Medicare beneficiaries in Arizona who need help paying for Original Medicare expenses may want to consider enrolling in a Medicare Supplement plan (also referred to as a Medigap plan). Medigap plans in Arizona are available through private insurance companies, and they can help with expenses incurred under Original Medicare, Part A and Part B, like copayments, coinsurance, deductibles, and other out-of-pocket costs. As an Arizona resident, you may have a number of Medigap plan options, usually depending on the zip code you live in.
There are 10 standardized Medigap plans available in 47 states, each of them labeled with a letter (such as A, B, C, D, F, G, K, L, M, and N), with plans of the same letter offering the same benefits. Massachusetts, Minnesota, and Wisconsin offer Medicare Supplement plans that differ from the 10 standardized plans available in Arizona and the rest of the country.
Medicare beneficiaries in Arizona are generally eligible to sign up for Medigap plans once they are enrolled in Original Medicare, Part A and Part B.
The best time to buy a Medicare Supplement plan is during your Medigap Open Enrollment Period. This six-month period starts the first day a beneficiary is age 65 or older and is also enrolled in Medicare Part B. During this time, Medicare beneficiaries in Arizona have “guaranteed-issue rights,” meaning they can sign up for any Medicare Supplement plan available in their area, with the Medigap insurance company of their choosing, without being denied coverage or charged higher premiums because of their health status. Keep in mind that some insurance companies may still require waiting periods before covering pre-existing conditions. If you’re looking to enroll in a Medigap policy outside of this period, you can do so at any time. However, unless you’re eligible for guaranteed-issue rights, you may be denied coverage or charged more for his or her insurance policy. You may be able to switch or enroll in Medicare Supplement plans in certain situations with guaranteed issue; for example, if your Medigap insurance company goes bankrupt or misled you.
In Arizona and the rest of the United States, Medigap plans do not offer prescription drug coverage, so you may want to enroll in a stand-alone Medicare Part D Prescription Drug Plan to receive coverage for prescription drug expenses. Medicare Part D Prescription Drug Plans in Arizona are available through Medicare-approved private insurance companies and, like Medicare Supplement insurance, work alongside Original Medicare.
Be aware that even if you sign up for a Medigap plan in Arizona, you must remain enrolled in Original Medicare, Part A and Part B, and go on paying your Medicare Part B premium, to keep your health insurance coverage. Medigap plans are meant to supplement – not replace – Original Medicare. You’ll still get your hospital and medical coverage through Original Medicare.
Before you purchase a Medigap plan, it’s important that you familiarize yourself with what each of the 10 standardized plans has to offer. Here’s a look at the Medigap benefits you may be eligible to receive as a Medicare beneficiary in Arizona. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Supplement Plan F is the most comprehensive of the 10 plans available, covering almost 100% of Medicare-associated out-of-pocket costs once Original Medicare has paid its share of costs. But, even under Medicare Supplement Plan F, beneficiaries in Arizona are still responsible for certain out-of-pocket costs, such as the Medicare Part B premium.
Even though Medicare Supplement plans in Arizona with the same letter designation don’t vary in coverage or benefits, each independent insurance company offering Medicare Supplement plans is allowed to determine its own monthly premium structure. Some Medigap plans charge all members the same premium, while other plans depend on your age when you enroll and go up as you get older. Because costs may vary by insurance company and location, this means that a resident of Tucson in Pima County may pay more or less than a resident of Phoenix in Maricopa County for an identical Medicare Supplement plan. It can be to your advantage to compare all Medicare Supplement plans in Arizona available to you, and then make your final choice based on your personal budget and health requirements.
With so many Medicare Supplement plan options available in Arizona, it’s important that you understand what each plan has to offer before making your choice. To get help selecting the plan that works for your personal health needs, feel free to start browsing coverage options in your area using the plan finder tool on this page. Or, if you have questions about finding coverage that may work for your needs, call eHealth to speak with a licensed insurance agent today.