Summary: If you’re on Medicare in Arizona, you may have several Medicare plan options. You can get your health benefits in two main ways: through Original Medicare or the Medicare Advantage program. Adding a Medicare Part D prescription drug plan could be another option. You might also consider a Medicare Supplement insurance plan.
Original Medicare in Arizona
Original Medicare, Part A and Part B, is a U.S. federal health insurance program. It works the same in Arizona as in all states.
- Part A covers inpatient services. This includes hospital and skilled nursing facility care, short-term home health care, and hospice care.
- Part B covers outpatient medical services. This includes doctors’ visits, preventive care, and durable medical equipment.
Restrictions apply to both Part A and Part B coverage. Certain costs, such as premiums, deductibles, and coinsurance, also apply.
Original Medicare includes limited prescription drug coverage. It doesn’t cover most prescription medications you would take at home. It also doesn’t cover certain long-term nursing home care, or routine vision and dental services.
If you have Original Medicare, your benefits will generally be the same wherever you live. You can see any provider that accepts Medicare.
Medicare in Arizona Enrollment Requirements
Most people become eligible for Medicare in Arizona when they turn 65.
What if you’re already receiving Social Security or Railroad Retirement Board (RRB) benefits before turning 65? In this case, you’ll automatically get Medicare the first day of the month that you turn 65.
Otherwise, you can enroll in Medicare in Arizona during your Initial Enrollment Period (IEP). This is the seven-month period that begins three months before you turn 65, includes the month you turn 65, and ends three months later.
In some cases, you may be eligible for Medicare in Arizona before age 65.
- If you receive disability benefits from the Social Security Administration or the Railroad Retirement board for 24 months, you’ll be enrolled in Medicare automatically.
- If you have Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS), you’ll be enrolled in Medicare during the first month that you receive disability benefits.
- If you have end-stage renal disease (ESRD), you might qualify for Medicare before age 65. However, you need to contact the Social Security Administration to sign up.
You can enroll in Medicare in Arizona with the Social Security Administration. Here’s how you can sign up:
- Visit the Social Security website. If you’re delaying retirement, you can also apply for Medicare only.
- Call Social Security at 1-800-772-1213. If you are a TTY user, you can call 1-800-325-0778. Social Security operators are available Monday through Friday, from 7AM to 7PM.
- Visit your local Social Security office. To find an office in Arizona, click here.
If you don’t sign up during your IEP, you can enroll in Part A and Part B during the General Enrollment Period. This takes place each year from January 1 to March 31. You may have to pay a late enrollment penalty for not signing up when you were first eligible.
What if you have other health insurance, like an employer group plan? You may choose to delay Part B enrollment since it has a monthly premium.
Most people get Part A with no monthly premium 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, you may not want to pay for 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. This will allow you to enroll in Part B without paying the Part B late enrollment penalty.
Talk to your employer’s benefits administrator about how your insurance would work with Medicare.
Medicare in Arizona Plan Options
You may have several Medicare plan options available to you besides Original Medicare.
Medicare Advantage (Part C) in Arizona
Private, Medicare-approved insurance companies offer Medicare Advantage plans. Also called Medicare Part C, these plans let you get your Part A and Part B benefits in an alternate way. Some plans may have extra benefits. These could include vision, dental, or wellness programs.
In 2020, zero dollars is the lowest monthly premium for a Medicare Advantage plan in Arizona. All people in Arizona with Medicare have access to a zero-dollar premium Medicare Advantage plan.
Depending on the Medicare Advantage plan, you may have network provider restrictions or pay more to go outside the plan’s network. Costs and any extra benefits vary by plan.
To get prescription drug coverage, you could look at Medicare Advantage prescription drug plans. These may allow you to get Part A, Part B, and Part D benefits through one plan. You will still have to pay your Part B premium, as well as any plan premium. You will also still need to pay any copayments, coinsurance, and deductibles.
Medicare prescription drug coverage (Part D) in Arizona
Original Medicare includes only limited prescription drug coverage. This is usually during an inpatient Medicare-approved hospital stay. If you have Original Medicare in Arizona, you can enroll in a stand-alone Medicare Part D prescription drug plan. This may help to pay for your prescriptions.
Your out-of-pocket costs for a Medicare Part D prescription drug plan will depend on several factors. These may include:
- Your medications
- The plan you enroll in
- How the plan organizes drugs into payment tiers
Each Medicare Part D prescription drug plan has a formulary. This is a list of drugs the plan covers. The list may change at any time. You will receive notice from your plan when necessary.
Medicare Supplement (Medigap) plans in Arizona
If you decide to stay with Original Medicare, another option you may have is to sign up for a Medicare Supplement (Medigap) insurance plan to help pay for Original Medicare’s out-of-pocket costs. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.
Resources for Medicare in Arizona
Here are a few state resources for Medicare in Arizona that may be helpful to you:
- Official Arizona Website: Find information on Medicare in Arizona, Medicaid, the State Health Insurance Assistance Program (SHIP), and long-term care services.
- Arizona Department of Insurance: Learn about health coverage and state services. This includes mental health services, preventing fraud, and how to file a complaint against an insurer.
- Arizona Health Care Cost Containment System: This is Arizona’s Medicaid program. The program provides help with health costs to low-income Arizona residents, including those on Medicare. Find out about eligibility and how to enroll.
Learn more about how Medicare in Arizona works:
- Medicare Advantage plans in Arizona
- Medicare Supplement (Medigap) plans in Arizona
- Medicare Part D plans in Arizona
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.
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