Medicare Plan Finder for Agents: 2027 Needs Analysis Guide

Medicare Plan Finder is the Medicare.gov tool for comparing Medicare health and drug plans by ZIP code. Agents use it in a needs analysis to check a client's drugs, pharmacies, doctors, Star Ratings and estimated costs against each plan. For 2027 coverage, CMS said plan data would be on Plan Finder by October 1, 2026, and the 2027 Star Ratings were published there on October 8, 2026.

This guide covers how to run a client review in Plan Finder, what has to happen before you share results, where the tool's numbers fall short, and what to keep in the file after each review.

Key takeaways

• Plan Finder works with a ZIP code alone or with the client's own Medicare account. Guest answers improve cost estimates but don't change which plans appear.
• For AEP reviews, pick the 2027 coverage year. Open Enrollment for 2027 coverage runs October 15 to December 7, 2026, and coverage starts January 1, 2027.
• Get the Scope of Appointment, say the TPMO disclaimer before benefits come up, and record the call before you walk a client through results.
• Treat Plan Finder as a cross-check. Costs are estimates, and CMS doesn't expect first-year provider directory data to be error free.
• Cover every needs topic in 42 CFR 422.2274(c)(12), and review the Pre-Enrollment Checklist on phone enrollments.
• Document drugs, pharmacies, providers checked, plans compared, Star Ratings and year, your rationale and materials delivered. Keep sales call recordings at least 6 years.

What does Medicare Plan Finder show agents?

The Plan Finder start page asks for a ZIP code or a login and lets the user pick the 2027 or 2026 coverage year. Logged-in users can get a summary of their current coverage and use saved drugs and pharmacies to compare plan costs. Users without an account answer a few questions that improve cost estimates but don't change which plans are shown.

CMS's 2027 announcement lists what changed. Since the last Open Enrollment, users can sign in with Login.gov, ID.me or CLEAR and can find and save providers to compare plans. Starting in October 2026, users can see more preventive-service detail, connect to plan documents such as formularies and the Summary of Benefits, and see messages about changes to their current plans for 2027.

Medicare.gov also shows estimated Medigap costs, which work differently. More on their limits below.

When did 2027 data go live on Plan Finder?

The Open Enrollment and October 1 dates come from CMS's 2027 landscape fact sheet. The ANOC, Evidence of Coverage and non-renewal dates come from 42 CFR 422.2267. For every other election window, see our Medicare enrollment periods cheat sheet.

Should you use guest mode or your client's Medicare account?

Both work. Guest mode needs only a ZIP code, so it's the simplest way to run a first comparison. The client's account adds a current coverage summary, saved drugs and pharmacies, and (from October 2026) messages about changes to their current plan.

Keep the client in control of their login

This is advice, not a CMS rule: never ask for, write down or store a client's Medicare.gov username, password or sign-in codes, and don't sign in as the client. If the client wants to use their account, have them sign in on their own device and share their screen or read the results to you. Otherwise, work in guest mode and keep the drug and pharmacy list in your own client record. Ask your carriers and compliance team whether they have a written policy on this.

What if the client can't find their Medicare card?

Per Medicare.gov, the Medicare Number is unique to the beneficiary and isn't their Social Security Number. A client who lost the card can log into (or create) their secure Medicare account and print an official copy, or call 1-800-MEDICARE (TTY 1-877-486-2048) to order a replacement.

What has to happen before you open Plan Finder with a client?

Plan Finder results show benefits and costs, so get the sales-call basics done first.

• Permission to contact. Under 42 CFR 422.2264(a), unsolicited calls, robocalls, texts and voicemails to Medicare beneficiaries are barred, including calls based on referrals. A contact isn't unsolicited if the beneficiary consented or started it, for example when you return their call.
• Scope of Appointment. The CY 2027 final rule removed the 48-hour wait between the SOA and the appointment but still requires the SOA, for outbound contact and for inbound contact such as walk-ins, unscheduled calls, web chats and web forms when the contact is a personal marketing appointment. An SOA is valid for 12 months for the agreed products only. If the beneficiary asks not to be contacted, honor it even within that 12-month window. It must be agreed upon and recorded before the appointment, and in writing for in-person appointments. Our Scope of Appointment guide covers the details.
• TPMO disclaimer. Under the CY 2027 changes, you give it verbally before benefits are discussed, not within the first minute, and it no longer lists SHIPs.
• Recording. Under 42 CFR 422.2274(g)(2)(ii), all marketing and sales calls, including the audio of web-based calls, must be recorded and kept in full for at least 6 years. That means audio for years 1 to 3, then audio or complete and accurate transcripts for years 4 to 6. The CY 2027 rule cut retention from 10 years.
• Your credentials. Agents who represent MA organizations must be licensed and appointed where state law requires it and trained and tested every year with a score of 85 percent or higher.

During the appointment, 42 CFR 422.2264 lets you review the client's health care needs, commonly used medications and financial concerns. You can't market health products beyond the agreed scope. For the full call order, see how to sell Medicare over the phone.

How do you run a needs analysis in Plan Finder?

This sequence is advice. Follow your carriers' procedures where they add steps.

1. Pick 2027. Confirm the coverage year on the start page before you enter anything.
2. Enter the ZIP code where the client lives, and confirm the address matches their records.
3. Review the current plan. Ask whether the client received the ANOC, and read its 2027 changes. If they're logged in, check the change messages too.
4. Build the drug list. For each medication, record the exact name, strength, quantity and how often it's taken. Read it back to the client.
5. Add pharmacies. Ask which pharmacy they use now and whether they use mail order. Enter each one.
6. Check doctors. Search each primary care doctor and specialist in the provider directory and save them.
7. Answer the guest questions accurately if you're not using the client's account, since they affect cost estimates.
8. Compare plans on each needs topic: providers, pharmacy, drug coverage and costs, health care service costs, premiums, benefits and specific health needs.
9. Note Star Ratings for each plan you present, with the year.
10. Cross-check every finalist against its own plan documents before you recommend one.

Why pharmacies need their own check

CMS says the pharmacy networks shown on Plan Finder are collected separately from provider directories, through the Part D Pricing File Submission module in HPMS. A plan can have accurate doctor data and a pharmacy problem, or the reverse, so check each one.

Questions to ask on the call

"Let's go through your medications one at a time. What's the name on the bottle, the strength, and how many do you take a day? Which pharmacy fills it, and do you get anything by mail? Now, which doctors and specialists do you want to keep seeing?"

How do you read Plan Finder results?

Estimated costs

Plan Finder shows estimated drug and premium costs for each plan. Present them as estimates, with the assumptions behind them: which pharmacy, which quantities, and whether you were logged in. For copays, coinsurance and other cost-sharing, read the plan's Summary of Benefits and Evidence of Coverage rather than relying on the summary view.

Star Ratings and the performance icons

Per CMS's 2027 Star Ratings fact sheet, MA-PD contracts are rated on up to 43 measures, MA-only contracts on up to 32 and standalone PDP contracts on up to 13. The overall rating is a weighted average of the Part C and D measure stars.

For 2027, 15 MA-PD contracts carry the high-performing (five-star) icon and four MA-PD contracts carry the low-performing icon. CMS says year-over-year changes are normal and expected, so compare this year's rating rather than assuming last year's still applies.

Under 42 CFR 422.2267(e)(13), updated Star Ratings can't be used until CMS releases them on Plan Finder and must be used within 21 calendar days of that release. The Star Ratings Document must accompany an enrollment form. On a telephonic enrollment, tell the client verbally where to find it.

Plan exits and non-renewals

When a plan won't renew for a December 31 contract end, the Non-renewal Notice must be dated October 2 and provided at least 90 calendar days before the non-renewal takes effect. If a client mentions a notice, ask them to read you the date and plan name, then compare replacement options in the 2027 view.

What are Plan Finder's limits?

Drug prices are only as good as what plans post

Star Ratings include an MPF Price Accuracy Part D measure, meaning CMS scores plans on the accuracy of the drug prices they post to Plan Finder. Confirm a high-cost drug against the plan's formulary before you quote its cost.

The provider directory is in its first year

MA provider directory data was scheduled to go live on the CY 2027 Plan Finder on October 1, 2026, under 42 CFR 422.111(m). The CMS office hours Q&A says:

• CMS ingests and validates the data daily, and plans may keep updating it after launch.
• CMS doesn't expect first-year submissions to be fully free of errors.
• Records with Level 2 errors are suppressed until fixed, so a missing doctor may be a data issue, not a network issue.
• Telehealth providers aren't yet supported.
• Provider group affiliations don't appear at this time.

Plans must also update their own online directories within 30 days of receiving information that requires an update. Check the carrier directory, and as a practical step, call the doctor's office.

Medigap prices are estimates

The Medicare.gov Medigap tool shows estimated costs, and Medicare.gov tells users to contact the insurance company for a more accurate price. Benefits in each lettered Medigap plan are the same no matter which company sells it, so only the premium differs. Premiums can depend on discounts, medical underwriting when the client has no guaranteed issue right or Medigap Open Enrollment Period, Medicare SELECT network rules and high-deductible options. Premiums typically rise each year.

How do you cross-check before recommending a plan?

Plan Finder narrows the field. Plan documents decide it. Before you recommend a plan, check:

• ANOC for the client's current plan and its 2027 changes
• Evidence of Coverage for the rules behind each benefit
• Summary of Benefits for premiums, copays and coinsurance
• Formulary for every drug on the list
• Carrier provider and pharmacy directories for every doctor and pharmacy

Before an enrollment, 42 CFR 422.2274(c)(12) requires these topics to be fully discussed: whether current providers and specialists are in network, whether the current pharmacy is in network, prescription drug coverage and costs, costs of health care services, premiums, benefits and specific health care needs.

For telephonic enrollments, review the contents of the Pre-Enrollment Checklist with the client before the enrollment is completed. It covers the EOC, provider directory, pharmacy directory, formulary, premiums, copays and coinsurance, emergency and urgent coverage, plan-type rules and the effect on current coverage.

What should you document after every Plan Finder review?

Use this checklist (advice) for each client review:

• Basis for contact: inbound call, returned call or consent, with the date
• SOA: products agreed, date, format (written for in-person)
• TPMO disclaimer given before benefits, noted with the time on the recording
• Full call recording, kept at least 6 years
• Coverage year used (2027) and whether you worked in guest mode or the client's account
• Drug list with name, strength, quantity and frequency
• Pharmacies entered, including mail order
• Each provider checked, where you checked, and the result
• Plans compared, with estimated costs and the date you ran them
• Star Ratings shown, with the rating year
• Your rationale, tied to each needs topic
• Materials delivered or pointed to: Summary of Benefits, Star Ratings Document, PECL review
• Any ANOC or non-renewal notice the client mentioned

Ask your carriers how long they want your notes and forms kept beyond the recording requirement.

How do clients enroll after the comparison?

Use your carrier's approved enrollment process. Whichever route the client uses, Medicare.gov says the plan must get the Open Enrollment request by December 7, and changes take effect January 1. The Medicare Advantage Open Enrollment Period (January 1 to March 31) is only for people already in an MA plan.

Clients who want to keep their current coverage generally don't need to re-enroll, according to CMS. That's still a decision to make after reviewing the ANOC.

Common mistakes and edge cases

• Running the 2026 view during AEP. The start page offers both years. If you discuss current and next year in one meeting, 42 CFR 422.2263(a) requires materials to say which year is being discussed.
• Mixing up rating years. Updated 2027 ratings couldn't be used before CMS posted them on Plan Finder on October 8, 2026, and they must be used within 21 calendar days of that release. Note which rating year each document shows, and don't present 2027 ratings from any source dated before October 8.
• Treating a missing doctor as out of network. Suppressed records and unsupported telehealth providers can hide real network doctors.
• Skipping the pharmacy check because the drug is on formulary.
• Quoting the Medigap tool's price as final, including for Medicare SELECT plans with network rules.
• Missing a non-renewal because the client didn't open the October 2 notice. Ask about plan mail on every review.
• Calling a client's referral to offer a review. The referred person has to consent or contact you first.

Keeping review records in LeadGPT

LeadGPT can hold the review file alongside the lead. Store drug, pharmacy and rating-year details in custom fields and notes, and attach SOA forms as files on the lead record. Calls made or answered in LeadGPT are recorded with a transcript and AI summary in the Call Log, and the AI Assistant can search transcripts for a drug or plan name. Recording is always on with no announcement, so confirm your disclosure and retention process with your compliance team. See the features overview or take the interactive demo.

What to do next

1. Bookmark the 2027 Plan Finder view and remove any shortcuts to 2026.
2. Put the documentation checklist into your client record template.
3. Confirm SOA, recording and enrollment procedures with each carrier.
4. Work through the rest of your Medicare AEP preparation checklist before December 7.

This guide is general information, not legal or compliance advice. Confirm each rule with CMS, your carriers or upline, and your compliance team. Find more workflow guides in our best practices category, and read how we research them in our editorial policy.