October 6, 2016
If you’re an Arizona Medicare beneficiary requiring more thorough coverage than what’s available under Original Medicare, Part A and Part B, you may want to consider enrolling in a Medicare Advantage plan. Benefit details depend on the specific health insurance plan you choose and where in Arizona you live.
As in other states, Medicare Advantage in Arizona is available from private, Medicare-approved health insurance companies. Medicare Advantage plans are required by law to offer at least the same benefits as Original Medicare, Part A and Part B (except hospice care, which Part A covers). Medicare Advantage beneficiaries are covered through their individual health plans and not directly through Original Medicare (except for hospice care).
Arizona Medicare Advantage plans are available through private insurance companies that contract with Medicare. They often come with additional benefits, like routine vision, hearing, and dental coverage, depending on the plan. Most Medicare Advantage plans include prescription drug benefits.
To qualify for a Medicare Advantage plan, you need to:
You can enroll in a Medicare Advantage plan during your Initial Coverage Election Period (ICEP):
If you don’t sign up for Medicare Advantage during your ICEP, you can enroll in a Medicare Advantage plan during the Annual Election Period. It runs from October 15 to December 7 each year. You can add, switch, or drop Medicare Advantage plans during the Annual Election Period; your new coverage will start on January 1 of the following year.
Medicare has special provisions to help you deal with certain situations. Some examples of these situations include moving to a new address, losing your current health coverage, qualifying for a different type of coverage, and experiencing changes in your current plan that affect your health benefits. You can switch health plans during Special Enrollment Periods if your situation qualifies you to do so.
Arizona Medicare Advantage beneficiaries who decide to opt out of Medicare Advantage and switch back to Original Medicare, Part A and Part B, can do so during the Medicare Advantage Disenrollment Period, which lasts from January 1 to February 14 each year. The only other change you can make at this time is to add a stand-alone Medicare Part D Prescription Drug Plan.
Arizona Medicare Advantage beneficiaries may have a number of options when it comes to choosing the type of Medicare Advantage plan that might suit their health and prescription drug needs:
Most Medicare Advantage plans also include prescription drug coverage. These policies, known as Medicare Advantage Prescription Drug plans, combine health and prescription drug coverage into one plan.
If you choose to enroll in a Medicare Advantage plan, you have to stay enrolled in Original Medicare and continue paying your Medicare Part B premium to keep your Medicare coverage.
There may be a number of Medicare Advantage plans available to Arizona residents; your costs may vary depending on the plan you choose. Each plan’s policies may change on an annual basis, so it’s usually a good idea to compare available Arizona Medicare Advantage plans based on where you live and your individual health needs.
Also remember that premiums for Medicare Advantage plans offering similar benefits can vary between among plans in Arizona. In addition, some Medicare Advantage plans may offer premiums as low as $0, while others may charge higher amounts, depending on the type of coverage they provide. Be aware that you must continue paying your Medicare Part B premium no matter which Medicare Advantage plan you choose.
Another important decision you have to make is whether or not you want prescription drug coverage with your Medicare Advantage policy, and which medications you need it to cover.
To start comparing plans in your part of Arizona, just enter your zip code in the form on this page.
You can reach a Medicare representative 24 hours a day, seven days a week (except federal holidays) at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
* Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.