Private printable checklist
Check providers and prescriptions before comparing Medicare plans
Gather the details first, then check them against official plan information. Entries stay on this page unless you print or save them yourself.
Provider list
Record the provider name, specialty, location, and whether the plan or office confirmed access.
Prescription list
Record the drug name, dosage, quantity, refill frequency, and preferred pharmacy.
Final verification checklist
Protect sensitive information
Medication names can be sensitive health information. This page does not submit the entries, but use a private device and do not enter a Medicare number, Social Security number, or financial account number. Verify plan networks and formularies again before enrolling.
Official sources
Verified 2026-07-21; scheduled for review by 2026-09-15. Use Medicare.gov for the official decision or amount.
Get help
Have your providers and prescriptions ready?
Use the completed checklist during a free Medicare review or while comparing plans on Medicare.gov.
- Licensed insurance agency support
- Phone and online Medicare help
- Private agency, not government
- Support before and after enrollment
Friendly support, careful disclosures
Choose the Medicare help path that fits you best right now.