If I only focus on monthly premium, what am I missing?

Trust and Decision
Last updated: 
April 10, 2026
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The short answer

Monthly premium is just one part of what you pay. Deductibles, copays, drug costs, and network limits can end up costing far more than a low premium saves you.

The full explanation

It is easy to shop by premium because it is the number you see every month. But Medicare costs are structured in layers, and the premium is often the least significant one for people who use healthcare regularly.When you go to the doctor, fill a prescription, or have a procedure, you typically pay a share of the cost. That might be a flat copay or a percentage called coinsurance. Those costs add up fast, especially if you have ongoing health needs. A plan with no monthly premium might have a much higher deductible or higher cost-sharing per visit than a plan with a modest premium.Drug coverage deserves its own look. The specific medications a plan covers, and at what cost, depends on the plan's formulary. Two plans with identical premiums can have very different costs at the pharmacy. If you take maintenance medications, the difference can be significant over a year.You also want to understand the plan's network before enrolling. A plan that does not include your primary care doctor or a specialist you see regularly can force you to either switch providers or pay more. And if something serious happens, your hospital and specialist access matter a great deal. Review plan details each year since coverage, costs, and networks can change.

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