollment if you want to.

Note: If you sign up for a supplemental plan within the first six months of enrolling in Medicare Part B, insurers cannot deny you a plan or charge more for the coverage based on your health status. But if you miss that window, coverage could be expensive or difficult to find unless you live in (or move to) Connecticut, Maine, Massachusetts, or New York, where insurers cannot charge more for or deny coverage based on age, sex, or health status. (Minnesota recently passed a law that will provide the same protections starting in August 2026.) The only other exception is if you’ve been on an Advantage plan for less than 12 months or moved out of the plan’s coverage area.

If you don’t meet those conditions but you still want to switch to traditional Medicare with a supplemental plan, Hoadley says not to lose hope: Lower-priced options are often available, so it’s worth looking for one.

You travel frequently, or live in two (or more) states. Traditional Medicare covers doctor and hospital visits throughout the U.S. If you travel internationally, several of the supplemental plans—Types C, D, G, M, and N—cover 80 percent of medical costs if you’re outside the U.S. and require emergency care.

Medicare Advantage plans are run by private insurers and usually accepted only by local networks of doctors and hospitals. More than half the people enrolled in Medicare are on Advantage plans, which can come with very low (or no) premium costs. They also typically include drug coverage—so you won’t need to choose a Part D plan—and perks like dental and vision coverage, at a price that can be hundreds of dollars less per month than traditional Medicare with a supplemental plan.

Because Medicare Advantage plans can cover most costs (minus nominal copays and coinsurance), you do not need a separate supplemental plan. "Besides convenience, a single premium fee helps make budgeting for healthcare easier and more predictable," says CR program director Chuck Bell.

Here are some situations where an Advantage plan might make sense.

You’ve been denied (or can’t get) a supplemental plan that will cover you on traditional Medicare. If you missed the initial six-month sign-up window and live in a state that allows insurers to deny coverage or to charge more based on your age, sex, and health status, you may not be able to obtain or afford a supplemental plan.

If that happens, an Advantage plan will provide a higher level of coverage for less than traditional Medicare alone and protect you from the risk of high out-of-pocket costs, Hoadley says.

You can get a top-rated plan. Advantage plans are given a star rating by the government’s Centers for Medicare & Medicaid Services based on patient surveys. The ratings, which are found next to the name of each plan at medicare.gov, reflect factors including complaints, customer service, and how well the plan manages people with chronic conditions. Hoadley and Whicheloe say to look for plans that earn four to five stars. If you live in an area where only plans that earn three stars or less are available, consider traditional Medicare. 

Your doctors are in the network—and the Advantage plan offers out-of-network options. Always confirm that your physicians and local hospitals are in any Medicare Advantage plan that you’re considering. For added peace of mind, you may also want to choose a plan that provides at least some coverage for out-of-network doctors or services. That will give you the option to see, for example, a specialist who is not in the network. Note that only preferred provider organization (PPO) plans cover any out-of-network costs and that coverage is somewhat limited: Some plans pay as much as 50 percent.

About half of all Advantage plans are PPOs. Monthly premiums for PPO plans average around $18 but can climb as high as $200.

You stay close to home (mostly). A few of the plans provide regional or national coverage, but most are limited to healthcare providers in the area where you live. Emergency services are covered anywhere in the U.S.

You want coordinated medical care and simplified billing. Most Medicare Advantage plans offer care coordination between physicians to help manage a patient’s treatment, including scheduling office visits, sharing records, and helping with billing. That’s especially useful if you have a chronic condition, and it’s not something traditional Medicare provides if you see doctors in multiple health systems.

The ideal time to enroll in Medicare is the seven-month window that includes the month you turn 65 and the three months before and after. Miss that time frame and you may have to wait months to sign up. You’ll also have to pay a monthly penalty for as long as you’re on Medicare: an additional 10 percent of the premium for each year you delay. (If you’re still covered by your employer’s insurance, you have eight months after you stop working to enroll.)

You must sign up for both Medicare Part A and Part B on the Social Security website, regardless of whether you decide to enroll in traditional Medicare or Medicare Advantage. Then you can go to medicare.gov to start shopping for Advantage plans, or for Part D drug plans and supplemental plans if you’re signing up for traditional Medicare. Whichever plans you choose will typically take effect during the month you sign up.

If you have traditional Medicare, it’s important to review your prescription drug coverage (Part D) plan annually because the medications it covers and how much you have to pay for them can change from year to year, says Stacie Dusetzina, PhD, a professor in the department of health policy at Vanderbilt University School of Medicine in Nashville, Tenn. For 2026, Medicare will cover all prescription costs after you’ve paid $2,100 out of pocket, but it’s still important to compare drug prices under various plans: A past CR analysis using five common medications found that you could pay hundreds or even thousands of dollars more for prescriptions annually if you use a pharmacy that isn’t in your plan’s network or isn’t designated as preferred. Here are the steps to take:

Sign in to your medicare.gov account. Select "find a drug plan," then log in to your account. Next, enter all of your medication information (name, strength, dosage, etc.) into the Plan Finder.

Select up to five pharmacies. Pharmacies in your ZIP code are automatically listed as choices; you can add others manually. Once you’ve chosen up to five, select "Continue to view plans.”

From the list of results, select "Star Ratings" and highlight "3-stars or higher." Taking this step will eliminate all of the available Part D plans that do not rate well in terms of customer service and price.

Compare monthly premiums and deductibles. Some plans have monthly premiums as high as $100 (with no deductible); others may have no premiums but come with deductibles as high as $590. You can compare the total cost of coverage for up to three plans. Select a plan that fits your budget.

Next, select "Plan Details" and then the tab "Drug Coverage." Here you’ll see the cost of each of your medications. Scroll down to "Yearly Drug Costs By Pharmacy" to compare the total annual cost of your meds at the various pharmacies. The lowest prices will be at preferred pharmacies. A search in July using four common drugs in the 78759 ZIP code showed a range of prices for the rest of the year from $225 at an in-network Sam’s Club pharmacy to just $25 at an HEB supermarket, a preferred pharmacy.

Once you’ve found a plan, scroll back to the top and select the green "Enroll" button. Have your Medicare number ready and fill out the application form. You can get free help from one of your state’s SHIP counselors, medicarerights.org, or a local pharmacist.