Before you begin comparing Medicare Advantage plans, it is first important to understand the current Medicare enrollment periods. Below are a few of the most common enrollment periods for this time of year.
The Medicare Advantage Open Enrollment Period (MAOEP)
The Medicare Advantage Open Enrollment Period (MAOEP) runs from January 1st through March 31st each year, offering Medicare Advantage enrollees a valuable second chance to review and change their coverage.
Unlike the Annual Enrollment Period in the fall, MAOEP is specifically designed for people already enrolled in a Medicare Advantage plan who have a one time chance to switch to a different plan or return to Original Medicare (Parts A and B) for 2026.
Understanding how to compare Medicare Advantage plans during this window can help you determine whether there is a plan out there that better fits your healthcare needs and budget for 2026.
Special Enrollment Periods (SEP)
A Special Enrollment Period (SEP) allows you to enroll in or make changes to Medicare coverage outside of standard enrollment windows if certain life events or circumstances occur.
You may qualify for an SEP if you:
- Move out of your plan’s service area
- Lose other health coverage
- Experience changes in Medicaid eligibility
- Have your current plan end or change its contract
- Qualify for certain assistance programs
SEPs vary based on the situation and typically last for a limited time.
Initial Enrollment Period (IEP)
Your Initial Enrollment Period (IEP) is the first time you’re eligible to enroll in Medicare. It’s a 7-month window that begins 3 months before the month you turn 65, includes your birthday month, and ends 3 months after.
During your IEP, you can:
- Enroll in Original Medicare (Parts A and B)
- Choose a Medicare Advantage or Part D plan
- Enroll in a Medigap (Medicare Supplement) plan (acceptance is generally guaranteed during this time)
This is often the most flexible enrollment window, with fewer restrictions and more plan options.
For a full list of Medicare enrollment periods, check out our Enrollment Periods educational page.
Whether you’re new to Medicare or you're dissatisfied with your current plan's provider network, prescription drug coverage, or overall benefits, this guide will walk you through the key factors to consider when comparing your options. Plus, we’ll run you through how online comparison tools like Healthpilot make it easier than ever to evaluate multiple plans side-by-side and find the right fit for your unique situation.
Key Factors To Consider When Comparing Medicare Advantage Plans
When comparing Medicare Advantage plans, there are a few critical factors that should guide your decision-making process:
- Start by examining premium costs; while some Medicare Advantage plans offer low monthly premiums, others charge varying amounts depending on the benefits included.
- Equally important are out-of-pocket maximums, which cap your annual spending and provide crucial financial protection.
- The provider network is another essential consideration. HMO plans typically require you to use network providers and get referrals from your primary care physician, while PPO plans offer more flexibility to see out-of-network doctors at a higher cost.
- PFFS plans (Private Fee-For-Service) provide another alternative, allowing you to visit any Medicare-approved provider who accepts the plan's payment terms.
- Verify that your current primary care doctor, specialists, and preferred hospitals are included in any plan's contracted network before making a switch.
- Prescription drug coverage (or Medicare Part D) varies significantly between Medicare Advantage plans. Review each plan's formulary to ensure your medications are covered, and compare copayments or coinsurance amounts for your prescriptions.
- Note that some plans may require prior authorization or step therapy for certain drugs.
- Additional benefits often distinguish Medicare Advantage plans from Original Medicare. If these benefits matter to you, compare what each plan offers and any associated costs.
- Consider Star ratings and plan performance measures. The Centers For Medicare & Medicaid Services rates plans on a scale of one to five stars based on quality of care, customer service, and member satisfaction. Higher-rated plans generally indicate better overall performance, though availability varies by location.
Healthpilot is a tool that allows you to compare all these factors side-by-side rather than digging through coverage information and extensive fact sheets, making it simple to see how different Medicare Advantage plans stack up against each other in your area.
Is There a Website That Compares Medicare Advantage Plans?
In addition to Healthpilot, there are several other websites that help you compare Medicare Advantage plans.
- The official Medicare Plan Finder at Medicare.gov is the government's tool for comparing available Medicare coverage options in your area. It provides detailed information about premiums, coverage, and benefits for every Medicare Advantage plan available where you live.
- Healthpilot offers an alternative comparison experience designed with user-friendliness in mind. Healthpilot helps you quickly evaluate coverage options based on your specific healthcare needs, budget, and preferences. We simplify the comparison process by presenting information in an easy-to-understand format, allowing you to filter plans by the features that matter most to you.
- Additionally, working with a licensed insurance agent can provide personalized guidance as you compare plans (Healthpilot has these, too). Agents can answer specific questions about plan details and help you understand how different options align with your healthcare situation.
- For general Medicare questions, you can also contact the Medicare Help Line at 1-800-MEDICARE (TTY 711).
Whether you use the official Medicare Plan Finder, Healthpilot, or consult with an agent, online comparison tools save significant time compared to manually researching individual Medicare Advantage companies and their plan offerings.
What Is The Most Highly Rated Medicare Advantage Plan?
As mentioned previously, the Centers For Medicare & Medicaid Services rates plans on a scale of one to five stars based on quality of care, customer service, and member satisfaction. Plans with 5-star ratings represent the highest level of performance, but these top-rated plans aren't available in every geographic area.
Though this system is designed to help you choose the plan that best fits your needs, the "most highly rated" Medicare Advantage plan will vary depending on your location and individual healthcare needs.
Furthermore, a highly rated plan in one region might not even be offered where you live. Medicare Advantage plans are sold on a county-by-county basis, so availability depends on which Medicare Advantage companies operate in your area and choose to offer coverage.
Rather than searching for a single "best" plan nationally, focus on comparing highly rated plans available near you. A 4-star or 5-star plan that includes your preferred doctors and covers your prescriptions will serve you better than a top-rated plan in another state.
When you use Healthpilot to compare Medicare Advantage plans for 2026, you'll see Star ratings alongside other crucial information, helping you identify high-performing plans available in your specific location. This localized approach ensures you're considering plans you can actually enroll in, not just plans with good reputations elsewhere.
Understanding Your Medicare Coverage Needs
Before diving into plan comparisons, take time to assess your personal healthcare needs:
- Review your healthcare history from the past year, including doctor visits, hospital stays, specialist care, and any ongoing treatments for chronic conditions. This information provides a realistic picture of the medical services you're likely to need in the coming year.
- Consider your current healthcare providers. If you have an established relationship with a primary care physician or see specialists regularly, check whether they participate in the provider networks of plans you're considering.
- Switching to a plan that doesn't include your trusted doctors could disrupt your care coordination and require you to build new patient-provider relationships.
- Evaluate your prescription drug needs carefully. Make a list of all of the medications you take, including dosages, and check each plan's formulary to confirm coverage.
- Pro Tip: Pay attention not just to whether drugs are covered, but also to which tier they're placed in, as this affects your copayment amounts.
- Think about additional services that enhance your quality of life. Different Medicare Advantage plans offer varying levels of these supplemental benefits.
Healthpilot can help you identify your specific coverage priorities by asking targeted questions about your health status, medications, and healthcare preferences. Our personalized approach ensures you're comparing plans based on what actually matters for your situation, not just general features.
Comparing Plan Types & Networks
Medicare Advantage plans come in several varieties, each with different rules for accessing care. Understanding these differences is crucial when comparing your options during an enrollment period.
Medicare HMO Plans
Health Maintenance Organizations (HMO plans) typically offer lower premiums, but require you to receive care from network providers. You'll usually need to choose a primary care doctor who coordinates your care and provides referrals to specialists. Except for emergency care, services received outside the network generally aren't covered.
Medicare PPO Plans
Preferred Provider Organizations (PPO plans) provide more flexibility. While you'll pay less when using in-network providers, you have the option to see out-of-network doctors and specialists without a referral, though at higher out-of-pocket costs. This flexibility makes PPO plans attractive if you want the freedom to choose providers or frequently need specialist care.
Private Fee-For-Service Plans
Private Fee-For-Service plans (PFFS plans) allow you to visit any healthcare provider that accepts Medicare and agrees to the plan's payment terms. These plans don't require you to stay within a network, but not all providers accept PFFS plans, so you'll need to verify acceptance before each appointment.
Special Needs Medicare Plans
Some Medicare Advantage plans are designed for specific populations, such as Dual Eligible Special Needs Plans (D-SNPs) for those who qualify for both Medicare and Medicaid, or Chronic Conditions Special Needs Plans (C-SNPs) for people with specific health conditions, such as Chronic Heart Failure (CHF), Diabetes, Chronic Obstructive Pulmonary Disease (COPD), or certain mental health conditions.
When comparing plan types, consider your healthcare usage patterns. If you rarely need medical care beyond preventive care screenings, an HMO plan with a lower premium might be cost-effective. If you have complex medical needs requiring multiple specialists, a PPO plan's flexibility might justify higher costs.
Making Comparing Plans Easy With Healthpilot
Healthpilot streamlines the Medicare Advantage comparison process by bringing all relevant information together in one easy-to-navigate platform. Instead of visiting multiple insurance company websites or juggling spreadsheets, you can compare coverage options, benefits, provider networks, and costs side-by-side in-platform.
Healthpilot helps you filter plans based on your priorities; whether that's finding the lowest premium costs, ensuring specific doctors are in-network, or maximizing additional benefits. You can see how different plans handle prescription drug coverage by entering your medications and comparing the total estimated costs across plans.
We also provide transparency about each plan's out-of-pocket maximums, helping you understand your potential financial exposure in a high-usage year. This is particularly valuable if you have chronic conditions or anticipate needing significant medical care.
As a free Medicare plan finder tool with no obligation to enroll, Healthpilot gives you the information you need to make an informed decision without pressure. You can take your time exploring different Medicare Advantage plans for 2026, return to compare options multiple times, and ultimately choose the plan that best fits your healthcare and financial needs.
Ready To Take Action During an Enrollment Period?
If you are in an enrollment window and you're considering switching Medicare Advantage plans or exploring whether a different plan type better serves your needs, now is the time to act.
Start by comparing Medicare Advantage plans available in your area using Healthpilot's comprehensive comparison tool:
- Evaluate how your current plan stacks up against alternatives in terms of provider networks, prescription drug coverage, additional benefits, and overall costs.
- Don't forget to check Star ratings to gauge plan performance and member satisfaction.
Use this opportunity to ensure your Medicare coverage aligns with your current health status and financial situation.