We reviewed the top 66 Medicare Advantage Plans available in Maricopa County, Arizona (2024 plans will be available in early October. Sign-up for notification HERE). Here's what we discovered:
- The average premium is $11.18 per month.
- The average out-of-pocket limit is $4,245 per year.
- The average drug plan deductible (for plans that include Part D) is $88.49 per year.
- Medicare rated 35% of all plans available in Maricopa County 4 stars or higher.
- There are no 5-star plans available.
- There are 4 plan types to choose from, including PPO, HMO, HMO-POS, MSA, and possibly SNP plans, as well.
Maricopa County, Arizona Medicare Advantage Plans
Maricopa County, AZ
Medicare Advantage Plan Information
In County, Maricopa, Medicare Advantage (MA) plans offer a distinct option for Medicare beneficiaries. These plans, also referred to as Medicare Part C, are provided by private companies authorized by Medicare, adhering to stringent regulations. Presently, there are 66 MA plans available (not including Special Needs Plans). Many deliver supplementary benefits beyond what Original Medicare provides.
Prescription medication coverage is one of the most popular additional benefits. These plans are also known as Medicare Advantage Prescription Drug Plans (MAPDs). These plans offer Maricopa County beneficiaries comprehensive coverage that can help them reduce their out-of-pocket costs.
The best Medicare Advantage plans in Arizona have a rating of 4.0 stars and higher. These plans are worth looking into first. See: medicarewire.com/medicare-advantage/arizona/
Types of MA Plans in Maricopa County
Medicare allows 7 distinct types of private health plans, although the availability of these plans may vary by location. In Maricopa County, Medicare beneficiaries can select from 4 out of the 7 plan types, which are as follows:
Health Maintenance Organization (HMO) members usually receive services through the plan's local network of providers. Referrals are typically required to see a specialist and other providers. However, plans allow out-of-network care for emergencies and out-of-area dialysis. Prescription drug coverage is often included in HMO plans, and many plans include some coverage for dental, vison, and hearing.
Preferred Provider Organization (PPO) members can usually use in-network and out-of-network providers for care, including hospitalization. However, visits to non-network providers could cost significantly more. PPO plans often include prescription drug coverage and other benefits, and referrals are typically not required for specialist visits.
An HMO-POS (point-of-sale) plan offers the same features as an HMO plan. There is however one major difference. HMO-POS plans allow members to access healthcare providers outside of the plan's network to receive some or all of their services. In most cases, to go out of the plan's network a member will need to get a referral from their physician. Plus, there are separate deductibles for in-network and out-of-network services.
Medicare Medical Savings Account (MSA) plans are private companies that the Medicare program pays to manage a beneficiary's Medicare benefits. As with all types of Medicare Advantage plans, MSA plans must offer the same basic benefits included in Medicare Part A and Part B. However, benefits may have different rules, restrictions, and costs. Unlike other Medicare Advantage plans, MSAs have a high deductible health plan (HDHP) and a government-funded bank account for paying your medical costs.
Getting Enrolled in a Medicare Advantage Plan
Most people with Medicare in Arizona qualify to join a Medicare Advantage plan. The availability of plans in your area that meet your needs may be the determining factor.
There are several different Medicare Election Periods. This is when you can join or change your plan elections. Most people wait until October 15 to December 7 to make changes. This is the Open Enrollment Period.
There's also an Individual Election Period (IEP) that you can use once. Your IEP is a 7-month period of time around your 65th birthday. It begins three months before you turn 65 and ends three months later. If you have Social Security Disability Insurance (SSDI), your IEP begins on the 25th month.
Adding Prescription Drug Coverage
Some people may be eligible to join a standalone prescription drug plan. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds prescription coverage to Original Medicare and Medicare Advantage plans that do not include coverage for prescriptions.
It’s important to note that health plans that include prescription drug coverage may disenroll members who sign up for a separate drug plan. You cannot be enrolled in plans with overlapping benefits.
An Option to Medicare Advantage
If you are concerned that your Medicare Advantage plan options in Maricopa County won't meet your needs, or that Medicare Advantage plans are bad, inconvenient, or will limit your services, there is another way to get more coverage. There are Medicare Supplements available in Arizona, as well as Medicare prescription drug plans. These work hand-in-hand with your Original Medicare to give you more coverage and more flexibility.
If you're not familiar with Medigap policies, and how they protect you from medical care liability, please review our Medicare supplements directory, where you can learn about and compare Medigap plans. All Medigap plans are standardized. That means you can choose the plan you need based on the best price without worrying about the benefits.
Special Needs Plans (SNP) in Maricopa County
Millions of Americans have unique healthcare needs. This includes institutional care, care for chronic diseases, and financial assistance for low-income households. Consider a Medicare Advantage Special Care Plan (SNP) if you or your loved one has one or more of these special healthcare issues.
MedicareWire has a special directory for Maricopa County, Arizona Special Needs Plans. Although managed under the Medicare Advantage program, SNP plans are designed specifically for three types of people:
- Beneficiaries in a nursing home or receiving skilled nursing care at home;
- Beneficiaries with both Medicare and Medicaid benefits; and
- Beneficiaries with certain chronic health conditions.
The MA and MAPD plans on this page are available to Medicare beneficiaries enrolled in both Medicare Part A and Part B living in Aguila, Avondale, Buckeye, Carefree, Cave Creek, Chandler, El Mirage, Fort McDowell, Fountain Hills, Gila Bend, Gilbert, Glendale, Goodyear, Laveen, Litchfield Park, Luke Air Force Base, Mesa, Morristown, New River, Paradise Valley, Peoria, Phoenix, Queen Creek, Rio Verde, Scottsdale, Sun City, Sun City West, Surprise, Tempe, Tolleson, Tonopah, Waddell, Wickenburg, Wittmann, Youngtown, and all other areas of Maricopa County, Arizona.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.
Citations & References
- CMS.gov, "2024 Medicare Part C Landscape Source Files", Last Accessed September 27, 2023
- Medicare.gov, "Types of Medicare Advantage Plans", Last Accessed 17 May, 2022
- Medicare.gov, "Special Needs Plans (SNP)", Last Accessed 11 June, 2023
- Medicare.gov, "How to compare Medigap policies", Last Accessed 1 June, 2023