Below you’ll find the information you need to know about Medicare in Arizona. Learn about enrollment, the different options available to you, and how you can get help paying for Medicare.
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There are 1.4 million Arizona Medicare beneficiaries, making up 19% of the state’s total population. Most beneficiaries are on Medicare due to age, but about 10% are on Medicare due to disability. 17% of Medicare enrollees also receive full or partial Medicaid benefits.
Medicare beneficiaries have options. One decision you need to make is whether you stay on Original Medicare or switch to a Medicare Advantage plan. We’ll explain more about the pros and cons of Medicare Advantage and Original Medicare later on. In Arizona, 55% of Medicare beneficiaries choose to remain on Original Medicare and 45% choose to move to a Medicare Advantage plan.
All US citizens over the age of 65 are eligible for Medicare. You’re also eligible if you’re under 65 but have certain disabilities like ALS or End-Stage Renal Disease.
Most become eligible for Medicare due to age. If this is the case, you are able to enroll during your Initial Enrollment Period. Your Initial Enrollment Period is a seven-month period surrounding your 65th birthday. It begins three months before the month you turn 65, includes your birth month, and goes until three months after. Some people choose to delay their Part B enrollment because they’re still receiving employer coverage. Before you do so, make sure you’re fully eligible for a Special Enrollment Period. Learn more here.
After signing up for Medicare, you can choose to stay on Original Medicare or switch to Medicare Advantage (Part C). If you stay on Original Medicare, you have the option to add a Medicare Supplement plan as well as a stand-alone Part D plan. Medicare Advantage plans bundle together Part A, Part B, and often Part D. Whether you should go with Original Medicare or Medicare Advantage depends on your unique health and financial needs. To help you make your decision, we’ll explain the pros and cons of all of these options later on. Our licensed Arizona Medicare Advisors are also here to answer any questions and provide expert advice.
There are two things you should do to get more value from your Medicare coverage. First, use your plan! You’re paying for insurance, so give your new insurance info to your pharmacies and doctors, schedule preventive appointments, and use any extra benefits your coverage may provide. Second, especially if you’re on a stand-alone Part D plan or a Medicare Advantage plan, make sure to review your needs and the plans available to you each year to be sure you’re always getting the best value.
There are 105 Medicare Advantage plans available in Arizona, but insurance carriers, pricing, and availability vary by county. For example, Maricopa County, AZ has 66 Medicare Advantage plans from 17 different insurance carriers and Coconino County has 26 plans offered by nine insurance carriers.
Medicare Advantage plans offer a bundled approach to Medicare. They combine Part A and Part B and generally also include Part D (prescription drug) coverage. They often come with a variety of additional benefits with no or low additional premiums (you do still pay your Part B premium). Some of the benefits that may come with Arizona Medicare Advantage plans are:
Dental, vision, and hearing coverage
More coverage at no (or a low) additional costs sounds nice, and you may be wondering why everyone doesn’t choose Advantage. Medicare Advantage plans also come with big drawbacks:
Networks are limited
Preauthorization requirements are common
Out-of-pocket costs are higher (when compared to coverage through Original Medicare + Medigap)
There are ten different Medicare Supplement (Medigap) plans available to Arizona Medicare beneficiaries. Pricing may vary from one insurance carrier to another, but each plan of a type (e.g., every Plan N) is the same. This means choosing the right plan type and looking at pricing is all you need to do once you’ve decided to go with a Medigap plan. Plan G is generally considered the best Medigap plan because it virtually eliminates your out-of-pocket costs. All you’ll need to pay is your Part B deductible, then Medicare takes care of the rest of the costs for covered services.
Medigap plans pair with your Original Medicare to help cover the 20% of costs that Original Medicare doesn’t cover. Compared to Medicare Advantage plans, Medigap plans have some key benefits:
No networks - you can see any doctor who accepts Medicare nationwide
No prior authorization requirements for covered services
Lower out-of-pocket costs
The best time to enroll in a Medigap plan is during the Medigap Open Enrollment Period. Your Medigap Open Enrollment Period occurs for six months after your Medicare Part B effective date. During this time, you are guaranteed acceptance to any Medigap plan offered by any insurance company. Outside of this and a few other special guaranteed issue periods, insurance carriers can deny your application for coverage based on your age or health history.
The government added Medicare Part D because Original Medicare doesn’t provide prescription drug coverage. Arizona Medicare beneficiaries can get prescription drug coverage by either enrolling in a Medicare Advantage plan that includes Part D coverage or enrolling in a stand-alone Part D plan. There are 28 Arizona Part D plans, but each county will have different pricing and availability.
Even if you don’t currently take any prescriptions, you should consider enrolling in a low-cost drug plan to avoid the Part D penalty.
If you have questions about your Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed Arizona Medicare Advisors or give us a call at (888) 604-0055.
Arizona Medicare enrollees with low income and resources can apply for three programs to get help paying for Medicare-related costs.
Medicaid is a joint federal and state program that helps US citizens with low income and resources pay for medical expenses. Each state operates its Medicaid program a little differently.
Arizona’s Medicaid program is called the Arizona Health Care Cost Containment System (AHCCCS). AHCCCS offers health insurance for people 65 or older who are Arizona residents, US citizens, and under the income limits. If you qualify, you’ll receive health insurance with no monthly premium. Learn more about this program here.
Arizona also has Medicare Savings Programs for residents on Medicare who have low income and resources. Arizona has three levels of Medicare Savings Programs:
Specified Low-Income Medicare Beneficiary (SLMB)
Qualified Individual-1 (QI-1)
Qualified Medicare Beneficiary (QMB)
For more information about the eligibility requirements and application process for Arizona’s Medicare Savings Programs click here.
If you have limited income and resources, you may be eligible for Extra Help. Extra Help is a federal program that helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance.
You automatically qualify for Extra Help if you:
Receive full Medicaid coverage from Arizona
Arizona pays your Part B premium
Are eligible for Supplemental Security Income (SSI)
If you don’t automatically qualify, you can learn more about Extra Help or talk to one of our licensed Arizona Medicare Advisors to get free support with your application.
Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:
You are 65 and older, blind, or have a disability
You have limited income and limited resources