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Medicare Plan Finder: How to Use It

By Kolt Legette

Jul 14, 2020

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The Medicare Plan Finder is an online tool that helps beneficiaries compare their plan options. In response to user feedback, Medicare revamped the tool so that it's easier to use and offers more relevant information regarding total out-of-pocket costs. This page explains the Medicare Plan Finder tool and how to compare your options.

What Is the Medicare Plan Finder?

The Medicare Plan Finder is one of the many features available on Medicare.gov. It allows you to compare Medicare plans, including Medicare Advantage (also known as Medicare Part C) and Medicare Part D prescription drug plans (PDPs).

The Plan Finder helps Medicare beneficiaries understand their options, especially during the Annual Enrollment Period (AEP). It is also useful during each beneficiary's unique Initial Enrollment Period (IEP). This is the 7-month period that surrounds your 65th birthday. It begins 3 months before the month you turn 65 and ends 3 months after your birth month.

This Medicare comparison tool provides a wide array of plan information, including:

  • Medicare rating
  • Cost details, including monthly premiums, yearly drug costs, and copays/coinsurance
  • Plan benefits
  • Deductibles

Information varies according to whether you're using the Medicare drug plan finder or comparing Medicare Advantage plans.

Changes to the Medicare Plan Finder in 2020

Changes Medicare implemented for 2020 start with making the tool mobile friendly. Previously, you could really only use the Medicare Plan Finder on a desktop or laptop computer. This new mobile-friendly design lets you use your smartphone or tablet without losing functionality.

Medicare also made the new Plan Finder more user-friendly by removing unnecessary details that were often more confusing than helpful. The result is a streamlined tool with information that's easier to understand.

Another valuable update is the default filter, which lists plan options in order of estimated out-of-pocket cost. Previously, the Plan Finder filtered your options according to the monthly premium. And, while the monthly premium is valuable information, it doesn't necessarily reflect the plan's total cost. In fact, rock-bottom premiums often hide higher out-of-pocket costs.

One of the neatest new features is the prescription drug list builder. Use it to see whether a standalone Part D plan or a Medicare Advantage Prescription Drug plan (MA-PD) covers your medications.

If you have a MyMedicare.gov account and you sign into it before using the Plan Finder, it auto-suggests every prescription you've filled in the past 12 months. If you do not have an account, or if you're new to Medicare, you can enter your prescriptions.

Finally, you also have the choice to learn more about your Medicare options. This feature explains the differences between Original Medicare and Medicare Advantage, how to get Medicare drug coverage, and Medicare Supplement Insurance plans (more commonly known as Medigap).

How to Use the Medicare Plan Finder

For personalized results, you should log into your MyMedicare.gov account. This makes it easier to enter your pharmacy and prescription drug information. You can use this link to create your account if you don't have one yet.

You may also use the Plan Finder without logging in. For this option, start by entering your zip code and choosing your county. You may then enter your medications and pharmacies by hand.

Once you've entered the relevant data, Medicare displays the available plans in your area. As you scroll through the results, you can place a check in the "Add to compare" box. Once you've selected the plans that you'd like to learn more about, you get a side-by-side comparison that shows what you'd pay for each service. You'll also see the cost difference between "preferred in-network" pharmacies and "standard in-network" pharmacies.

You should also notice that every listing includes a note that the standard Medicare Part B premium is in addition to the Advantage or Part D plan's premium.

How to Compare Medicare Advantage Plans

To compare Medicare Advantage plans, one of the first things you'll see is the star rating. Plans rated 3 stars and above are considered good quality (with a 5-star rating being the highest). If it has fewer than 3 stars, this indicates significant issues.

Cost details include the monthly premium, yearly drug and premium costs if it's an MA-PD plan, any deductibles, and the yearly max for in-network services. Original Medicare does not have a max out-of-pocket, but Medicare Part C does. You'll also see the copayment or coinsurance amount for covered services, such as primary doctor visits and specialists.

Advantage plan listings also include the main benefits. All Medicare Part C plans must offer the same coverage as Original Medicare (Part A, hospital insurance, and Part B, medical insurance). But most offer additional benefits, such as prescription drug coverage, vision, dental, and hearing aids. If the plan provides these services, it will be listed here. You may also click to see the full list of plan benefits.

How to Compare Medicare Part D Plans

As with the Advantage plans, the Medicare Part D finder starts with the star ratings. And again, you're looking for plans rated 3 stars or higher.

The reason to enter your prescriptions and pharmacy information is because that is how you'll know what the estimated annual cost of the plan is. Without that information, you're just guessing what you'll pay for your medications.

It's also a good idea to review the Part D plan's drug formulary and tier pricing to estimate your out-of-pocket for any medications your doctor may prescribe if you become sick or injured.

How to Compare Medigap Plans

On the main Plan Finder page, you'll see a link that reads "Looking for Medigap policies?" Once you click it and enter your location, you'll see which plans are available in your area, including a short description of each plan's benefits and the average price range.

Medigap plans are standardized, which means Plan A provides the same benefits no matter which insurance provider you choose. So does Medigap Plan B, D, G, etc. Click "Plan Details" to see the full list of what the plan covers and what you'd pay out-of-pocket for covered services. Choose "See Companies" for more information about who sells your preferred plan in your area.

You must apply directly to the private insurance company selling the plan – you cannot apply for or join a Medigap plan through the Medicare plan finder.

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Originally posted on Aug 19, 2020 10:08:20

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Last Updated 10/01/2021