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HOW DO YOU FIND THE BEST MEDICARE PLAN?
- Michael Braden
- Dec 28, 2025
- 8 min read
Updated: Jan 2
Michael T. Braden December 10, 2025 Medicare 101
WHAT IS MEDICARE?
Medicare is a federal health insurance program that provides essential health coverage to people aged 65 and older, as well as specific younger individuals with disabilities or End-Stage Renal Disease. Administered by the Centers for Medicare & Medicaid Services (CMS), Medicare offers a range of coverage options to help beneficiaries access the health services they need.
Medicare is divided into several Parts, each covering different types of services. These include hospital insurance, medical insurance, Medicare Advantage plans, and prescription drug coverage. Understanding how these Parts work together is crucial for Medicare beneficiaries to make informed decisions about their healthcare coverage.
To help you compare plans and determine the best Medicare coverage for your needs, online tools such as the Medicare Plan Finder are available onTo help you compare plans and determine the best Medicare coverage for your needs, online tools such as the Medicare Plan Finder are available on Medicare.gov. These resources allow you to review coverage options, compare costs, and evaluate benefits side by side. It’s essential to take time each year to review your current plan and make any necessary changes, ensuring you always have the coverage that best fits your health needs.
Whether you’re new to Medicare or reviewing your options for the upcoming year, staying informed and using available resources can help you find the right plan and maximize your benefits.
UNDERSTANDING THE FOUR PARTS OF MEDICARE
Medicare is made up of several parts, each offering different types of coverage to meet your health insurance needs:
Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services. Most people do not pay a premium for Part A if they or their spouse paid at least 10 years of Medicare taxes while working.
Medicare Part B provides coverage for physician visits, outpatient care, preventive services, and certain medical supplies. Part B requires a standard monthly premium, which may vary based on your income.
Medicare Part C (Medicare Advantage) combines the benefits of Parts A and B and is offered by private insurance companies approved by Medicare. Medicare Advantage plans often include additional benefits such as vision, dental, and hearing coverage, and may have different costs and more limited provider networks.
Medicare Part D offers prescription drug coverage through a variety of plans, each with its own list of covered drugs (formulary) and cost structure. Choosing the right Part D plan for you is essential for managing your prescription drug expenses.
Medicare Supplement Insurance (Medigap) helps pay for out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Medigap plans can provide additional financial protection and peace of mind.
Carefully review the benefits, costs, and services covered by each Part to ensure you select the appropriate combination of plans for your health and budget.
ACCESSING THE MEDICARE PLAN FINDER TOOL
The Medicare Plan Finder, available on Medicare.gov, is the official tool designed to help you compare plans for Medicare side by side. This user-friendly tool allows you to enter your ZIP code and current prescriptions, then view costs and compare various Medicare plans based on premiums, deductibles, and medication coverage.
What the Medicare Plan Finder does not offer is the knowledge, experience, and expertise that you will find at Medicare Seminars Insurance Agency. Braden Medicare Insurance provides a more detailed explanation of all of your options, and you work with an experienced, independent, licensed Medicare Broker. Our Brokers have access to over 40 Insurance Companies, which gives you more options and better rates than from just one or two insurance companies. And perhaps the best part is that all of our services are provided at no cost to the consumer. We will be with you long after your policy begins, and we offer every client a complimentary review of your coverage each year, in advance of the Medicare Annual Enrollment Period (AEP).
To take advantage of our services, use the Contact Us form on our website at www.bradenmedicare.com, or you can call or text us anytime at (480) 225-1393. We will spend the time you need to ensure you understand the pros and cons of your choices, including the insurance companies offering Medicare Part C or Medigap Plans in your local area.
TAKE CHARGE OF YOUR OWN HEALTHCARE, YOU HAVE EARNED IT
Before exploring the many Medicare coverage options, start by listing your healthcare needs and budget to create a clear picture of what coverage you’re looking for. Identify your daily medications, travel needs, and any chronic health issues to ensure that the plan covers all necessary services.
Consider the need for frequent specialist visits or specific medications; these factors should be clearly outlined to avoid any surprises later. Chronic health conditions, for instance, typically require a comprehensive list of healthcare needs, including routine check-ups and specialist visits, which facilitates effective comparison with Medicare's more frequent medical visits and specialized care, significantly influencing the type of Medicare coverage required.
Creating a comprehensive list of your healthcare needs, including routine check-ups and specialist visits, facilitates effective comparison of Medicare options. The Medicare Plan Finder allows you to filter plans based on these specific needs, helping you make the most informed choice possible.
HELP WITH UNDERSTANDING EACH OF THE DIFFERENT MEDICARE ADVANTAGE PLANS IN YOUR AREA
Medicare Advantage Plans, also known as Part C, offer additional benefits beyond Original Medicare, including coverage for vision, dental, and wellness programs. When comparing these plans, it’s crucial to understand the different types available: HMO, PPO, and PFFS.
Health insurance plans differ in terms of provider flexibility:
HMO(Health Maintenance Organization) plans typically require that you use in-network providers for all non-emergency services, making it essential to check whether your preferred doctors are included.
PPO (Preferred Provider Organization) plans offer more flexibility, allowing you to see out-of-network providers, although this may result in higher costs.
PFFS (Private Fee-For-Service) plans provide greater flexibility in choosing healthcare providers but entail specific payment terms that must be followed.
The Medicare Advantage Plan Finder helps you filter plans by HMO, PPO, or PFFS and evaluate extras such as fitness programs and telehealth services, ensuring you select a plan with the benefits you value most.
LEARN HOW TO PROPERLY EVALUATE ALL OF THE MEDICARE SUPPLEMENT (MEDIGAP) PLANS
Medicare Supplement Plans, also referred to as Medigap plans, are designed to cover costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. These plans are standardized across states, facilitating comparison of benefits and premiums across insurers.
The Medicare Supplement Plan Finder allows you to:
Filter plans by specific needs, such as coverage types and monthly premiums.
Compare standardized Medigap plans that offer the same benefits regardless of the insurance company, thereby enabling direct premium comparisons.
Review detailed summaries of each plan, including coverage for services like hospital stays and skilled nursing care.
KNOWING HOW TO COMPARE MEDICARE PRESCRIPTION DRUG PLANS EFFECTIVELY
Prescription drug coverage is a critical component of your Medicare plan, and that’s where the Medicare Part D prescription drug plan comes in. The Part D drug plans Finder on Medicare.gov allows you to enter your medications and dosages to identify suitable plans that cover your prescription drug needs.
Each Medicare Part D plan has a formulary that categorizes covered drugs into tiers, affecting cost-sharing. Generic medicines are typically placed in lower tiers and offer a more affordable alternative to brand-name drugs, thereby reducing out-of-pocket expenses. Verify whether your preferred pharmacies are in-network and review the formulary tiers to understand your out-of-pocket costs for any medications you take.
REVIEWING THE ANNUAL COSTS AND THE OUT-OF-POCKET MAXIMUMS
Understanding the financial implications of different Medicare plans is vital for setting a realistic budget. Users can view costs associated with each Medicare plan, including premiums, deductibles, and out-of-pocket expenses.
It’s crucial to consider budget factors, such as premium increases and out-of-pocket costs, when evaluating Medicare options. In 2026, the out-of-pocket maximum for Medicare Advantage plans is capped at $9,250. Many insurance companies offer excellent options for under $5,500. Remember, the out-of-pocket cost cap in 2026 is $2,100.
Regularly assess your health status and compare annual drug costs, out-of-pocket maximums, and total yearly costs, including deductibles and copayments, when choosing a Medicare plan.
BE SURE TO CHECK THAT ALL OF YOUR HEALTHCARE PROVIDERS ARE IN THE NETWORK FOR ANY PLAN YOU ARE CONSIDERING
When considering an Advantage Plan, you will want to confirm whether your healthcare providers are in the plan’s network. Online tools can help you verify whether specific doctors are included, so don’t neglect to use those resources to understand your options better.
Many Medicare Advantage plans have a limited provider network, which affects access to specialists or facilities. Out-of-network services often incur higher costs, so check network availability beforehand.
WHAT ARE MEDICARE STAR RATINGS?
Star Ratings help consumers assess the quality of Medicare Advantage and Part D plans, thereby influencing their healthcare choices. Contracts with higher Star Ratings often reflect better customer satisfaction and health outcomes.
Approximately 42% of Medicare Advantage plans scored four stars or higher in the 2024 ratings, indicating greater consumer trust and stable performance. Plans with longer tenure in the program tend to achieve higher Star Ratings, suggesting that experience correlates with performance.
FREQUENT MISTAKES YOU SHOULD UNDERSTAND AND REMEMBER
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Navigating Medicare can be complex, and making the wrong choices, even unknowingly, can lead to coverage gaps or unnecessary costs. Below are some common mistakes Medicare beneficiaries should avoid:
Not enrolling in Medicare Part B when first eligible can result in higher monthly premiums and delayed access to critical medical services.
Failing to review and compare Medicare Advantage or Part D drug plans during the Annual Election Period may result in missing better coverage options or lower costs. Plans and benefits can change each year, so it’s essential to review your choices annually.
Not understanding the differences between Original Medicare and Medicare Advantage plans can lead to selecting a plan that doesn’t fit your health needs or lifestyle.
Delaying enrollment in a Medicare Supplement plan (Medigap) can increase your costs or make it harder to qualify, especially if your health changes.
Overlooking prescription drug coverage needs when choosing a Medicare plan can result in unexpected out-of-pocket expenses for your medications.
To avoid these pitfalls, stay informed about your options, review your coverage regularly, and consult trusted resources, such as licensed agents, for guidance. Taking these steps can help you identify the appropriate Medicare plan and protect your health and finances.
ASSISTANCE, CARE, SUPPORT, AND UNDERSTANDING WHENEVER YOU NEED IT
Agents and brokers assist individuals with Medicare enrollment and eligibility assessment, guiding them to select CMS-approved plans tailored to their needs in each state.
In-person assistance is available for eligible beneficiaries who prefer direct guidance during the enrollment process. This personalized support can significantly improve understanding and the selection of the appropriate plan.
KEEPING YOU AHEAD OF THE CURVE THROUGHOUT THE YEAR
Medicare policies, benefits, and costs can change from year to year, making it essential for beneficiaries to stay up to date. The official Medicare website (medicare.gov) and the Medicare Handbook are excellent resources for learning about the latest updates to Medicare coverage, costs, and enrollment periods.
Licensed insurance agents and brokers can also provide valuable support, helping you understand your options and guiding you through the enrollment process. The Medicare Annual Election Period, which runs from October 15 to December 7, is the ideal time to review your Part D or Advantage plans, compare new options, and make any necessary changes to your coverage.
By staying informed about Medicare changes and regularly reviewing your coverage, you can ensure you’re getting the most out of your benefits while minimizing your out-of-pocket costs. Proactive management of your Medicare plan helps you maintain the health coverage you need and provides peace of mind for the year ahead.
WRAPPING THINGS UP
Navigating Medicare can be complex, but with the right tools and resources, you can find a plan that suits your needs and budget. From using the Medicare Plan Finder to understanding Star Ratings and seeking agent assistance, each step is crucial to making an informed decision. Note that the right Medicare plan can significantly impact your health and finances, so take the time to review your options carefully. Take charge of your healthcare today and ensure you have the coverage you need for a healthier tomorrow.
