5 Questions to Ask Before Choosing a Medicare Advantage Plan

Don’t Choose Blindly — Choose Confidently

Medicare Advantage (Part C) can be a great option for many retirees—it often includes extra benefits like vision, dental, and wellness programs. But not all plans are created equal, and making the wrong choice can lead to coverage gaps or unexpected costs.

At Premier One, we help individuals in [your region] make smart, informed decisions. Before you sign up for a Medicare Advantage plan, be sure to ask these five essential questions.

Does This Plan Cover My Doctors and Hospitals?

Not all Medicare Advantage plans include your preferred providers. Many plans use networks, such as HMOs or PPOs, that limit which doctors and hospitals you can see.

Ask:

• Is my primary care doctor in-network?

• What about specialists or nearby hospitals?

• Can I see providers out of state if I travel or relocate part-time?

What Prescription Drugs Are Covered—and at What Cost?

Every Medicare Advantage plan has a drug formulary, which is a list of covered medications. Even if two plans look similar, their drug coverage can vary greatly.

Ask:

• Are my current prescriptions on the formulary?

• What tier are they in (affects cost)?

• Is there prior authorization or step therapy required?

We help you compare Part D coverage within Advantage plans, so you don’t pay more than necessary for your medications.

What Will I Pay Out of Pocket Each Year?

While many Advantage plans have $0 premiums, that doesn’t mean $0 out-of-pocket. You’ll want to know how much you'll pay when you actually use the plan.

Ask:

• What’s the maximum out-of-pocket limit?

• What are the copays for office visits, specialists, and ER visits?

• Are there extra charges for labs, imaging, or hospital stays?

We’ll walk you through every line of the Summary of Benefits so there are no surprises later.

What Extra Benefits Are Included?

Many people are drawn to Medicare Advantage because of added perks like:

• Vision and dental

• Hearing aids

• Over-the-counter (OTC) allowances

• Gym memberships or wellness programs

• Transportation to appointments

Ask:

• What extra benefits are included?

• Are they automatically provided, or do I need to opt in?

• Are there limits or restrictions on how I use them?

Some benefits may sound great in ads but have narrow availability—our team helps you find real value that fits your lifestyle.

What Happens If My Health Needs Change?

Medicare Advantage plans are annual contracts—you’re locked in for the calendar year unless you qualify for a Special Enrollment Period.

Ask:

• What if I develop a chronic condition next year—will this plan still work?

• What’s the process for switching plans if needed?

• Can I return to Original Medicare in the future?

We help you weigh your options based on long-term flexibility, not just short-term savings.

Choose the Right Plan with Expert Help

Medicare Advantage can be a great fit—if you pick the right plan for your doctors, medications, budget, and future needs. At Premier One, we specialize in helping you compare plans from top insurance carriers and find the best match for your unique situation.

Need help choosing a Medicare Advantage plan that works for you?

Contact Premier One for free, unbiased guidance from local experts who care. We’ll help you ask the right questions—and get the right answers.