Three things to compare
Medicare plan comparison breaks down to three core questions:
- Are my doctors and hospitals in the network?
- Are my medications covered, and at what cost?
- What's my total yearly cost: premiums plus what I expect to pay when I get care and fill prescriptions?
Everything else, such as extra benefits, plan ratings and customer service, comes after those.
Tools to compare plans
- Medicare Plan Finder at Medicare.gov/plan-compare, run by Medicare. Enter your ZIP code, medications and pharmacy to see estimated costs for the Medicare Advantage and Part D plans in your area. 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) can also help.
- Licensed insurance agents can compare plans from the insurance companies they work with. Call (206) SENIORS (206-736-4677), TTY 711 to reach a licensed insurance agent with Benefits Life, at no cost to you, or find a licensed insurance agent in Washington.
- Plans in your ZIP code: see plans in your ZIP code.
- Medigap premiums: the Washington Office of the Insurance Commissioner publishes a list of approved Medigap plans and their monthly premiums (linked in Sources).
How to compare Medicare Advantage plans
Use this checklist for each plan you're considering. Each plan's Summary of Benefits and Evidence of Coverage show these details:
- Premium: the plan's monthly premium, if any, on top of your Part B premium
- Out-of-pocket maximum: the yearly limit on what you pay for covered in-network care (no higher than $9,250 in 2026)
- Primary care and specialist copays, and whether you need referrals
- Hospital stays: how the plan charges for an inpatient stay, for example a copay per day for a set number of days
- Are your doctors in the network? Confirm by name with the plan for the coming year
- Are your hospitals in the network? Especially important for cross-border care between Vancouver and Portland or Clarkston and Lewiston
- Drug list (formulary): check each medication and its tier
- Pharmacies: your local pharmacy may be preferred, standard or out of network
- Extra benefits: Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
- Star Rating: Medicare's 1-to-5-star quality and service measure
- Is the plan continuing? Many Washington Medicare Advantage plans end December 31, 2026; see plans ending in 2027
How many plans you can choose from depends on your county. For 2027, CMS lists 71 Medicare Advantage plans open to everyone in Washington, from 14 companies; see Medicare Advantage in Washington for county counts.
How to compare Medigap plans
Medigap plans are standardized, so for the same plan letter, comparison comes down to price and service:
- Get quotes from several companies for the same plan letter, such as Plan G or Plan N.
- Washington requires community rating and bans attained-age rating, so companies can't raise your premium because you get older (RCW 48.66.045(3); WAC 284-66-310). Premiums can still rise for inflation and claims.
- Ask how each company's premiums have changed over recent years. Rate changes must be approved by the insurance commissioner (WAC 284-66-243).
- Check the company's financial strength ratings from independent rating agencies.
- If you already have Medigap, you can switch to another company's plan at any time without health questions (Plan A to Plan A, or any other plan to Plan B through N). See Medigap in Washington.
How to compare Part D plans
Part D comparison depends on your own medications. The same plan can fit one person well and another poorly, depending on which drugs are covered and at what tier.
- List every medication you take, with dose and how often
- Note your preferred pharmacy
- Run the comparison in Medicare Plan Finder for estimated yearly cost
- Check that any specialty drugs are on the drug list at a tier you can manage
- Check whether mail order could lower your costs
In 2026, what you pay for covered Part D drugs is capped at $2,100 for the year, and covered insulin costs no more than $35 for a month's supply. More on Part D in Washington.
Washington-specific considerations
Cross-state care
Vancouver residents who use Portland providers, Clarkston residents who use Lewiston, Idaho, hospitals, and Pullman residents who use Moscow, Idaho, all need to check out-of-state network coverage. Some plans include those providers; others don't.
Ferry-dependent areas
People in the San Juan Islands and other ferry-dependent communities should check which mainland specialists and hospitals are in the network. See ferry-dependent health care.
Tribal health
American Indian and Alaska Native people can use Indian Health Service and tribal facilities along with Medicare. In Washington's Apple Health Medicare Connect plans (D-SNPs), Indian Health Care Providers are treated as in-network, according to the Health Care Authority. More
Snowbirds
If you spend winters out of state, a PPO or Original Medicare with Medigap may fit better than an HMO. More
Annual review during the Annual Enrollment Period
Even if you're happy with your plan, plans change every year. Review your options during the Annual Enrollment Period (October 15 to December 7). Things to re-check:
- Is your plan continuing next year?
- Has the premium changed?
- Are all your medications still on the drug list at the same tier?
- Are your doctors still in the network?
- Has the out-of-pocket maximum changed?
- Have extra benefits changed?
The plan you chose two years ago may not fit as well now, even if your situation hasn't changed. See our open enrollment guide.
Sources
- Medicare.gov — Medicare Plan Finder
- Medicare.gov — Compare Medigap plan benefits
- CMS — Medicare Advantage and Part D Landscape files, contract year 2027
- Washington State Legislature — RCW 48.66.045, Replacement policies; community rating
- Washington State Legislature — WAC 284-66-243, Filing and approval of policies and premium rates
- Washington State Legislature — WAC 284-66-310, Attained age rating prohibited
- Washington Office of the Insurance Commissioner — Approved Medigap plans and monthly premiums (PDF)
- Washington State Health Care Authority — Apple Health Medicare Connect (D-SNP) eligibility (PDF)
Frequently asked questions
What's the official Medicare plan comparison tool?
Medicare's Plan Finder at Medicare.gov/plan-compare. It's run by Medicare and lets you enter your ZIP code, drugs and pharmacy to compare Medicare Advantage and Part D plans in your area, with estimated yearly drug costs.
How often should I review my Medicare plan?
Every year during the Annual Enrollment Period (October 15 to December 7). Plans can change their premiums, drug lists, costs and networks each year, and some plans end. Read your Annual Notice of Change each fall.
Should I pick the plan with the lowest premium?
Not necessarily. A plan with a lower premium can cost more over a year if your drugs cost more on it or your doctors aren't in its network. Compare your estimated total yearly cost, not just the premium.
Can a licensed insurance agent compare plans for me?
Yes. A licensed insurance agent can compare plans from the companies they work with, at no cost to you, and check your doctors and drugs. For information on all your options, you can also use Medicare.gov or call 1-800-MEDICARE.
Should I choose a plan by its Star Rating?
Medicare's Star Ratings measure plan quality and service, but they don't tell you whether your own doctors, hospital and medications are covered well. Use them as one factor along with networks, drug coverage and cost.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
