Medicare Advantage Plans for 2027: 7 Questions to Ask Before Choosing a Plan
Medicare’s Annual Enrollment Period is right around the corner. From October 15 through December 7, 2026, you can review your options, switch Medicare Advantage plans, or move between Medicare Advantage and Original Medicare for coverage beginning January 1, 2027.
Choosing among Medicare Advantage plans does not have to feel overwhelming. The right plan depends on your doctors, prescriptions, budget, travel habits, and health needs, not just the monthly premium or a list of extra benefits.
Use these seven questions to make your comparison easier. And if you want personal guidance, we can help you review your situation during a free consultation.
Medicare Advantage or Original Medicare + Medigap?
Before comparing individual plans, it helps to understand the two main paths.
Medicare Advantage, also called Medicare Part C, is offered by private insurance companies approved by Medicare. Most plans combine hospital and medical coverage with prescription drug coverage. Many also include benefits such as dental, vision, hearing, fitness programs, or over-the-counter allowances. Medicare Advantage plans usually use provider networks and copays or coinsurance for covered services.
Original Medicare includes Part A and Part B. You may add a standalone Part D prescription drug plan and a Medicare Supplement Insurance policy, also called Medigap. Medigap can help pay certain out-of-pocket costs left by Original Medicare, depending on the plan you choose.
Medigap policies are not designed to work with Medicare Advantage. If you enroll in Medicare Advantage, you generally cannot use Medigap to pay that plan’s copays or coinsurance.
Read our Medicare Supplement and Medigap overview for a helpful look at the other coverage path. Then use the questions below to compare Medicare Advantage plans based on your actual needs.
1. Does My Preferred Doctor and Hospital Accept the Plan?
Your doctors are one of the most important parts of your Medicare coverage. Before choosing a plan, check whether your:
- Primary care doctor
- Specialists
- Preferred hospital
- Pharmacy
- Clinics, labs, and imaging centers
are included in the plan’s network.
Do not stop after checking one doctor. If you regularly see a cardiologist, orthopedic specialist, oncologist, or other provider, confirm each one separately. Also check whether your preferred hospital is in-network for planned procedures, not only emergencies.
Provider directories can change, and online information may not always be current. Call the doctor’s office and the plan to confirm network participation for 2027.
Your next step: Write down your important providers before you compare plans. If keeping your current doctors is a priority, tell us during your free consultation and we can help you focus on plans that fit your situation.
2. Are My Prescription Drugs Covered, and What Tier Are They?
A Medicare Advantage plan with prescription drug coverage is often called an MAPD plan. Each plan has a formulary, which is the plan’s list of covered medications.
Review every prescription you take. Include the:
- Exact drug name
- Dosage
- Quantity
- Number of refills
- Pharmacy you prefer
Then check whether each medication is covered and what tier applies. A higher tier may mean a higher copay or coinsurance. Also look for restrictions such as prior authorization, quantity limits, or step therapy.
Your preferred pharmacy matters, too. Some plans offer lower costs when you use a preferred in-network pharmacy or mail-order service.
The official Medicare Plan Compare tool allows you to enter your prescriptions and pharmacies so you can compare estimated costs. You can also review your current plan’s Annual Notice of Change and Evidence of Coverage when those documents arrive.
Your next step: Keep a current medication list handy. We can help you organize the questions, but always verify final drug coverage directly with the plan before enrolling.
3. What Are the Total Out-of-Pocket Costs?
A $0 premium may sound attractive, but it is only one part of the cost picture. Compare what you could pay throughout the year, including:
- Monthly plan premium
- Medicare Part B premium
- Annual medical deductible
- Primary care copays
- Specialist copays
- Hospital copays or coinsurance
- Emergency room costs
- Lab work and imaging
- Prescription drug costs
- Annual maximum out-of-pocket limit
Every Medicare Advantage plan has an annual maximum out-of-pocket limit for covered Part A and Part B services. Once you reach that limit, the plan pays 100% of covered Part A and Part B services for the rest of the plan year. The limit varies by plan, so compare it carefully.
Look at both a typical year and a difficult year. A plan with a low monthly premium may have higher costs when you need frequent appointments, outpatient procedures, or hospital care.
Your next step: Compare estimated yearly costs, not just premiums. We can help you review copays, deductibles, coinsurance, and the plan’s maximum out-of-pocket limit in plain language.
4. Is It an HMO or PPO?
Plan type affects how you receive care.
An HMO, or Health Maintenance Organization, usually requires you to use in-network doctors and facilities except for emergencies, urgent care, or certain approved situations. You may also need a referral to see a specialist.
A PPO, or Preferred Provider Organization, generally allows you to use in-network or out-of-network providers. However, out-of-network care typically costs more, and not every service may be covered in the same way.
Ask:
- Do I need referrals for specialists?
- Is prior authorization required for certain procedures?
- Is routine out-of-network care covered?
- What will I pay if I use an out-of-network provider?
- Does the plan work well if I travel or spend part of the year elsewhere?
Neither plan type is automatically best for everyone. An HMO may work well if your preferred providers are in-network and you want predictable in-network costs. A PPO may be a better fit if flexibility is important and you understand the higher out-of-network costs.
Your next step: Choose the network rules that match your lifestyle. A local agent or local broker can explain the practical differences and help you compare plans available where you live.
5. Are the Extra Benefits Actually Useful to Me?
Many Medicare Advantage plans include extra benefits that Original Medicare generally does not cover. Depending on the plan, these may include:
- Dental exams, cleanings, or allowances
- Vision exams and eyewear benefits
- Hearing exams or hearing aid benefits
- Fitness memberships
- Over-the-counter allowances
- Transportation benefits
- Meal or wellness programs
These benefits can be valuable, but only if they fit your needs and are easy for you to use.
Ask how often the benefit is available, which providers accept it, and whether there are limits, approved vendors, spending deadlines, or service-area restrictions. A large benefit allowance may not help if the participating provider is far away or the items you need are excluded.
Review Fidelity Insurance Group’s Dental, Vision, and Hearing plan information if you are also considering standalone supplemental coverage.
Your next step: Circle the benefits you will realistically use. Then compare the full plan, not just the most exciting benefit in the brochure.
6. Is the Provider Network Stable and Is the Plan Rated Well?
A plan’s network can affect your experience throughout the year. Look for signs that your important providers and facilities will remain available in 2027.
Review your current plan’s Annual Notice of Change and Evidence of Coverage. These documents may identify changes to the network, benefits, costs, or drug coverage. For a new plan, confirm provider participation before enrolling.
You should also check the plan’s Medicare Star Rating. Medicare rates many Medicare Advantage and Part D plans on a scale from one to five stars. Ratings consider areas such as member experience, customer service, preventive care, and health outcomes.
A higher rating is a helpful signal, but it should not be your only deciding factor. A highly rated plan may still exclude your doctor or place your prescriptions on an expensive tier.
Your next step: Compare Star Ratings alongside doctors, drugs, costs, and network rules. The Medicare Plan Compare tool is a good place to start.
7. How Will This Plan Work With My Existing Medicare Coverage?
If you enroll in Medicare Advantage, the plan becomes the way you receive your Medicare Part A and Part B benefits. You generally continue paying your Part B premium, and you follow the plan’s network and coverage rules.
You also cannot use a Medigap policy with Medicare Advantage. If you currently have Original Medicare, Medigap, and a Part D plan, switching to Medicare Advantage changes how your coverage works. If you later return to Original Medicare, your ability to buy a Medigap policy may depend on your timing, state rules, guaranteed-issue rights, and medical underwriting.
Do not cancel existing coverage until your new enrollment is confirmed and you understand the effective date. Compare both options carefully:
Your next step: Tell us what coverage you have now before you make a change. We can help you review how a new plan fits into your overall Medicare situation.
Get Ready for the 2027 AEP
The Annual Enrollment Period for 2027 coverage runs October 15 through December 7, 2026. Changes made during this period generally begin January 1, 2027, if the enrollment request is received by December 7.
Before AEP begins, gather your:
- Current plan documents
- Provider and hospital list
- Prescription list
- Preferred pharmacy information
- Budget and coverage priorities
Then schedule a free consultation with Fidelity Insurance Group. We have provided 100% telephonic consultations since 2008, so you can review your options from home and on your schedule. Video consultations are also available.
Schedule your free Medicare consultation or learn more about Medicare Advantage. Simply tell us about your situation, and we can help you compare available options with less stress and more confidence.
Important Medicare Disclosures
Fidelity Insurance Group, LLC is not affiliated with or endorsed by the U.S. government or the federal Medicare program.
Plan availability, benefits, premiums, provider networks, formularies, costs, and service areas vary by plan and county. We do not offer every plan available in your area. Any information we provide is limited to the plans we offer in your area. Please contact Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to obtain information about all of your options.
This material is for educational purposes only and is not a complete description of benefits. For complete information about costs, coverage, limitations, exclusions, and applicable rules, review the plan’s official materials, including the Evidence of Coverage and Summary of Benefits. Contact the plan directly for additional information.
Medicare Advantage plan enrollment is subject to eligibility and applicable enrollment periods. Availability of plans and benefits may change for 2027. Fidelity Insurance Group, LLC does not guarantee enrollment, coverage, provider participation, drug coverage, or savings.