More than 34 million Americans — over half of all Medicare-eligible individuals — are enrolled in a Medicare Advantage plan rather than Original Medicare. Yet a recent survey found that 48% of Medicare Advantage enrolls are unaware they have an annual opportunity to switch plans, potentially leaving significant savings on the table.
In fact, beneficiaries who compared their previous coverage to newer 2026 plans found an average potential savings of $1,676 per year in out-of-pocket costs. This guide explains how Medicare Advantage works, compares top-rated companies for 2026, and shows you exactly how to find the best plan for your needs.
Medicare Advantage vs. Original Medicare: What’s the Difference?
Understanding this distinction is the foundation for every other decision:
| Factor | Original Medicare (Parts A & B) | Medicare Advantage (Part C) |
|---|---|---|
| Who administers it | Federal government directly | Private insurance companies |
| Monthly premium | $0 for Part A; ~$202.90/month for Part B | Average $14/month (many plans $0) |
| Extra benefits | None included | Often includes dental, vision, hearing |
| Provider network | Any provider accepting Medicare | Often restricted to in-network providers |
| Prescription drugs | Requires separate Part D plan | Usually included (MA-PD plans) |
| Out-of-pocket maximum | No cap (unless you add Medigap) | Annual cap required by law |
| Referrals needed | No | Often yes, for HMO-style plans |
The trade-off in simple terms: Medicare Advantage typically costs less and includes more extra benefits, but comes with more restricted provider networks and tools like prior authorization. Original Medicare offers maximum flexibility to see any provider, but at higher potential out-of-pocket cost unless paired with a Medigap supplement policy.
How CMS Star Ratings Work (And Why They Matter)
Every year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage and Part D plans on a 1-to-5 star scale based on preventive care, chronic condition management, customer service, and overall member experience.
- 4 stars or higher = considered top-tier; these plans receive CMS bonus payments
- 5-star plans offer a unique enrollment advantage: you can switch to a 5-star plan once during the year, outside the standard enrollment window
- Star ratings can change annually as insurers update their networks, formularies, and benefits
Always check the current star rating on Medicare.gov before enrolling or renewing, since a plan you liked last year may have changed significantly.
Best Medicare Advantage Companies in the USA — 2026
1. Kaiser Permanente — Highest Overall Ratings
Kaiser Permanente consistently earns some of the highest CMS star ratings in the industry, largely due to its integrated care model where insurance and care delivery operate under one roof.
- Typical star rating: 4–5 stars in most regions
- Best for: Members in Kaiser’s service areas who want coordinated, preventive-focused care
- Available in: Limited states (primarily California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington)
- Standout feature: Seamless coordination between primary care, specialists, and pharmacy
If you live in a Kaiser service area, its consistently high star ratings make it one of the strongest options for overall care quality.
2. UnitedHealthcare — Largest National Network
UnitedHealthcare is the largest Medicare Advantage provider in the country by enrollment, offering extensive plan variety and one of the widest provider networks available.
- Typical star rating: 3.5–4.5 stars depending on contract and region
- Best for: Those wanting maximum plan choice and broad provider access
- Standout feature: Wide range of Special Needs Plans (SNPs) and strong telehealth integration through Optum
UHC’s sheer scale means more plan options are typically available in more counties than with smaller regional insurers.
3. Humana — Strong Regional Performance
Humana has built a reputation for strong performance in specific regions, with notably high J.D. Power satisfaction scores in states like Georgia and North Carolina.
- J.D. Power regional scores (2025): Ranked highest in Georgia (648) and North Carolina (663) on a 1,000-point scale
- Best for: Members in Humana’s strongest-performing states; those prioritizing customer service
- Standout feature: Extensive wellness and fitness program inclusions (often through SilverSneakers-style benefits)
Performance varies meaningfully by state and even by county, so always check region-specific ratings rather than assuming national reputation applies everywhere.
4. Aetna (CVS Health) — Best for Pharmacy Integration
Aetna’s Medicare Advantage plans benefit from deep integration with CVS pharmacy and MinuteClinic locations, offering convenience for members who fill prescriptions regularly.
- Best for: Members who want pharmacy benefits closely tied to a major retail pharmacy chain
- Standout feature: CVS HealthHUB locations offering integrated wellness services alongside standard pharmacy
- Available in: Most states nationwide
5. Blue Cross Blue Shield — Best for Broad State Availability
Operating through 36 regional companies, BCBS offers Medicare Advantage plans with some of the broadest geographic availability of any insurer, making it a reliable option regardless of where you live.
- Best for: Those wanting consistent brand recognition and broad doctor acceptance nationwide
- Standout feature: Strong existing relationships with most major hospital systems and physician networks
What Extra Benefits Do Medicare Advantage Plans Include?
Virtually all Medicare Advantage plans for 2026 include multiple extra benefits beyond what Original Medicare covers:
| Extra Benefit | % of Individual Plans Offering It (2026) |
|---|---|
| Dental coverage | Majority of plans |
| Vision coverage | Majority of plans |
| Hearing coverage | Majority of plans |
| Fitness benefits (gym memberships) | 93% |
| Over-the-counter item allowance | 66% |
| Acupuncture | 34% |
| Transportation for medical needs | 24% |
| Bathroom safety devices | 21% |
| Reduction in Part B premium | 32% |
Note on Special Needs Plans (SNPs): Plans designed for those with specific chronic conditions or dual Medicare/Medicaid eligibility tend to offer even richer benefits — 67% include transportation assistance and 25% include in-home support services, compared to lower rates among standard individual plans.
How Much Does Medicare Advantage Cost in 2026?
- Average monthly premium across all enrollees: Approximately $14/month (many beneficiaries pay $0)
- Average number of MA-PD plan options per beneficiary: 32 plans in 2026 (down slightly from 34 in 2025)
- Average total plan options (with or without drug coverage): 39 plans, compared to 42 in 2025
While the number of available plans has decreased slightly, virtually all current plans continue to offer multiple extra benefits similar to prior years.
When Can You Enroll or Switch Plans?
Understanding Medicare’s enrollment periods is essential to avoid missing your opportunity to switch:
| Enrollment Period | Dates | What You Can Do |
|---|---|---|
| Annual Open Enrollment | October 15 – December 7 | Switch between any Medicare Advantage or Part D plans, or move to/from Original Medicare |
| Medicare Advantage Open Enrollment | January 1 – March 31 | Switch to a different Medicare Advantage plan, or return to Original Medicare |
| 5-Star Special Enrollment | Anytime | Switch once to a 5-star rated plan if one is available in your area |
| Special Enrollment Periods | Triggered by qualifying events | Moving, losing other coverage, qualifying for Medicaid, and other specific situations |
Critical fact: Nearly half of Medicare Advantage enrollees are unaware that the January–March enrollment window exists, meaning many miss a second yearly chance to switch to better coverage.
How to Compare Medicare Advantage Plans Effectively
Step 1: Use the Medicare Plan Finder Medicare.gov’s official Plan Finder tool lets you compare pricing and benefits across Original Medicare, Medicare Advantage, Part D, and Medigap options side by side.
Step 2: Check star ratings, not just price A cheaper plan with a 2-star rating may indicate poor customer service or care coordination issues. Prioritize plans rated 4 stars or higher when costs are otherwise similar.
Step 3: Verify your doctors are in-network Medicare Advantage plans often use restricted networks. Confirm your current doctors and preferred hospital accept the specific plan before enrolling.
Step 4: Review the prescription drug formulary If you take regular medications, check which tier they fall into and what your specific copay will be — this varies significantly between plans even within the same company.
Step 5: Calculate your realistic total annual cost Add the premium, deductible, expected copays, and the plan’s out-of-pocket maximum. A $0-premium plan with high copays may cost more in a bad health year than a plan with a modest premium and lower cost-sharing.
Frequently Asked Questions About Medicare Advantage
Q: Is Medicare Advantage better than Original Medicare? Neither is universally “better” — it depends on your priorities. Medicare Advantage typically offers lower costs and extra benefits like dental and vision, but with network restrictions. Original Medicare offers more provider flexibility but no out-of-pocket cap unless paired with Medigap.
Q: Can I switch from Medicare Advantage back to Original Medicare? Yes. This can be done during the Medicare Advantage Open Enrollment Period (January 1 – March 31) or the Annual Open Enrollment Period (October 15 – December 7). Note that switching back to Original Medicare may require medical underwriting if you want to add a Medigap policy at that point, depending on your state.
Q: Why did my Medicare Advantage plan change or get terminated? Insurers can modify or discontinue plans annually. The number of enrollees facing plan terminations has been increasing, making it more important than ever to review your Annual Notice of Change letter each fall.
Q: What is a 5-star Medicare Advantage plan? It is a plan that achieved the highest possible CMS quality rating. These plans also come with a unique benefit: you can enroll in a 5-star plan once during the year, even outside normal enrollment windows, if one is available in your service area.
Q: Do all Medicare Advantage plans include prescription drug coverage? No. While many plans (called MA-PD plans) include Part D drug coverage, some Medicare Advantage plans do not. Always verify this specifically when comparing options.
Q: How do I know if a plan covers my specific doctors and medications? Use the Medicare Plan Finder tool, or call the plan directly with your doctors’ names and your medication list. Network and formulary details are also typically available in each plan’s “Evidence of Coverage” document.
Final Verdict: Best Medicare Advantage Plans by Need
| Need | Best Company |
|---|---|
| Highest overall quality ratings | Kaiser Permanent (where available) |
| Largest plan selection nationally | United Healthcare |
| Strong regional performance | Humans |
| Pharmacy-integrated convenience | Etna (CVS Health) |
| Broadest nationwide availability | Blue Cross Blue Shield |
The most valuable single action you can take is to compare your current plan against new 2026 options during open enrollment — beneficiaries who do this find meaningful savings on average. Do not assume your current plan is still the best fit; insurers update premiums, networks, and benefits every single year.
