Monthly premium
This is in addition to your Part B monthly premium. so it affects your monthly cash flow. You pay whether or not you access your benefits. You should have access to at least one zero premium plan with drug coverage in your area.
Provider network
Check to make sure your doctors, hospitals, and pharmacies are in network to keep costs as low as possible.
Are your doctors in-network?
Will you need to be referred to see a specialist?
Does the plan cover services from out-of-network providers?
Out-of-pocket max
This is the most you’ll spend ― not including your premium, deductible, and drug costs ― for Medicare-covered services as long as you follow the plan’s rules for in and out of network coverage.
Is there a yearly limit on what you could pay out-of-pocket?
Deductibles, coinsurance & copays
Also known as cost-sharing, these expenses apply when you access your benefits. Check to see what your plan charges for doctor’s visits, services, treatments, and prescription drugs.
Drug coverage/formulary
See if your drugs are on the plan’s formulary and how much they cost each time you fill a prescription. You may want to talk with your doctor about a generic or alternative version of a drug you need.
Does the plan cover your prescription drugs?
Will you hit the prescription drug coverage gap?
Is your pharmacy is in the plan’s network?
Will your prescription drugs require prior authorization?
Additional benefits
Consider which additional benefits are important to you. Most plans require you to use network providers and may charge extra premiums for more comprehensive coverage.
How well does the plan cover the services you need like vision, hearing, or dental?
Are you eligible for a Medicare Advantage Plan?
How does the plan compare to your current coverage?
