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What a free plan comparison actually includes

A real comparison is not a brochure. Here is exactly what we check, what goes in the written summary, and why a plan that fails two specific tests never makes the shortlist.

Walker Bolin Licensed Insurance Broker · Founder
Published
Reading time
5 min read
Length
900 words

“Free plan comparison” is one of the most abused phrases in this industry. It usually means a brochure, or a call center reading a script from whichever carrier pays best that quarter.

Here is what it means when we say it.

The two hard filters, applied first

Before price enters the conversation, two checks eliminate most of the field.

Every doctor, by name. Your primary care physician, every specialist you see, and the hospital you would want to use. Each one gets checked against each candidate plan’s current network file, for the coming plan year — not last year’s directory. A plan that excludes a provider you will not give up is not a candidate, regardless of how good the rest of it looks.

Every prescription, at its tier. Name, strength and quantity, checked against each plan’s formulary, at the pharmacy you actually use. Preferred and standard pharmacies are priced separately, because the same drug can cost meaningfully different amounts two streets apart.

Most plans fail one of these two tests. What survives is a genuine shortlist rather than an alphabetical list of everything sold in your ZIP code.

The numbers that go in the written summary

For each surviving plan:

Figure Why it is there
Monthly premium The number everyone looks at first, and the least useful alone
Annual deductible What you pay before the plan participates
Out-of-pocket maximum The worst realistic year — the single most important figure
Specialist copay Drives cost for anyone managing a condition
Inpatient cost share The largest single exposure in most plans
Drug tier, per prescription Where low-premium plans quietly get expensive
Network status, per provider Already filtered, but shown so you can see it

Then two columns most comparisons skip: a normal year and a bad year. A normal year is premium plus the copays you would realistically incur. A bad year is premium plus the out-of-pocket maximum. A plan is only affordable if the second number is one you could actually absorb.

Why “$0 premium” tells you almost nothing

A $0 plan premium is real — Medicare pays the carrier a monthly amount to manage your care, and a carrier delivering benefits for less than that can offer a $0 plan.

What it does not mean is $0 cost. You still pay your Part B premium, and you pay copays as you use care. Two $0-premium plans in the same county can have out-of-pocket maximums thousands of dollars apart. On the mailer they look identical. In a year with a hospitalization in it, they are completely different products.

What we will tell you that a call center will not

  • That the plan you already have is the right one, when it is.
  • That the extras being advertised at you are worth less than the copay structure underneath them.
  • That the cheapest premium in the county is the most expensive plan for someone with your drug list.
  • That a product someone else recommended is fine and you do not need to move.

We are paid by the carrier when you enroll, which gives us an obvious incentive to recommend change. We would rather keep a client for twenty years than earn a commission this month, and that trade-off is the whole basis of how we work.

What we cannot do

We compare plans from the carriers we are appointed with, which covers most of what is available in most counties. We do not offer every plan available in your area. Where something material sits outside our appointments we will say so plainly and point you at Medicare.gov or your state Marketplace so you can look at it yourself.

Any broker who implies they can see everything is overstating it.

What to have ready

  • Your current insurance card, and the summary of benefits if you have it
  • Every doctor and facility you want to keep
  • Your prescriptions — names, strengths, quantities, read off the bottles
  • Whether you travel or spend part of the year in another state
  • Roughly what feels comfortable monthly, and what a bad year could look like

That is enough for a genuinely useful answer in one conversation.

Try the arithmetic yourself first

If you would rather see the shape of it before calling, the Part D total cost estimator compares three drug plans on annual total rather than premium, and the enrollment window checker works out which windows apply to you.

Then get in touch and we will run the real version — every plan in your county, against your actual doctors and drugs, at no charge.

Full detail on the service is on the plan comparison page.

Frequently asked questions

Does a plan comparison cost anything?

No. There is no fee for the comparison or for enrolling through us. Premiums are filed with regulators and are identical whether you enroll on your own or through a licensed broker.

How long does it take?

One conversation of twenty to forty minutes, plus the time we spend running networks and formularies afterwards. You usually have the written comparison within a day or two.

Do I have to switch plans afterwards?

No. A significant share of our comparisons end with a recommendation to change nothing. You are not signing anything by asking.

About the author

Walker Bolin is a licensed independent insurance broker and the founder of WLB Insurance Group in Marlborough, Massachusetts (NPN 14656745). He places Medicare, individual health, life insurance and retirement income products nationwide, and charges clients nothing — carriers pay the commission, and it is already inside the premium.

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