If you’re shopping for Medicare plans in Arizona, you’ve likely already come across a lot of information. That’s because you have a lot of options.
The first step toward choosing the coverage that best suits your needs is understanding how the different parts of Medicare work.
Medicare is a national program for people ages 65 and over, as well as for people of any age with certain health conditions. Original Medicare comes directly from the federal government and includes some basic coverage for outpatient and inpatient healthcare services.
Medicare is made up of different parts. Original Medicare, which is basic coverage, has two parts:
- Part A covers a portion of the costs for the inpatient care you get in the hospital, a skilled nursing facility, or hospice, as well as some limited home health services. You likely won’t need to pay a premium for Part A if you or your spouse worked for at least 10 years. In that case, you’ve probably already paid the necessary amount through a payroll tax while you or your spouse worked.
- Part B covers a portion of the costs for services and supplies you receive when you see a doctor or specialist. You do pay a premium for Part B. That premium amount depends on your income.
Parts A and B cover a portion of these costs. They don’t cover things like prescription drugs, dental, or vision care. To supplement or replace your original Medicare coverage, you can purchase plans from private insurance companies.
Medicare Supplement (Medigap)
Medicare supplement (Medigap) plans help cover the gaps in original Medicare coverage, which might include copays and coinsurance, as well as coverage for services that original Medicare doesn’t cover at all. You can purchase these plans in addition to having parts A and B.
Medicare Part C (Medicare Advantage)
They usually include prescription drug benefits; lower out-of-pocket costs when you seek care; and extras like dental, vision, and hearing benefits. Medicare Advantage plans often offer health and wellness benefits too, such as fitness programs or health coaching to support you in managing chronic conditions.
Medicare Part D
Part D covers prescription drugs. These plans are sold by private insurance companies. To be sure that a plan covers the medications you need, make sure to review its formulary. A formulary is a list of medications covered by a plan.
If you decide to go with a Medicare Advantage plan, you have plenty of choices in Arizona. Keep in mind, though, that not all of these plans are available in all counties. Availability varies depending on where you live.
The following private insurance companies offer Medicare Advantage plans in Arizona:
- Banner Medical
- Blue Cross Blue Shield of Arizona
- Bright Health
- Devoted Health
- Imperial Insurance Company, Inc.
- Lasso Healthcare
These companies offer plans in many counties in Arizona. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
You can enroll in Medicare if you meet at least one of the following requirements:
Your initial enrollment period begins 3 months before you turn 65 and continues for 3 months after your 65th birthday.
It usually makes sense to at least enroll in Part A during this period. Even you’re not ready to retire, Part A benefits can coordinate with your employer-sponsored coverage and likely won’t cost you anything. If you choose not to enroll in Part B during this time, you likely will qualify for a special enrollment period later.
Other enrollment periods include:
- Medigap initial enrollment. You can enroll in a Medigap plan for up to 6 months after you turn 65.
- General enrollment. From January 1 through March 31, you may enroll in a Medicare plan or Medicare Advantage plan if you did not enroll during your initial enrollment period.
- Medicare Part D/Add-ons enrollment. From April 1 through June 30, if you don’t have Medicare Part A, but you enrolled in Part B during the general enrollment period, you can choose a Part D prescription drug plan.
- Open enrollment. From October 15 through December 7, you may enroll in, drop out of, or change your Part C or Part D plan, or you may switch back to original Medicare.
- Special enrollment. For an approved reason, you may qualify for a special enrollment period of 8 months during which you may enroll in Medicare or switch your Part C, Part D, or Medigap plan.
Medicare Advantage plans vary in structure and design. Some may be Health Maintenance Organization (HMO) plans that require you to choose a primary care physician, who then refers you to other doctors as needed. Others plans may be Preferred Provider Organization (PPO) plans that allow you to see in-network specialists without getting a referral.
When you’re shopping for Medicare Advantage plans in Arizona, you’ll want to consider factors like:
- Cost. How much are the premiums? How much will you need to pay when you see a doctor or fill a prescription?
- Provider network. Does the plan’s provider network include doctors and hospitals that are convenient for you? What if you need to seek care while traveling outside the network area?
- Covered services. Does the plan suit your needs for dental, vision, or hearing services?
- Included programs. Are you likely to use the plan’s member perks and programs?
The following resources can be useful in learning more about Arizona Medicare coverage options:
- Arizona Department of Insurance
- Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, from the Arizona Department of Insurance
- Social Security Administration
If you’re ready to investigate plan options and begin the enrollment process, consider these steps:
- Do some research on the specific Medicare plans available to you. The list above can be a good starting point. It might also be useful to talk with an experienced insurance agent who sells Medicare plans in Arizona and can offer guidance tailored to your individual situation.
- Read some reviews to see what other people are saying about plans you might be considering and their coverage. You could also ask trusted friends or acquaintances about their Medicare plans.
- Sign up for Medicare online through the Social Security Administration website. The application takes just minutes to complete. The site even includes a checklist to make it easier for you to gather the information you need.
This article was updated on October 6, 2020 to reflect Medicare costs in 2021.
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