You are not choosing a logo. You are choosing the rules that will stand between your parent and the doctors, hospitals, prescriptions and follow-up care already in use.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Start with the care pattern, not the plan brochure. Make one page listing every physician, hospital system, pharmacy, prescription, medical equipment supplier and recurring service your parent uses. Add any specialist appointment, procedure or move that is being considered. This is your comparison sheet.

Who pays

A Medicare Advantage plan receives Medicare funding and administers Medicare-covered services under its own network and utilization rules. Your parent generally keeps paying the Medicare Part B premium. The plan may charge another premium and may set copayments, coinsurance and an annual limit on covered Part A and Part B out-of-pocket spending. Medicare says that plan costs, networks, drug coverage and authorization requirements can differ. The federal Medicare Plan Compare tool and each plan's Evidence of Coverage are the controlling places to check those details. Paying for Care STL keeps the relevant government references on its Sources page.

Do not compare only the monthly premium. Copy these fields for every plan you are considering: medical premium, drug deductible, primary care charge, specialist charge, hospital charge, outpatient surgery charge, ambulance charge, preferred pharmacy status and the maximum out-of-pocket limit for covered medical services. Leave a blank marked "not confirmed" when the document does not answer the question.

Then ask what does not count toward that maximum. Prescription drug spending and noncovered services generally follow different rules. A plan representative should identify the page and section of the plan document supporting the answer. Record the representative's name, call reference number and the document cited.

Check the network one provider at a time

A provider directory is a starting point, not the final answer. Search each clinician under the exact practice name and location your parent uses. A doctor may participate at one office but not another, or a hospital may be in network while particular clinicians working there are not.

Call the provider's billing office and ask: "Does this specific clinician accept this exact plan and network?" Give the full plan name shown in Medicare Plan Compare, not only the insurance company name. Ask the same question of the hospital system, therapy clinic, laboratory, imaging center, equipment supplier and pharmacy.

Write down who answered and when you checked. Do not ask only whether the office "takes Medicare." That can mean Original Medicare and tells you nothing about participation in a particular Medicare Advantage network.

If your parent spends substantial time outside St. Louis, ask how routine care works outside the service area. Emergency and urgently needed care are not the same as ordinary specialist visits, therapy or follow-up testing. Find the applicable language in the Evidence of Coverage before treating travel access as settled.

Run every prescription

Enter the exact drug name, strength, quantity and frequency in Medicare Plan Compare. Confirm that the pharmacy your parent actually uses is preferred, standard or out of network. Then open the plan's formulary and record the tier for each drug.

Mark every drug carrying prior authorization, step therapy or a quantity limit. Those labels tell you that coverage may depend on an approval or another condition. They do not tell you whether a physician will recommend changing treatment. Medication decisions belong with the prescriber.

For an expensive or hard-to-replace prescription, call the plan. Ask whether the exact drug and dose are on the formulary, what restriction applies, who submits the request and where the rule appears in writing. If the drug is excluded or restricted, take that information to the prescriber before enrollment. Do not substitute a salesperson's assurance for the formulary.

Find the permission rules

Search the plan materials for "prior authorization," "referral," "precertification" and "organization determination." Ask whether the services your parent uses require approval, including therapy, imaging, outpatient procedures, medical equipment and care from certain specialists.

If the answer matters to a scheduled service, ask the provider's authorization staff too. Your question is not merely whether the service is covered. Ask who requests approval, what records are required, whether approval has been obtained and what happens if the plan denies it.

CMS Form 1696, Appointment of Representative, can authorize someone to act for a beneficiary in a Medicare claim, appeal or grievance. It is not a general power of attorney and does not transfer control of the person's finances. If your parent wants you to discuss plan details during comparison calls, have your parent join the call or ask the plan what verbal or written permission it requires.

The papers

Build one folder for each finalist. Save the Summary of Benefits, Evidence of Coverage, provider directory, formulary and drug restriction information. Add screenshots or printouts from Medicare Plan Compare showing the exact plan and your entered pharmacies and prescriptions.

Put a comparison cover sheet on top with four headings: confirmed in writing, confirmed by phone, still open and deal breaker. A network listing confirmed only by a directory belongs under "confirmed in writing" until the provider verifies it.

Do not sign an enrollment request while a deal breaker remains open. Examples include an oncology practice that cannot confirm participation, a required drug missing from the formulary, an out-of-area care pattern the plan cannot accommodate or a hospital charge you cannot explain from the plan documents.

Free help

Missouri SHIP provides free Medicare counseling and is not an insurance sales agency. A counselor can help you compare plan records, understand enrollment choices and identify the Medicare rule that applies. Start with Paying for Care STL's directory of local help with paying for care.

Bring your comparison sheet, Medicare card, medication list, provider list and plan documents. Ask the counselor to help you check the gaps, not to choose based on extra benefits before the core medical and drug coverage works.

Stop at the professional line. The physician decides whether a different drug or treatment is medically appropriate. A lawyer takes over when the question becomes whether a document gives you legal authority, whether someone lacked capacity when signing or whether legal rights were violated. Your job before that line is narrower: identify the exact plan, verify every essential provider and prescription, record every unresolved rule and keep the paper that supports each answer.

How Do You Compare Medicare Advantage Plans for a Parent Who Uses Several Doctors?