Medicare Plan Options
There are two primary ways to get your Medicare coverage in Arizona. Original Medicare with hospital coverage (Part A) and outpatient/medical coverage (Part B) or Medicare Advantage Plans, called Part C, which cover the same services as parts A and B and often include Part D prescription drug coverage. You can add a Medicare Part D prescription drug plan and/or Medicare Supplement Insurance (Medigap) to Original Medicare. Availability and pricing for Medicare Advantage, Part D, and Medigap coverage vary.
Medicare plans in Arizona include Part A to help pay for hospitalizations and Part B to help pay for outpatient medical care such as doctors’ office visits. You’ll need a Part D prescription drug plan if you want drug coverage. If you don’t sign up for Part B or Part D when you’re first eligible, you could pay a penalty. If you have limited income and resources, Arizona’s Medicare Savings Program may help pay for Part A and/or Part B, and the Low Income Subsidy, or Extra Help, may help pay for prescription drug expenses like copays and deductibles.
Medicare Advantage Plans
Arizona’s Medicare Advantage program provides the same coverage as Original Medicare. Medicare Advantage offers a bundled alternative to Original Medicare because plans include parts A and B and usually Part D. Plans often include extra benefits, such as hearing, vision, and dental care, and wellness programs like gym memberships. Some plans even cover health care needs like rides to medical appointments, adult day care services, and over-the-counter medications. MA Plans may have lower out-of-pocket costs than Original Medicare, but many plans require you to use health care providers within a network.
Medicare Prescription Drug Coverage Plans
Medicare prescription drug coverage plans are known as Part D plans. These are optional but available to everyone with Original Medicare and some Medicare Advantage Plans to help pay for prescription medications. Even if you don’t take prescription drugs now, it’s important to consider your future needs because there’s a lifelong late enrollment penalty for not signing up when you first become eligible. Part D plans pay for a wide range of prescription medications, but each plan may cover different drugs. Plans provide a covered prescription list called a formulary with drugs placed on tiers with varying costs.
Medicare Supplement Insurance Plans
Medigap is the common name for Medicare Supplement Insurance Plans. Arizona has 12 Medigap plans available. If you have employer or union coverage that pays for costs that Original Medicare doesn’t, you may not need a Medigap policy. For those who don’t, Medigap helps pay out-of-pocket costs like coinsurance. The best time to get a Medigap plan is during the six-month Medigap Open Enrollment Period, which typically offers more options and better prices. After this period, you may not be able to buy a Medigap policy. You can’t enroll in Medigap with a Medicare Advantage Plan, only Original Medicare.
Medicare in Arizona by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|781,211||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Arizona
Medicare plans in Arizona can be confusing due to the program’s complexity and the many options available to you. If you’re new to Medicare or need to make changes to an existing plan, a little guidance can go a long way toward helping you make the right decisions. Many local and statewide resources offer counseling and assistance with the enrollment process, understanding your benefits, and demystifying your medical bills. Arizona’s Department of Economic Security provides a great starting point.
Department of Economic Security Division of Aging and Adult Services
The DES Division of Aging and Adult Services administers two programs to help you with Medicare coverage: the State Health Insurance Program (SHIP) and the Senior Medicare Patrol (SMP). SHIP offers free health benefits counseling for Medicare to educate and help you make informed decisions that optimize your care and benefits. The SMP helps you recognize, report, and prevent health care errors, abuse, and fraud through counseling and education. It operates eight SHIP/SMP offices in counties around the state.
Contact Information: Website | 800-432-4040
Arizona Area Agencies on Aging
Arizona’s Area Agencies on Aging (AZ4A) is a statewide network with seven regional agencies scattered around the state. Each office offers various programs to deliver much-needed services to seniors, disabled individuals, and their families and caregivers free of charge. You’ll find several programs dedicated to helping you with Original Medicare and Medicare Advantage Plans, plus Medigap and Medicare prescription drug coverage.
Contact Information: Website | 928-298-2574
Northern Arizona Council of Governments
The Northern Arizona Council of Government (NACOG) provides free assistance with Medicare through one-on-one counseling with staff and volunteer counselors. NACOG offers telephone consultations and outreach programs to the public. If you live in Apache, Navajo, Coconino, or Yavapai counties, NACOG can answer your Medicare and Medicare Advantage questions, help you fill out Medicare forms, and explain enrollment, benefits, penalties, claims, appeals, billing, and fraud prevention. Counselors can help you compare Medicare Supplement Insurance and prescription drug plans and fill out applications for Medicare Savings Programs and the Low Income Subsidy.
Contact Information: Website | 928-774-1895 or 877-521-3500
Region One Area Agency on Aging
The Region One AAA in Phoenix offers services throughout Maricopa County. These services are free if you’re aged 60 or older, younger than 60 with a disability or long-term care needs, or a family caregiver. Its benefits assistance counselors provide information about Original Medicare and Medicare Advantage Plans. They can assist you with Medicare prescription drug coverage and your Medicare claims and appeals. Appointments are required. To help you navigate complex Medicare benefits yourself, it offers an online resource library and has a 24-hour senior helpline.
Contact Information: Website | 602-280-1059 or 888-264-2258