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Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). are private health plans available to people with Medicare benefits. Unlike Original Medicare, they are not the same in all states. In fact, plans in every Arizona County are different. For this reason, you must shop and compare plans locally.
Use our zip code lookup above to see which plans are available in your region. Or click below to select your county. Keep reading to learn more about the Medicare Advantage program in Arizona.
Compare the Best Medicare Advantage Plans in Arizona by County
Arizona Medicare Advantage Plans Explained
The advantages of Medicare Advantage plans are found in what they can cover that Original Medicare cannot. Specifically, the MA plans (aka, Part C of Medicare) available in Arizona can include minor healthcare benefits such as prescription drug coverage, vision, hearing, dental, fitness, telehealth, and more. In contrast, Original Medicare only covers major medical healthcare services. To join a plan you must first be enrolled in both Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Medicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services..
Althought the extra benefits, particularly a prescription drug plan, are nice to have, it's important to fully understand what you're getting if you enroll in a Medicare Advantage plan in Arizona. Specifically, Medicare Advantage is managed care health insurance, and the plan controls your access to healthcare providers. If you have ever had an HMO or PPO plan through your employer's group health insurance, you have a pretty good idea of what managed care health insurance is all about.
Original Medicare vs. Arizona Medicare Advantage Plans: How Do They Compare?
The big differences between Original Medicare coverage and what you get with a Medicare Advantage plan in Arizona are easy to see by pointing out the pros and cons. Neither type of insurance is perfect. They each suit different needs.
Pros and Cons: Medicare vs. Medicare Advantage
- When you have Original Medicare, you are free to use any Medicare-approved doctor you choose. When you join a Medicare Advantage plan, your choices are limited to the plan's network of Arizona providers.
- If you travel frequently or you are a snowbird and winter or summer in another state, your Original Medicare coverage remains the same. It goes where you go. This is not true with Arizona Medicare Advantage plans, which are only required to cover you if you have a When you believe you have an injury or illness that requires immediate medical attention to prevent a disability or death..
- With Original Medicare, there are no limits on your Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments.. However, all Arizona Medicare Advantage plans have an annual maximum out-of-pocket (MOOP) limit. If you reach the MOOP spending limit on your copays and Coinsurance is a percentage of the total you are required to pay for a medical service. , the plan picks up the tab for the remainder of the year.
- If you want prescription coverage and have Original Medicare, you must purchase a Medicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan. However, most Medicare Advantage plans include a Arizona Medicare Part D plan. Just be aware that a stand-alone Part D plan gives you the best opportunity to get your most expensive prescriptions at the lowest cost.
- In the Medicare Advantage program, the government allows plans to set their own copays and coinsurance for each healthcare service offered. This makes comparing plans difficult, at best. However, in the Original Medicare system, A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share. and coinsurance are fixed, making them predictable. Plus, you can get a Medigap plan to help pay these costs.
- There are eligibility requirements with Medicare Advantage plans. For example, you must have both Medicare Part A and Medicare Part B to join, and you cannot have End-Stage Renal Disease (ESRD), also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age. (ESRD) or one of a handful of other diseases.
Arizona Medicare Advantage Plans vs. Medigap
Most Arizona seniors just getting their Medicare benefits want to know which type of plan is better. We commonly see these three questions:
- Why are Medicare Advantage plans bad?
- What are the disadvantages of Medicare Advantage plans?
- Is it better to have Medicare Advantage or Medigap?
Let's take a minute or two to compare and contrast, shall we?
Why Arizona Medicare Advantage Plans are Bad
First things first. Medicare Advantage plans are not bad. More than 26 million people have a Medicare plan. But, it's not for everyone. Before you enroll, learn the disadvantages of Medicare Advantage plans, particularly if you live in Arizona.
A good way to figure out which coverage is best for you is to look at your health and your finances. If you have one or more chronic conditions and you can afford a supplement, Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. is likely the best option because you have the ability to choose your doctors. Conversely, if you are super healthy, or you are unable to afford a Medicare supplement, then Medicare Advantage is a viable option.
Here's the fundamental truth. Medicare plus a Medigap plan works best for people with chronic health conditions. It's also the best coverage for people who can afford a higher monthly A premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. , even if they rarely see a doctor.
You can learn more about what Medicare supplements are available to you on our Arizona Medigap Plan Finder page.
What are the Disadvantages of Arizona Medicare Advantage Plans?
As you have already read, both Medicare Advantage and traditional Medicare have their benefits. But the two types of coverage are apples and oranges. However, if you remove the issue of doctor choice from the equation, the primary difference is when and how you pay. This fact remains the same no matter what type of Medicare Advantage plan you are considering (e.g., HMO, PPO, PFFS, Cost, or HSA).
With most Medicare Advantage plans, you pay a little each month (the monthly premium) and A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. when you use medical services. It does not matter if you have a Health Maintenance Organization (HMO) plan or a Preferred Provider Plan (PPO). You pay the majority of your costs when you use health services.
With most Medigap plans, you pay most of your costs upfront with your monthly premium. As a result, your costs (e.g., the deductible) are more predictable than they might be if you have Medicare Advantage and use a lot of healthcare services
Which is Best in Arizona, Medicare Advantage or Medicare Supplement Insurance?
- If you can afford Medicare Supplement Plan F is the most comprehensive Medicare supplement plan available. This plan covers all Original Medicare deductibles, coinsurance, and copayments, leaving you with no out-of-pocket costs on all Medicare-approved services., G, or N, then keep your Original Medicare and add one of these supplements. These plans help you manage your out-of-pocket costs the best, giving you complete peace of mind.
- If you are a healthy senior and have good health in your family heritage, Medicare Supplemental Plan N is one of the ten standardized Medigap plans. Although it is one of the newest plans available, Medicare Plan N is quickly becoming a favorite with Baby Boomers aging into their... will let you save money by sharing some costs when you see your doctor. The plan benefits are excellent, and you pay just a little to see your doctor (up to $25 per visit).
- If you are a healthy senior but you cannot afford a Medigap Plan F, G, or N, Medicare Advantage is a good choice. Both Original Medicare and Medicare Advantage cover preventive care at no additional cost to keep you healthy
- If you are turning age 65, have one or more chronic health conditions that require frequent doctor visits, and you do not qualify for both Medicare and Medicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. (dual eligible), the most Medigap coverage you can afford is the best option.
- If you qualify for both Medicare and Medicaid, regardless of your health condition, Medicare Advantage is your best option.
- If you have special needs (i.e., a full-time nursing home resident, diabetes, etc.) and an appropriate Medicare Advantage Special Needs Plan (SNP) is available, this is your best option.
- With both Medigap and Medicare Advantage, you must continue to pay your The Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary's premium may be uplifted by an IRMAA surcharge if their income is above... (it typically comes straight out of your Social Security income, unless you're not yet taking it).
- With Medicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage., there are no service area restrictions. With Medicare Advantage, you must receive care within the plan's provider network unless you need emergency care.
- Medicare Advantage plans have an enrollment period. You get an individual enrollment period when you're first eligible. After that, there's an The Annual Enrollment Period is when Medicare beneficiaries can join, drop or change Medicare Advantage and Medicare Part D prescription drug plans. AEP begins on 15 October and ends on 7 December. to switch plans or go back to Original Medicare. Medigap plans do not have the same restrictions, but you can be turned down if you leave a Medigap plan and later want to come back. Medicare Advantage plans cannot generally turn you down as a Medicare supplement insurance company can.
Find Plans in your area with your ZIP Code
- Medicare.gov: the official U.S. government site for Medicare | Medicare http://www.medicare.gov/
- Find a Medicare plan https://www.medicare.gov/plan-compare/
- Medicare Benefits | SSA https://www.ssa.gov/medicare/
- Social Security's Low-Income Subsidy (LIS) program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as "Extra Help", beneficiaries who qualify for LIS receive premium... with Medicare Prescription Drug Plan Costs | SSA https://www.ssa.gov/medicare/prescriptionhelp/
- Medicare Benefits | SSA https://www.ssa.gov/benefits/medicare/
- Five-Star Quality Rating System | CMS https://www.cms.gov/medicare/provider-enrollment-and-certification/certificat...
- Medicare Open Enrollment | CMS https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-h...
This Medicare Advantage state information page was last updated on .