The best Medicare Advantage is different for everyone.
Believe me, I know this is a frustrating answer, but it’s 100% true.
In fact, if someone tries to tell you the best Medicare Advantage plan without talking to you about your specific healthcare needs and budget, they’re not being honest with you. And all those websites that have lists of the “best” or “top rated” Medicare Advantage plans are just regurgitating mostly irrelevant information.
I would never—ever—tell anyone that they should get a specific plan without talking to them first. See, there are thousands of Medicare Advantage plans out there. A plan that’s the obvious best fit for your wife or best friend could be a terrible plan for you. That’s because individual healthcare needs and Medicare Advantage plans can be very different.
If you have doctors you prefer to see, prescriptions you need to take, and preferences about your monthly premium and out-of-pocket cost limitations, then you should look only at plans that fit those needs and preferences to find the best Medicare Advantage plan for you.
Not your neighbor. Not your best friend. YOU.
To find the best Medicare Advantage plan for you, you should:
Only look at plans that have your preferred doctors in network and cover your prescriptions at a reasonable cost.
Consider all costs associated with a plan: the monthly premium, the annual deductible, copays and coinsurance amounts, and the total out-of-pocket costs you would incur.
Look at extra benefits that the plans fitting the top two criteria have and decide which of those benefits would provide the most value to you.
Consider star ratings and any other preferences you have about your healthcare plan.
My team is happy to help you understand your options and get through each of these steps. In fact, Chapter exists because comparing Medicare plans takes hours and causes people an immense amount of stress. We don’t want anyone to have to go through this alone, and we want everyone on Medicare to have the best coverage for their needs.
In case you don’t believe me, and you still think there really is a best Medicare Advantage plan, let me explain further.
Everyone doesn’t have access to the same Medicare Advantage plans
Each Medicare Advantage plan is only available to a subset of people, either due to where you live or your health or financial situation.
Specific Medicare Advantage plans are only available in certain counties. Some counties don’t have any Medicare Advantage plans. Off the bat, this means that there cannot be a best Medicare Advantage plan nationwide.
Many Medicare Advantage plans are Special Needs Plans (often called SNPs). These plans are only available to people who meet certain requirements (usually related to a health condition or their financial situation).
Then, should I choose the highest rated Medicare Advantage plan that’s available to me?
You’ll find many lists of the “highest rated” Medicare Advantage plans. These lists are mostly clickbait.
They aren’t necessarily false. The ratings may be accurate, but the way many people make these articles sound like they’ll tell you the “best plan” is misleading.
It’s true. Medicare Advantage plans have star ratings from 1-5 (with 5 being the best score). These ratings are intended to provide people with some information about how good the customer experience is for each plan.
But Medicare plan star ratings don’t matter if your doctor isn’t in network, your prescriptions aren’t covered, or you can’t afford the care you need. An article about “the best” or “highest rated” Medicare plans cannot replace a personalized recommendation based on your needs.
The most important thing to look at when you choose a Medicare Advantage plan is if that plan supports your health and financial needs.
Check:
Are your doctors in network?
Are your prescriptions covered—and are the copays affordable?
Can you afford the monthly premium for the plan, if there is one? (remember you will also still owe the Part B premium)
Are the copays, coinsurance, and annual out-of-pocket limit the best you can get?
Once you’ve checked for all of these, then you can consider star ratings.
You can also consider:
Extra benefits that plans offer, like OTC allowances, gym memberships, dental, vision, and hearing coverage,etc.
Any insurance carriers you prefer. Many people have been with one insurance company for many years and would like to stay with that company if they can. Some insurance companies are also known for better customer service or specific benefits.
Network flexibility that allows you to go out-of-network to see providers, or receive medical care when you travel outside the US.
About the Author: Ari Parker is the Lead Medicare Advisor at Chapter and author of the bestselling Medicare book, It's Not That Complicated." His approach to Medicare planning has been featured in The New York Times, The Wall Street Journal, and Forbes.
