Official data
CMS and Medicare.gov plan, benefit, county, and plan-year sources.
Local context
Plan availability is organized by ZIP code, county, and state.
User inputs
ZIP, prescriptions, providers, and preferences are used only when users choose to enter them.
Primary data sources
- CMS and Medicare.gov plan, benefit, county, and plan-year data.
- Publicly available Medicare plan information and permitted source files.
- User-entered ZIP code, county, prescriptions, provider preferences, and plan preferences when a user chooses to enter them.
How comparisons are displayed
Plan availability is localized because Medicare Advantage and Part D options vary by county and ZIP code. Medicare Choose may display premiums, deductibles, out-of-pocket limits, plan categories, supplemental benefits, Star Ratings, and estimated drug-cost context when enough data is available.
How personalized options are ordered
When you enter prescriptions, options listing all of them in the available formulary appear before options with incomplete or unavailable listing information. Plans without Part D coverage follow those groups. A formulary listing does not confirm restrictions, your pharmacy’s price or final coverage.
Within each prescription group, scores combine available annual costs, quality ratings, requested benefits, medical copays and in-network out-of-pocket limits. Balanced priorities use weights of 35%, 20%, 20%, 15% and 10%, respectively. Priority choices can change those weights. Requested supplemental benefits have equal weight.
When annual cost is unavailable for every candidate, including the current comparison plan when present, we exclude that category for all plans and redistribute its weight proportionally across the other four categories. With balanced priorities, the resulting weights are approximately 30.8% quality, 30.8% requested benefits, 23.1% copays and 15.4% out-of-pocket maximum. When at least one candidate has a known annual cost, all plans retain the original shared weights and unknown costs receive a neutral value of 50. Other missing scoring inputs also receive a neutral value of 50 out of 100. A requested benefit recorded as absent receives 0; one recorded as present receives 100. Unknown costs are never assumed to be zero. Copays and out-of-pocket limits are compared within the eligible candidate set. A score is a sorting aid, not the percentage of your needs met. The displayed shortlist may not include every available plan.
Provider searches do not verify plan networks or contribute to the numerical score. Network-flexibility and medical-cost-preference answers support educational guidance about coverage types. Agent payments do not determine plan ordering.
Important limitations
- Plan details can change and may vary by county, pharmacy, provider, drug dosage, or enrollment status.
- Not every plan, benefit, network detail, pharmacy price, or enrollment rule may be displayed.
- Before enrolling or switching, users should confirm details with Medicare.gov, 1-800-MEDICARE, the plan sponsor, providers, pharmacies, SHIP, or a licensed insurance agent.
How we handle recommendations
Medicare Choose can help users compare options and understand tradeoffs, but it does not make final enrollment decisions. The best plan depends on the user’s doctors, prescriptions, budget, travel habits, benefits, risk tolerance, and personal circumstances.
Learn more about our editorial policy and terms of service.