Medicare Advantage Plans in Arizona
Most Arizonans who have enrolled in Medicare Part A and Part B also have other ways to enhance their health coverage. This is because Original Medicare still makes beneficiaries pay coinsurance or deductibles for most services. The best Medicare Advantage plans in Arizona may help control costs and limit annual expenses. A Medicare Advantage plan in Arizona may also come with other useful benefits that can lower the cost of prescription drugs and other health-related services or products.
When to Enroll in Medicare Advantage Plans in Arizona
Almost every Arizona resident who has enrolled in Medicare Part A and B can select a Medicare Advantage plan.
However, the government limits enrollment for a Medicare Advantage plan in Arizona to specific times:
- Initial Coverage Election Period: This Initial Coverage Election Period, called an ICEP, is when a beneficiary can enroll in a Medicare Advantage plan in Arizona for the first time. This period usually starts three months before the beneficiary turns 65 and then lasts for three months afterwards. Some people may get this ICEP earlier because they take Medicare before age 65; however, other folks may delay it because they postpone taking Part B until later.
- Annual Election Period: You may see the Annual Election Period referred to as Open Enrollment. Every fall, you get a chance to enroll in another Medicare Advantage plan if you choose.
- Special Election Period: If you move or lose your coverage because of circumstances beyond your control, you may also qualify for a Special Election Period.
- Medicare Advantage Disenrollment Period: Everybody also gets six weeks that begin on January 1 to drop their Part C plan and continue on with Medicare Part A and Part B. After that, people who only have Medicare Part A and Part B can also choose between Medicare Advantage Prescription Drug plans if they need to.
Best Choices for Medicare Advantage Plans in Arizona
You will probably choose between one of these common kinds of Medicare Advantage plans in AZ:
Health Maintenance Organization HMO plans:
An HMO will have the most restrictive network rules. Almost all covered medical services must come from in-network providers. You also have to pick a primary care doctor or PCP, and that doctor needs to give you specialist referrals. In turn, you may enjoy cheaper rates and lower copayments or deductibles than with other choices. Just about nine out of ten Arizonans select an HMO for their Medicare Advantage plan.
Preferred Provider Organization PPO plans:
A PPO will cost less if you visit an in-network doctor or hospital, but it will still cover out-of-network providers. You also don’t need to pick a PCP or get that doctor to give you a referral to visit specialists. About 9% of Arizona MA members choose a PPO.
Special Needs Plans SNPs:
People who need to manage institutional conditions or chronic health conditions might enroll in Special Needs Plans. These Medicare Advantage plans have been tailored to better suit the needs of people who are in nursing homes or have specific medical conditions.
Medicare Advantage Plans in Arizona Enrollment Statistics
These are some highlights of enrollment statistics for Medicare Advantage plans in Arizona:
- Beneficiaries with a Medicare Advantage plan in Arizona: Over 460,000
- Percentage of Arizonans who enroll in Arizona Medicare Advantage plans instead of Original Medicare: About 39%
- Percentage who enroll in an HMO Medicare Advantage plan: 91%
It’s likely that many beneficiaries choose an HMO Medicare Advantage plan in Arizona because most come with a modest or even a $0 premium.
This list shows the top Arizona counties by population:
- Maricopa County, AZ: 4,307,033
- Pima County, AZ: 1,022,769
- Pinal County, AZ: 430,237
- Yavapai County, AZ: 228,168
- Yuma County, AZ: 207,534
How Medicare Advantage Plans in Arizona May Cover Prescription Medicine
Some of the best Medicare Advantage plans in Arizona come bundled with a Part D prescription plan. It’s most likely that a PFFS Medicare plan in Arizona won’t have drug benefits, but you can also purchase stand-alone Medicare Advantage Prescription Drug plans if you need to.
You should learn about these two parts of Part D benefits to help you compare various plans:
- The formulary: Every plan has a list of covered medications.
- Prescription Drug tiers: The insurance company may also cover brand-name drugs, generics, and specialty drugs at different levels.
Will Medicare Advantage Plans in Arizona Have Network Restrictions?
The most common kinds of Arizona Medicare Advantage plans will have network restrictions. Medicare Part A and Part B do not use networks, but Medicare Part C plans in Texas usually do. Always make sure that your favorite doctor or hospital is an in-network provider before enrolling.
You should also know that most network Medicare Advantage plans won’t have in-network providers outside of your local area. You can find some PPOs with national networks, but these usually charge somewhat higher premiums. If you plan to travel, you may find that paying higher rates is still a good idea to have the assurance you can find medical care anywhere you go.
In any case, you may need to change Medicare Advantage plans if you move away, but this action should trigger a Special Enrollment Period that will give you 63 days to switch health insurance.
Other Benefits of Medicare Advantage Plans in Arizona
Original Medicare Part A and Part B only help with the cost of prescriptions under very specific circumstances, so it’s handy to get drug benefits with your Medicare Advantage plan. Even many $0 premium options cover prescriptions, so that can make an MAPD plan an affordable choice that won’t cost more than Original Medicare.
Besides medicine, Original Medicare Part A and B do not offer any benefits for routine vision and dental, hearing care, or wellness programs, but most Medicare Part C plans in Arizona do. When many Arizona seniors compare Original Medicare Part A and Part B to Part C, they find that Medicare Part C offers them the best way to control their premium rates and expenses.
Also, most seniors who are enrolled in Medicare Part A and Part B also qualify for a Medicare Advantage plan in Arizona. This alone may make it the best choice over alternative kinds of Medicare insurance that may require answers to medical questions.
Arizona Medicare Resources
These authoritative sources can offer more information about Arizona Original Medicare and Medicare insurance: