How do I compare worst-case costs across Medicare plans?
The short answer
To compare worst-case costs across Medicare plans, look at each plan's out-of-pocket maximum, not just the monthly premium. That ceiling tells you the most you could owe in a bad year before the plan covers 100% of covered costs.
The full explanation
The premium is just the entry fee. The number that really matters when comparing plans is the out-of-pocket maximum, which is the most you'd have to pay in a single year before the plan picks up everything else for covered services. Medicare Advantage plans are required to have this cap. Original Medicare alone does not have one, which is why many people pair it with a Medigap (supplemental) policy.To do a real worst-case comparison, pull up each plan's Summary of Benefits and find three numbers: the monthly premium, the deductibles (what you pay before coverage kicks in), and the annual out-of-pocket maximum. Then do some rough math. Add your annual premiums to the out-of-pocket max. That total represents roughly how bad a year could get.Also check whether your regular doctors and any hospitals you'd want to use are in-network. Going out of network can blow past the in-network out-of-pocket max entirely on some plan types. And if you take prescriptions, run your specific drugs through the plan's formulary tool before you decide. A low premium plan with poor drug coverage can cost you far more in the end.Plan details vary by carrier and change each year, so always verify current figures during the Annual Enrollment Period or when you first sign up.
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