Every ad says $0 premium and free dental. How do I choose a Medicare plan?

The question

An illustrative letter.

The answer

My dear, you are not imagining it. Every autumn, the calls and mailers swell as Medicare's open enrollment approaches, and a Senate Finance Committee report found that complaints about Medicare Advantage marketing more than doubled from 2020 to 2021. Feeling bombarded is a sensible reaction. The good news is that you do not have to sort through it alone, and you do not have to believe a word of the advertising.

What does a $0 premium plan really cost?

A $0 premium is real, but it describes only one cost. With a Medicare Advantage plan, you still pay your Part B premium, $202.90 a month in 2026 for most people, with the 2027 amount usually announced each autumn. Then come the costs when you use care: copays for doctor visits, specialists and hospital stays, coinsurance for some services, and your drug costs.

Every Medicare Advantage plan has a yearly limit on what you pay for covered in-network care. In 2026, that limit can be as high as $9,250. A plan with a $0 premium and a high limit can cost far more in a year with a hospital stay than a plan with a small premium and a lower limit. So compare the total you might pay in a healthy year and in a hard one, not just the premium.

Is the free dental really free?

Many plans offer dental, vision or hearing benefits, but read the details. Dental coverage often has a yearly maximum, sometimes small, and may cover cleanings but little toward crowns, dentures or implants. Ask for the plan's Evidence of Coverage or summary of benefits, and check the numbers before you count on them. If dental work is a priority, compare a separate dental policy too.

What should I check first?

Three things matter more than any advertising.

• Your doctors and hospitals. Medicare Advantage plans usually have networks. Confirm that the doctors and hospitals you use are in the network for next year, and ask your doctors' offices directly.
• Your medicines. Make a list of every prescription and dose, then check each plan's coverage and what you would pay. The Medicare Plan Finder at Medicare.gov does this for you. In 2026, drug plans cap your out-of-pocket drug costs at $2,100 for the year.
• What you pay when you are sick. Look at copays for hospital stays, specialists, imaging and outpatient surgery, and whether you need referrals or prior approval for care.

What about Original Medicare and Medigap?

This is the choice behind all the advertising. Original Medicare lets you see any doctor who accepts Medicare, and many people add a Medigap supplement to cover most of what Medicare does not, plus a separate drug plan. It usually costs more each month but brings fewer surprises when you are sick. Medicare Advantage plans often cost less upfront but use networks and limits.

One rule deserves care. Federal law gives you a six-month Medigap open enrollment period starting when you first have Part B. After it ends, insurers in most states can turn you down or charge more because of your health. If you leave Original Medicare for an Advantage plan, you may not be able to buy a Medigap policy again later, except in certain situations, such as trying an Advantage plan for the first time and changing your mind within a year. Ask a counselor before you switch.

Who can help me compare without selling me anything?

Every state has a State Health Insurance Assistance Program, with trained counselors who give free, unbiased help and do not work for any insurance company. In Kansas, it is called Senior Health Insurance Counseling for Kansas, or SHICK, and you can reach it at 1-800-860-5260. Bring your Medicare card, your list of medicines and your doctors' names, and they will help you compare plans side by side. You can also call 1-800-MEDICARE.

How do I protect myself from the calls?

Medicare will never call you to sell you a plan, and plans are not allowed to call you unless you are already a member or have given them permission. Never give your Medicare number, Social Security number or bank details to someone who calls you. If a call feels pushy, hang up. You can report suspicious calls to 1-800-MEDICARE, and adding your number to the National Do Not Call Registry can cut down on sales calls.

When can I make a change?

Open enrollment runs from October 15 to December 7 each year, and changes take effect January 1. If you join a Medicare Advantage plan and regret it, you can make one change between January 1 and March 31, either to another Advantage plan or back to Original Medicare with a drug plan.

Take your time this autumn. A quiet hour with a SHICK counselor is worth more than every glossy mailer in your hallway.

One thing to do this week

Write down your doctors and every medicine you take, then call SHICK at 1-800-860-5260 to book a free plan review before December 7.