Medicare beneficiaries living in Arizona may have multiple private Medicare options available, depending on where they live.
If you are eligible for Medicare, you can get your health coverage in two ways: through Original Medicare or through a private Medicare plan, such as Medicare Advantage (Medicare Part C).
Original Medicare, Part A and Part B, is the traditional, federally-administered program that provides health coverage to seniors. Part A covers inpatient services, including hospital and skilled nursing facility care, short-term home health care, and hospice care. Part B covers outpatient medical services, including doctors' visits, preventive care, and durable medical equipment.
Original Medicare doesn't include prescription drug coverage, which must be purchased separately under Medicare Part D. It also doesn't cover most types of nursing home care, personal care, vision, or dental services.
If you have Original Medicare, your costs and benefits will be the same regardless of where you live. You can see any provider that accepts Medicare.
Most people become eligible for Medicare when they turn 65, although some beneficiaries can get Medicare coverage before then if they have a disability. If you are already receiving Social Security or Railroad Retirement Board (RRB) benefits before turning 65, you will automatically get Medicare the first day of the month that you turn 65. Otherwise, you can enroll in Medicare during your Initial Enrollment Period (IEP), the seven-month period that begins three months before you turn 65, includes the month you turn 65, and ends three months later.
Medicare beneficiaries in Arizona, as in other states, can enroll in Medicare through the Social Security Administration. You can sign up:
If you don't sign up during your IEP, you can enroll in Part A and/or Part B during the General Enrollment Period (GEP) that takes place annually from January 1 to March 31. Keep in mind that you may have to pay a late enrollment penalty for not signing up in Part A and/or Part B when you were first eligible.
If you have other health insurance, such as through an employer group plan, you may choose to delay Part B enrollment, since it comes with a monthly premium. Most people get Part A for free if they've worked at least 10 years (40 quarters) and paid Medicare taxes during that time. If you're still working and have employer coverage, however, you may not want to pay for additional benefits you don't need. If you decide to delay Part B, you can sign up during a Special Enrollment Period (SEP) when your group coverage ends, without paying the Part B late enrollment penalty. Talk to your employer's benefits administrator about how your insurance would work with Medicare.
Medicare beneficiaries in Arizona also have many private Medicare options available. Certain types of Medicare coverage, such as prescription drug coverage and supplemental coverage, are only available through private insurance companies. You can also choose to receive your Original Medicare benefits through a private plan (Medicare Part C).
As an Arizona resident, your private Medicare options will depend on where you live and the plans available in your zip code.
Medicare Advantage plans (Part C) are offered by private insurers and are another way to receive your Original Medicare benefits. All plans cover the same Part A and Part B benefits, and some plans may have extra benefits, such as vision, dental, or health wellness programs. Depending on the type of Medicare Advantage plan, you may be restricted to seeing providers in a network or pay more to go out of the plan's network. Costs and any extra benefits will differ from Original Medicare and depend on your plan. No matter which Medicare Advantage plan you join, you will have to keep paying the Part B premium, in addition to any premium your plan requires. Hospice care is still covered under Part A when you have a Medicare Advantage plan.
Unlike Original Medicare, you don't need to buy a separate plan to get prescription drug coverage in Medicare Advantage. If you choose to get drug coverage, you can get it through your health plan. Medicare Advantage plans that include prescription drug coverage are known as MAPD plans. These plans offer your Part C and Part D coverage in one plan. So, make sure you sign up for an MAPD plan if you want drug coverage with a Part C plan.
Original Medicare doesn't include prescription drug coverage, which must be purchased separately. If you have Original Medicare, you can enroll in a stand-alone Medicare Part D Prescription Drug Plan.
If you have Medicare Advantage, you'd normally get this coverage through an MAPD plan. You can't have both Medicare Advantage and a stand-alone Medicare Part D Prescription Drug Plan.
Your Part D costs will depend on the drugs you take, the plan you enroll in, and how the plan categorizes those drugs into different payment tiers.
If you have Original Medicare, you may decide to join a Medicare Supplement (Medigap) plan to help with some of the out-of-pocket costs. Medigap plans help pay for costs like deductibles, copayments, and coinsurance. Some plans also include foreign travel coverage, which isn't covered under Original Medicare except in limited circumstances.
Medicare Supplement plans can only be used to pay for Original Medicare costs. These plans will not work with Medicare Advantage plans.
Arizona residents with Medicare may find the following list of state resources helpful.