Introduction to Medicare Advantage in Arizona (Part C)

Original Medicare (Medicare Parts A and B) possess some unfortunate coverage gaps which, if left uncovered, could become expensive in the future. If you want to protect yourself from these future charges, Medicare Part C (a.k.a. Medicare Advantage) could be a potential solution for you. Medicare Advantage policies are issued by private insurance companies which offer the same coverage as Original Medicare, and usually some additional benefits which help protect you from expensive gaps. However, the government will no longer be responsible for your Original Medicare coverage.

Federal Regulations for Medicare Advantage

Federal consumer protection laws prevent any provider of a Medicare Advantage policy from selling you coverage which is less comprehensive than Traditional Medicare. Your Medicare Advantage benefits, therefore, will be as good, or better, than Medicare Parts A and B. They will also likely include protection from Medicare coverage gaps, prescription drugs benefits (a.k.a. MAPD plans), and other extras.

Medicare Advantage Enrollment In Arizona

There are many seniors 65+ in Arizona who are currently receiving some sort of Medicare benefits, whether it’s Traditional Medicare alone or Medicare with a supplement. Of those, 38% have chosen to sign up for a Medicare Advantage policy. But not all of these policies are exactly alike. Consult the chart below for a breakdown of plans, as well as the percentage of enrollees each one has.

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

The fact that you live in Arizona, as opposed to somewhere like Pennsylvania, will have a significant influence on your rate with a Medicare Advantage plan. Age, Medicare enrollment status, and other factors will also change how much you can expect to pay. Reference the chart below for estimated plan rates near you:

Most Popular Medicare Advantage Plans in Arizona

There are so many different types of Medicare Advantage plans, as well as companies that provide them, that it can be hard to find a plan which is right for you. What makes these policies even more complicated is the fact that your provider network will alter your rates even further. Some networks are more restrictive than others, but cost less. Other plans are much less restrictive, but will cost you more. Your budget and personal circumstances will determine which plan is right for you.

Helpful Medicare Advantage Tips & Tricks

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Doctor/Provider Network Restrictions

One of the most complicated aspects of Medicare Advantage plans are the network restrictions. For the most part, you are only permitted to get medical care from the pre-approved doctors and facilities which your plan has chosen. Some of these plans offer more choice than others, so do your research into which plans offer what access in your area. Also, keep in mind that rules and restrictions can change at any time, and may hinder your ability to get care in the future.

Doctor/Providers List

Drug, Vision and Dental Coverage

One advantage which Medicare Part C plans have over the competition is the convenience of bundling different coverage benefits into one policy. Medicare Advantage is one of the few supplements which can provide you with Vision, dental, and Medicare Part D prescription drug coverage all within the same policy. However, you will pay a higher rate for this convenience.

Enrollment Options & Best Time To Enroll

As a warning, you should know that certain providers in specific states may deny you coverage based on your health status or a pre-existing condition. With the exception of ESRD (End Stage Renal Disease), though, most seniors can easily get coverage if they are in good health and new to Medicare. For more information on enrollment, please take a moment to visit our Medicare Advantage Enrollment Options page. And make sure you get in touch with a licensed insurance agent to properly evaluate your circumstances, as well as your options.

  • Initial Enrollment Period: 6-month timeframe when you first enroll in Medicare to purchase a Medicare Advantage plan.
  • Annual Enrollment Period (AEP): This timeframe runs from October 15th through December 7th every year, and during this time you can change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): During special circumstances, you may be eligible to purchase/change a plan outside of the Annual Enrollment Period. Things such as moving out of the plans’ service area, losing group health or employer coverage, a company no longer offering plans in the area, etc. are all events that could trigger a SEP.

What Medicare Advantage Plan Is Best For Me?

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