Compare Medicare Plans Side-by-Side for Lower Costs

Most people spend more time picking a Netflix plan than comparing their Medicare options. I’ll be honest: I spent years watching that pattern play out, and it still frustrates me. Because the stakes here aren’t $15 a month. They’re your savings, your health, and whether you can afford to see the doctors you trust.

Here’s the assumption I want to challenge right out of the gate: most seniors believe the plan with the lowest premium is the cheapest plan. It’s almost never true. The premium is just one number on a page full of numbers, and focusing on it alone is one of the most expensive mistakes I see people make year after year.

So let me walk you through how I actually compare Medicare plan costs, including the parts most articles skip entirely.

The Numbers That Actually Matter (And the Ones That Don’t)

Before you can compare anything, you need to understand what you’re comparing. Medicare has four basic parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage, which bundles A, B, and often D together), and Part D (prescription drug coverage). Most people I counsel are choosing between Original Medicare (Parts A and B, often paired with a Medigap supplement and a Part D plan) and Medicare Advantage (Part C).

Here’s what surprised me the first time I mapped out the real cost structure: Original Medicare, on its own, has no out-of-pocket maximum. None. A catastrophic illness could cost you $50,000 or more in a bad year. Medicare Advantage plans, by contrast, are required to cap your annual out-of-pocket spending. In 2026, that cap can be as high as $9,350 for in-network services, but many plans set it lower.

The numbers you absolutely must compare across any plans you’re considering:

Monthly premium. Yes, this matters. But weight it against everything else.

Deductibles. Part A has a per-benefit-period deductible (in 2026, that’s $1,676). Part B has an annual deductible of $257. Medicare Advantage plans often have their own separate deductibles, and they vary wildly.

Copays and coinsurance. This is where the real money hides. A plan with a $0 premium might charge you a $45 specialist copay every visit. If you see four specialists a month, that’s $2,160 a year in copays alone.

Out-of-pocket maximum. For Medicare Advantage plans, this is non-negotiable information. If you have a chronic condition or expect any significant medical care, this number could be the most important one on the page.

Drug costs. If you take any regular prescriptions, run your specific medications through each plan’s formulary (the list of covered drugs). Two plans with identical premiums can have wildly different costs for the same medication. Metformin might be free on one plan and $47 a month on another.

As certified Medicare counselor Diane Holt, who has been working with seniors in the Pacific Northwest for 22 years, puts it: “Most people come in focused on the monthly premium. I spend the first half of every appointment getting them to stop staring at that number and start thinking about their actual health situation, what they spend in a typical year, and what they’re risking in a bad year.”

That reframe alone changes everything.

Check our Medicare plan comparison guide to see how different plan types stack up across all these cost dimensions.

How to Actually Run the Numbers

Helpful resource: Life Alert Style Medical Alert Button for Seniors is a top-rated option for this. (As an Amazon Associate this site earns from qualifying purchases.)

This is the step most comparison articles gloss over, so I’m going to be specific.

Start at Medicare.gov. The Plan Finder tool there is genuinely good, and it’s official, so the information is required to be accurate. You’ll enter your ZIP code, your drugs (name, dosage, frequency), and your pharmacy. The tool will show you estimated annual costs across available plans, not just premiums. That total estimated cost figure is the one you should be ranking plans by.

I also want you to do something the Plan Finder won’t fully do for you: model a bad year.

Here’s what I mean. Look at the plan’s out-of-pocket maximum and ask yourself: if I hit that number this year, what does my total annual cost look like? Add the out-of-pocket max to your annual premiums. That’s your worst-case cost under that plan. Compare that number across your finalist plans. Sometimes a plan with a higher monthly premium is dramatically cheaper in a bad year because its out-of-pocket cap is $2,000 lower.

Worked example 1:

Situation: Carol, 69, in suburban Ohio, takes three daily medications and sees her cardiologist and endocrinologist regularly. Action: She compared a $0-premium Medicare Advantage plan (out-of-pocket max: $7,900) against Original Medicare plus a Plan G Medigap supplement ($198/month) and a Part D plan ($37/month). Result: In a typical healthy year, the Advantage plan saved her roughly $2,820 in premiums. But when she ran the bad-year scenario, her worst-case cost under Original Medicare plus Plan G was about $2,844 total (the Plan G covers most out-of-pocket costs after her deductibles). Her worst case under the Advantage plan was over $8,700. The “free” plan wasn’t free at all.

Worked example 2:

Situation: Robert, 72, relatively healthy, takes only a blood pressure medication, sees one primary care doctor twice a year. Action: He compared the same plan types as Carol. Result: In his actual usage pattern, the $0-premium Advantage plan cost him about $340 in copays and drug costs all year. Original Medicare plus Plan G cost him $2,820 in premiums with minimal additional out-of-pocket. The Advantage plan was genuinely the right financial call for him, as long as he’s comfortable with the network restrictions.

See the difference? Same plan types, completely different right answers. This is why blanket advice is useless here.

Start comparing your own numbers using Medicare’s official Plan Finder at Medicare.gov, which lets you enter your specific drugs and see estimated total annual costs.

The Costs People Forget to Compare

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Network restrictions aren’t a premium line item, but they have a real dollar value.

Medicare Advantage plans are built around networks, either HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) structures. If your specialist isn’t in-network, you may pay dramatically more or be denied coverage altogether. I’ve seen people switch to a $0-premium Advantage plan and then spend $800 out-of-pocket at an out-of-network specialist they’d been seeing for years because they didn’t check the directory first.

Dental, vision, and hearing are another category that makes cost comparisons complicated. Original Medicare covers essentially none of this. Many Advantage plans advertise dental and vision benefits, which sounds great, but read the fine print carefully. A plan might offer “$1,000 in dental benefits” that covers only preventive care and basic fillings, with a separate waiting period for major work. If you need a crown or hearing aids, that “benefit” might not help much.

Dr. Patricia Newell, a geriatric care specialist with 17 years of practice in Florida who advises patients on Medicare decisions annually, told me: “The number one thing I tell my patients is to price out their specific situation, not the average situation. Age 65 and age 75 look completely different from a health cost standpoint, and a plan that’s perfect at 65 can become a financial burden by 70.”

That’s a point I can’t make strongly enough. Your health needs will change, and Part C plans, while often cheaper when you’re healthy, can become harder to leave if you develop a complex condition that requires out-of-network specialists.

Also: if you’re considering a Medigap (Medicare Supplement Insurance) policy, know that your ability to enroll in one with guaranteed issue (meaning no medical underwriting) is strongest during your initial enrollment period. If you wait and then try to switch from Advantage to Original Medicare plus Medigap later, you may face medical underwriting in most states, which can mean higher premiums or denial based on health history.

Learn more about when and how to enroll in Medigap by reading our supplement insurance explainer.

Getting Help That’s Actually Free

Here’s something that should be more widely known: free, unbiased Medicare counseling is available in every state through the State Health Insurance Assistance Program, or SHIP. SHIP counselors are not insurance agents. They’re not paid commissions. They’re trained volunteers and staff whose entire job is to sit down with you, look at your actual situation, and help you compare plans honestly.

I’ve sent dozens of people to SHIP over the years, and the feedback I get is consistently positive. They can walk you through the Plan Finder, help you understand your specific plan documents, and flag costs you might have missed.

What surprised me, honestly, is how underused this resource is. SHIP counseling appointments are often available within a week or two, and they’re completely free.

Worked example 3:

Situation: Margaret, 67, recently widowed, newly Medicare-eligible, overwhelmed by the options in her county in Tennessee. Action: She scheduled a SHIP appointment. The counselor spent 90 minutes with her, entered her eight medications into the Plan Finder, and compared her realistic annual costs across six plans. Result: The plan she’d been about to pick based on a TV commercial would have cost her an estimated $4,200 more per year in drug costs than the plan she ultimately enrolled in. Same benefit structure. Very different formulary.

Build your short list of plans to compare before your SHIP appointment using the Medicare.gov Plan Finder, then bring your questions to the counselor.

Sources

• Medicare.gov Plan Finder: Official federal tool for comparing Medicare Advantage and Part D plan costs by ZIP code, drug list, and pharmacy.
• SHIP National Technical Assistance Center: Directory of free, unbiased Medicare counseling services in every state.
• Kaiser Family Foundation Medicare Policy Analysis (current): Ongoing research on Medicare Advantage enrollment trends, out-of-pocket costs, and benefit design.
• Centers for Medicare and Medicaid Services (CMS), 2026 Medicare & You Handbook: Official annual reference for Part A, B, C, and D costs, rules, and enrollment windows.
• JAMA Internal Medicine, “Out-of-Pocket Spending Among Medicare Beneficiaries” (2022): Peer-reviewed analysis of how out-of-pocket costs vary by plan type and health status.

The real cost of a Medicare plan isn’t a number you’ll see advertised anywhere. It’s the sum of what you’ll actually pay across an entire year, in a typical year and a bad one, for the specific health situation you’re living with right now. That number is worth a few hours of careful research. A SHIP counselor and the Medicare.gov Plan Finder together can get you most of the way there, and the savings can be substantial enough to matter.

This article is for informational purposes only. Medicare rules change annually. Always verify current plan details at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). This site does not sell insurance or recommend specific plans.

Recommended Resources

Disclosure: As an Amazon Associate, we earn a small commission from qualifying purchases at no extra cost to you. We only recommend products that genuinely support the topics covered in this article.

• Medicare For Dummies (~$22), The definitive consumer guide to Medicare, enrollment windows, Part A/B/C/D, and supplement plans.
• Get What’s Yours for Medicare (~$17), Maximize your Medicare benefits and minimize out-of-pocket costs. Covers Part D drug coverage gaps and Medigap in depth.