Top 5 Questions to Ask When Comparing Medicare Advantage Plans

Choosing a Medicare Advantage plan can feel overwhelming — but it doesn’t have to be. At Premier One Financial, we specialize in helping clients make confident healthcare decisions as they transition into retirement.

If you're comparing Medicare Advantage plans, these five essential questions will help you make the best possible choice for your health and your wallet.

Are My Doctors and Specialists In-Network?

Most Medicare Advantage plans (especially HMOs and PPOs) have specific networks of doctors and hospitals. If you choose a plan where your current providers are out-of-network, you may face higher costs or need to switch doctors altogether.

Ask:

• “Can I keep seeing my current primary care physician and specialists?”

• “Are my preferred hospitals or clinics included in the plan’s network?”

Tip from Premier One Financial:We recommend checking provider directories carefully and confirming directly with your doctor’s office before enrolling.

Are My Prescriptions Covered — and at What Cost?

Not all Medicare Advantage plans cover every medication. Each plan has a formulary, or list of approved drugs, categorized into tiers that determine cost.

Ask:

• “Are my regular medications on the plan’s formulary?”

• “What are the copays or coinsurance for generic vs. brand-name drugs?”

• “Does the plan require prior authorization for any of my prescriptions?”

Bonus Tip:Some plans include mail-order pharmacy benefits that may reduce your overall costs.

Does the Plan Include Dental, Vision, or Hearing Coverage?

Original Medicare doesn't cover routine dental, vision, or hearing services — but many Medicare Advantage plans do.

Ask:

• “What dental services are included (cleanings, X-rays, dentures)?”

• “Are eyeglasses and hearing aids covered?”

• “Are there annual limits on coverage for these services?”

At Premier One Financial, we help you compare these benefits side-by-side to find plans that offer real value beyond basic healthcare.

What Are the Out-of-Pocket Costs?

It’s not just about premiums. Look at the total out-of-pocket costs you might incur — including deductibles, copays, and coinsurance.

Ask:

• “What’s the plan’s annual out-of-pocket maximum?”

• “How much will I pay for a specialist visit, emergency care, or hospitalization?”

• “Are there any hidden costs I should be aware of?”

Understanding the full cost picture is key to avoiding surprise bills — especially if you have chronic conditions or expect to use healthcare services frequently.

What Extra Benefits Does This Plan Offer?

Many Medicare Advantage plans offer extra perks to stand out — but not all benefits are equally valuable.

Ask:

• “Does the plan include transportation, fitness memberships, over-the-counter credits, or wellness programs?”

• “Are these benefits easy to use, or do they require extra steps?”

• “Do the extras actually align with my lifestyle and needs?”

At Premier One Financial, we always advise clients to focus on practical value — not just flashy extras.

There’s no “one-size-fits-all” Medicare Advantage plan. The right choice depends on your current health, budget, and personal preferences. By asking the right questions, you’ll feel confident that your plan is working for you — not the other way around.

Need Help Making the Right Choice?

At Premier One Financial, we don’t just sell plans — we help you make informed, strategic decisions that support your long-term well-being and financial security.

Schedule a no-pressure Medicare review with one of our advisors today. Let’s find the plan that truly fits you.