Edward Terragni's Guide to Choosing the Right Medicare Plan in 2026

Choosing Medicare coverage feels like navigating a maze blindfolded. With dozens of plan options, conflicting advice, and confusing terminology, most seniors make decisions based on incomplete information or worse, price alone. Edward Terragni, founder of My Family Assured and a Medicare specialist with over 15 years of experience, has guided thousands through this exact challenge. His approach combines technology-driven analysis with genuine human insight to match people with coverage that actually fits their lives. Here's his proven framework for choosing the right Medicare plan in 2026.

Understanding Your Medicare Foundation

Before comparing plans, you need to understand what you're building on. Original Medicare (Parts A and B) covers hospital stays and doctor visits, but leaves significant gaps—no prescription drug coverage, no out-of-pocket maximum, and potential costs that can spiral unexpectedly.

Edward Terragni emphasizes that your foundation determines your options. "Most people don't realize that choosing between Medicare Advantage and Medicare Supplement isn't just about premiums," he explains. "It's about how you use healthcare and what gives you peace of mind."

Medicare Advantage bundles everything into one plan through private insurers. You'll typically pay lower monthly premiums but face network restrictions and higher costs when you need care. Medicare Supplement (Medigap) works alongside Original Medicare, covering those gaps with predictable costs but higher monthly premiums.

The Real Cost Beyond Premiums

Here's what catches people off guard: a $0 premium Medicare Advantage plan isn't actually free. You'll pay copays every time you see a specialist ($40-$60 typical), visit the hospital ($300-$500 per day), or need outpatient surgery ($200-$400). Over a year, those costs add up fast.

Edward Terragni recommends calculating your total annual healthcare spending, not just monthly premiums. Include:

• Doctor visit frequency (specialist copays matter)

• Prescription medications (check each plan's formulary)

• Chronic condition management costs

• Potential emergency or surgery expenses

A plan with a $200 monthly premium but minimal copays might cost less annually than a $0 premium plan with high per-visit costs—especially if you see doctors regularly.

Assessing Your Personal Health Needs

Generic advice fails because your health situation is unique. Edward Terragni uses a systematic approach to match plans with individual needs rather than following one-size-fits-all recommendations.

Start with your medication list. Not all plans cover the same drugs, and tier placement dramatically affects your costs. A medication on Tier 1 (generic) might cost $5 monthly, while the same drug on Tier 4 (specialty) could run $300-$500. Check every plan's formulary before assuming coverage.

The Doctor Network Question

If you've built relationships with specific doctors or specialists, verify they accept the plan you're considering. Medicare Advantage plans restrict you to network providers—going out of network means paying full price or getting denied coverage entirely.

Edward Terragni notes that many seniors discover network limitations only after enrolling. "Call your doctor's office directly and ask which specific plans they accept," he advises. "Don't rely on online directories alone—they're often outdated."

Medicare Supplement plans, conversely, work with any doctor accepting Original Medicare (about 93% of providers nationwide). You gain flexibility but pay higher premiums for that freedom.

Travel and Geographic Flexibility

Do you spend winters in Arizona or summers visiting grandchildren across the country? Medicare Advantage plans typically limit coverage to your home region. Emergencies get covered anywhere, but routine care while traveling often doesn't.

For frequent travelers or snowbirds, Edward Terragni often recommends Medicare Supplement plans. You'll receive coverage anywhere in the United States without worrying about networks or prior authorizations.

Evaluating Plan Options Strategically

Edward Terragni partners with 20+ leading carriers, giving him insight into which plans deliver actual value versus marketing promises. His evaluation process focuses on these critical factors.

The Star Rating Reality

Medicare assigns star ratings (1-5 stars) based on quality and performance. While 4.5+ star plans generally indicate better service, Edward Terragni warns against relying solely on ratings. "A 5-star plan might have terrible coverage for your specific medications or exclude your preferred hospital," he points out.

Use star ratings as one data point, not the deciding factor. Check member satisfaction scores, complaint ratios, and how the plan handles appeals or claim denials.

Prescription Drug Coverage Details

Every Medicare plan handles prescriptions differently. Beyond checking if your drugs are covered, examine:

• Quantity limits: Some plans restrict how much medication you can get at once

• Prior authorization requirements: Certain drugs need insurer approval before coverage kicks in

• Step therapy protocols: You might need to try cheaper alternatives first before accessing your prescribed medication

• Pharmacy networks: Preferred pharmacies offer lower copays than standard network options

Edward Terragni recommends using Medicare's Plan Finder tool to input your exact medications and compare true out-of-pocket costs across plans. A plan with slightly higher premiums but better drug coverage often saves money overall.

Timing Your Decision Correctly

When you enroll matters as much as which plan you choose. Miss your enrollment window and you might face penalties or coverage gaps.

Critical Enrollment Periods

Your Initial Enrollment Period runs seven months—three months before your 65th birthday, your birthday month, and three months after. During this window, you can choose any Medicare plan without medical underwriting for Medigap policies.

Annual Enrollment Period (October 15 - December 7) lets current Medicare beneficiaries switch plans for the following year. Edward Terragni sees too many people stick with inadequate coverage simply because they missed this window or didn't realize they could change.

"Review your coverage every single year," he emphasizes. "Plans change benefits, costs, and networks annually. What worked last year might be terrible this year."

Special Enrollment Situations

Moving to a new coverage area, losing employer insurance, or qualifying for Medicaid might trigger Special Enrollment Periods. These give you time-limited opportunities to adjust coverage outside normal windows.

Making Your Final Decision

After analyzing your needs and comparing options, Edward Terragni recommends a final validation step before committing.

Create a decision matrix comparing your top three plans across:

• Total annual cost (premiums + estimated out-of-pocket expenses)

• Drug coverage specifics for your medications

• Provider network adequacy

• Maximum out-of-pocket limits

• Additional benefits (dental, vision, gym memberships)

Then ask yourself: "If I needed surgery or developed a serious condition, which plan would protect me best financially and give me access to quality care?"

Getting Expert Guidance

Working with an experienced Medicare specialist like Edward Terragni costs you nothing—brokers earn commissions from insurance carriers, not from clients. This means you get expert guidance, plan comparisons across multiple carriers, and enrollment assistance without any fees.

The value lies in avoiding expensive mistakes. Choosing the wrong plan can cost thousands in unnecessary medical expenses or leave you stuck with inadequate coverage for a full year.

Key Takeaways for 2026 Medicare Planning

Edward Terragni's approach simplifies Medicare decisions through systematic evaluation:

• Calculate total annual costs, not just monthly premiums—include copays, deductibles, and medication expenses

• Verify your doctors and prescriptions are covered before enrolling in any plan

• Review coverage every year during Annual Enrollment Period (October 15 - December 7)

• Consider your health trajectory—choose based on where you're heading, not just where you are today

• Use expert help to navigate the 20+ carrier options and find optimal coverage

Medicare decisions impact your health security and financial stability for years ahead. Take time to choose wisely, ask questions, and ensure you understand exactly what you're getting. Your future self will thank you.

Ready to find your ideal Medicare plan? Edward Terragni and the My Family Assured team offer free consultations to review your situation and compare options across top-rated carriers. Don't navigate Medicare alone—get expert guidance that puts your needs first.