How to Choose a Medicare Advantage Plan (2026 Guide)

Medicare Advantage, also called Medicare Part C, is a private health insurance plan that replaces Original Medicare Parts A and B. CMS-approved private insurers sell these plans, most of which bundle Part D drug coverage and add dental, vision and hearing benefits that Original Medicare doesn't cover.   

Original Medicare sets no annual limit on what you owe. Medicare Advantage adds that financial protection: CMS set the in-network out-of-pocket maximum at $9,250 for 2026. Plans use provider networks, which narrow your choice of doctors and hospitals, and many require prior authorization for certain services. You still pay the standard Medicare Part B premium ($202.90 per month in 2026, per Medicare.gov) on top of any plan premium. Unlike Medicare Supplement insurance, Medicare Advantage replaces Original Medicare rather than supplementing it.

Choosing a Medicare Advantage plan comes down to five checks: your doctors' network status, your plan's total cost structure, your drug coverage, the extra benefits on offer and the plan's CMS Star Rating. Each matters more than the monthly premium alone. Work through each step to assess any plan before you enroll and compare options at Medicare Plan Finder on Medicare.gov.

Check your doctors' network status first. HMO plans require in-network providers for all care except emergencies. PPO plans allow out-of-network visits at higher cost. Your plan's provider directory lists covered doctors and hospitals, but call your provider directly to confirm participation since directories aren't always current. Medicare Plan Finder at Medicare.gov lets you filter plans by your doctors. How HMO and PPO plans differ covers the full cost and referral tradeoffs by plan type. 

Six Medicare Advantage plan types set different rules for networks, referrals and drug coverage:

The monthly premium is only one of five costs to compare. Many Medicare Advantage plans have a $0 monthly premium, but $0-premium plans often offset that with higher deductibles, copay and co-insurance amounts per visit. The figure that matters most is the annual out-of-pocket maximum. CMS set the in-network limit at $9,250 for 2026, per CMS.gov. Plans can set lower limits. Once you reach that cap, your plan covers 100% of in-network costs for the rest of the year.

Most Medicare Advantage plans include Part D drug coverage and are called MAPD plans. MA-only plans require a separate Part D plan. The standard Part D deductible in 2026 is $615, per Medicare.gov. Some plans waive this deductible for preferred drug tiers. A plan's formulary and tier structure are as important as the premium when assessing total prescription costs. 

Check the plan's formulary before you enroll. Drug formularies group medications into tiers: lower-tier drugs have lower copays and higher-tier drugs cost more. A $0-premium plan can cost far more over the year if your prescriptions are in a high cost-sharing tier. Check any plan's formulary at Medicare.gov or on the plan's website. Prescription drug costs vary by state and plan type, which makes a formulary check non-negotiable before you sign up.

Medicare Advantage plans can include benefits that Original Medicare doesn't pay for. Benefit scope and dollar limits differ widely by plan and by region. Read the Evidence of Coverage (EOC) to see exact annual limits, since limits reset every January 1. Common extra benefits in 2026 Medicare Advantage plans include: 

• Routine dental care: cleanings, X-rays and fillings
• Vision care: eye exams and prescription eyeglasses or contact lenses
• Hearing care: hearing exams and hearing aids
• Fitness memberships such as SilverSneakers programs
• Transportation to and from medical appointments
• Over-the-counter health supply allowances
• Meal delivery after a qualifying hospital stay
• Telehealth and remote monitoring services
• Mental health services beyond Original Medicare's standard coverage 
  

For dental specifically, check whether the plan covers routine care or only emergency procedures. Dental coverage under Medicare through a Medicare Advantage plan works differently from medical coverage, and annual dollar limits vary widely by plan.

CMS rates every Medicare Advantage plan on a 1-to-5-star scale each year. Ratings cover quality of care, chronic condition management, member satisfaction and customer service. A rating of 4 stars or higher shows above-average performance. Plans rated 5 stars allow you to switch at any time during the year, not just during the Annual Enrollment Period. Check ratings at Medicare Plan Finder on Medicare.gov before you enroll.

Medicare Advantage enrollment is time-restricted. You can join, switch or drop a plan only during specific windows each year. Four periods govern when changes take effect: your Initial Enrollment Period, the Annual Enrollment Period each fall, the Medicare Advantage Open Enrollment Period each January and Special Enrollment Periods tied to qualifying life events such as moving or losing employer coverage. 

New to Medicare? MoneyGeek's guide to who qualifies for Medicare covers eligibility requirements, and how to sign up for Medicare covers the initial enrollment steps.

Most people who regret their Medicare Advantage plan made the same errors: they chose based on premium, skipped the formulary check or didn't confirm their doctors were in-network before the deadline passed. Plan rates, benefits and provider networks change every January 1. Miss the Annual Enrollment Period, which closes Dec. 7, and you wait a full year to switch. Avoid these six errors before you decide.

Choosing a Medicare Advantage plan takes more than comparing premiums. Your doctors' network status, prescription formulary and annual out-of-pocket maximum matter more than the monthly cost. Compare your options at Medicare Plan Finder on Medicare.gov before the Annual Enrollment Period closes Dec. 7.

MoneyGeek answers the most frequently asked questions about choosing, enrolling in and switching Medicare Advantage coverage in 2026: