Medicare Plan Comparison Checklist: Doctors, Drugs and Costs

Start with the care you need to keep

Write down the names and locations of your primary doctor, specialists and preferred hospitals. For a Medicare Advantage plan, check the exact plan's provider network and confirm with the provider's office. A familiar insurance company name alone is not a network confirmation.

Look at referrals, prior authorization and out-of-network rules. If you spend part of the year elsewhere, consider how you would get routine care away from home. Do not assume a plan's emergency coverage answers every travel question.

Check prescriptions at your pharmacy

Enter each medication with its strength, quantity and refill frequency. The formulary is the plan's list of covered drugs. Check the exact medication, its cost tier and any restrictions; similar drug names or a different dosage can change the result.

Review prior authorization, step therapy and quantity limits where they apply. Compare the pharmacy you intend to use, including preferred-network or mail-order arrangements. A drug appearing on the covered list does not establish its price at every pharmacy.

• Use your current medication list, including regularly filled prescriptions.
• Check the pharmacy location rather than just the chain name.
• Review the yearly drug estimate and any deductible alongside monthly costs.
• Discuss an unresolved coverage restriction with the plan and your prescriber.

Compare the full cost picture

A plan with a zero-dollar plan premium can still have other costs. Medicare Advantage members must continue paying the Part B premium, and deductibles, copayments or coinsurance can apply. Assistance programs or other arrangements may affect what you personally pay.

Use the same expected care and prescriptions for each comparison. An estimate is useful for planning, but it is not a promise of the amount you will spend.

Keep the comparison tied to your situation

Medigap supplements Original Medicare; it does not pay Medicare Advantage cost-sharing. Before dropping Medigap or employer coverage, check the consequences and any protections you have. Comparing options should not start by cancelling coverage.

MedaSynq's online entry starts with ZIP and county. When available, SunFire handles the plan results and the doctor, drug and pharmacy details. Verify the coverage year and plan documents there, then apply only during an enrollment period you qualify for. Save the provider's confirmation and verify coverage before using it. Neither a comparison visit nor an application submission by itself proves coverage is active.