The State of Arizona ranks 12th highest in percent of population aged 65 years and older, with over 1.5 million residents aged 65 and above.
In 2024, 1.4 million people in Arizona have access to Medicare plans.
Medicare is a fee-for-service plan administered by the federal government and funded by the General Revenue and Federal Insurance Contributions Act.
This health insurance plan provides medical and hospital coverage to people aged 65 and above, those with certain disabilities, and people with end-stage renal disease (ESRD).
Medicare features different plans that vary from State to State. Some of these plans, such as Medicare Advantage, offer additional benefits to provide more coverage to beneficiaries. Let’s examine the available plans in Arizona and how they benefit residents.
Medicare Advantage Plans in Arizona
Arizona, the Grand Canyon State, has more than seven million residents, with 18.5% of the population aged 65 and above. Since Arizona’s life expectancy is just under 74, programs such as Medicare have become necessary in the region to provide senior residents with healthcare coverage plans.
With growing age, medical needs tend to increase. As older adults approach the age of 65, healthcare finances become unmanageable due to skyrocketing hospital bills. The annual price increment for prescription drugs, medical equipment, and healthcare utilities due to inflation also makes it challenging to seek routine checkups.
Medicare Advantage plans in Arizona significantly lower these hospital costs by providing comprehensive coverage for medical and hospital bills along with additional coverage for vision, hearing, and dental care.
As of 2024, Medicare in Arizona has about 1.4 million beneficiaries, leveraging Medicare plans to lower hospital bills. Individuals enrolled in Original Medicare, the standard Medicare plan, can also join a Medicare Advantage plan.
Medicare Advantage plan works as an alternative to Original Medicare, consolidating the benefits of Medicare Parts A and B with supplemental benefits.
A whopping 45% of Medicare beneficiaries are enrolled in Medicare Advantage plans, which means there are about 630,000 beneficiaries across the State. This Grand Canyon State is served by 157 Medicare Advantage plans.
Since there are numerous Medicare Advantage plans across the State, you must look into the benefits, costs, and deductibles associated with each plan to make an informed decision.
Medicare Advantage Networks
The Medicare Advantage plans in Arizona feature networks available in certain areas of the State. Each plan option is based on a ZIP code. These plans have varying copayments, premiums, and deductibles.
However, the standard plans start at $0 premium. Every Medicare-eligible person in Arizona has access to this $0 premium Medicare plan.
The average monthly premium for the Medicare Advantage plan in Arizona is $12. However, these plans are offered by private health insurance companies. Hence, their premiums and deductibles may vary from plan to plan.
Regardless of the premiums, all Medicare Advantage plans come with one limitation. Private health insurance companies collaborate with specific medical service providers across the State.
The beneficiaries enrolled in a plan can only seek treatment from healthcare providers within their network of choice. To consult a physician outside their network, they must have pre-authorization or a referral from their primary healthcare provider.
General Analysis | Ratings of Medicare Plan Providers in Arizona
| Insurance Company | Medicare Rating | A.M. Best Rating | Better Business Bureau (BBB) Rating | J.D. Power ranking |
| Aetna | 4 stars | A | A+ | 6th out of 9 |
| Blue Cross Blue Shield | 4.5 stars | A | A+ | 5th out of 9 |
| Humana | 4 stars | A- | A+ | 2nd out of 9 |
| UnitedHealthcare | 3.5 stars | A- | A- | 4th out of 9 |
Types of Medicare Advantage Plans
The State of Arizona has four types of Medicare Advantage plans. Depending on your healthcare needs, you can enroll in any of the following plans.
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Special Needs Plans (SNPs)
- Private Fee-For-Service Plans (PFFS)
Let us look into the details of these Medicare Advantage plans to help you make an informed decision.
Health Maintenance Organizations (HMOs)
An in-network provider, typically called an HMO provider, is an approved healthcare expert within the plan’s network.
In an HMO plan, beneficiaries receive care from a doctor, healthcare physician, or hospital within their network of choice.
In emergencies, beneficiaries require pre-authorization or referral from their primary healthcare provider to consult another specialist outside their network. HMO plans mostly include prescription drug coverage.
Preferred Provider Organizations (PPOs)
PPO, another type of Medicare Advantage plan available in Arizona, allows you to receive medical care from both in-network and out-of-network providers.
However, seeking out-of-network care typically costs more than your standard plan. This plan doesn’t restrict you to your primary care doctor.
You also don’t require a referral from your primary care physician to consult physicians outside your network. However, you incur relatively lower costs for medical experts and hospitals within the plan’s network.
Special Needs Plans (SNPs)
SNPs are ideal for beneficiaries with specific diseases who require specialized healthcare. Individuals with chronic conditions, living in nursing homes, or those who have both Medicaid and Medicare receive tailored benefits.
Generally, beneficiaries are limited to the plan’s network of providers. Pre-authorization is required to consult physicians outside the network. SNPs also include prescription drug coverage.
Private Fee-For-Service Plans (PFFS)
PFFS allows you to consult any Medicare-approved provider within Arizona. Hence, you’re not obligated to see a specific healthcare expert. Thus, PFFS plans work the same as Original Medicare, but you can visit any doctor at any hospital if they agree with the plan’s payment terms and conditions. These plans have fewer restrictions.
However, this plan establishes the pay rate for the doctor, the hospital, and the healthcare provider, as well as your out-of-pocket expense for the care you receive.
In some PFFS, you have a network of providers where you incur lower costs. However, your plan may not always have prescription drug coverage.
Comparison of the Top-Rated Medicare Advantage Plans in Arizona
As of 2024, the following are the best Medicare Advantage plans in Arizona. Here’s a comparison.
| Medicare Advantage Insurance Company | Medicare Rating | A.M. Best Rating | Better Business Bureau (BBB) Rating | J.D. Power Ranking |
| Aetna | 3.9 stars | A | A+ | 6th out of 9 |
| Blue Cross Blue Shield | 3.9 stars | A | B | 5th out of 9 |
| Cigna | 4 stars | A | Not rated | 8th out of 9 |
| Humana | 4.2 stars | A- | A+ | 2nd out of 9 |
| United Healthcare | 4.2 stars | A | Not rated | 4th out of 9 |
Benefits of Medicare Advantage Plans in Arizona
Medicare Advantage plans provide a range of supplemental benefits in Arizona with your standard coverage options.
These benefits include coverage for wellness programs, hearing services, dental care, vision care, transportation services, meal accommodation, telehealth services, OTC benefits, chronic condition management, etc. Hence, Medicare Advantage plans work as a bundled coverage option for beneficiaries seeking an all-in-one solution.
Since Arizona has about 150 Medicare Advantage plans, it’s crucial to look into the supplemental benefits your plan of choice offers before enrolling yourself to choose the best available health coverage in your region.
Here are the common benefits offered to Arizona residents with Medicare Advantage plans.
Hospital and Medical Insurance
Medicare Advantage plans in Arizona combine hospital and medical insurance, providing the same coverage as Original Medicare Parts A and B. This ensures that you receive primary coverage with your healthcare services.
Prescription Drug Coverage (Part D)
Most Medicare Advantage plans include prescription drug coverage to lower the out-of-pocket costs of prescription medications. Therefore, in most cases, you don’t require additional prescription drug coverage with a Medicare Advantage plan in Arizona.
Hearing Services
Some Medicare Advantage plans offer coverage for hearing exams. These plans typically cover hearing aids and other necessary equipment.
Vision Care
Comprehensive Medicare Advantage plans also provide coverage for routine eye examinations, eyeglasses, and contact lenses, promoting better eye health.
Dental Care
Medicare Advantage plans also offer preventive dental services, including routine checkups, scaling, and medically deemed necessary dental procedures.
Wellness Programs
Many Medicare Advantage plans include wellness programs, such as gym memberships, fitness classes, and yoga classes, with the primary aim of bettering beneficiaries. Such plans help older adults achieve a healthy lifestyle and combat healthcare problems that arise from a lack of fitness.
Transportation Services
Various Medicare Advantage plans offer assistance with transportation services. These plans ensure you access medical care at facilities more conveniently since you don’t have to worry about transportation to and from a hospital.
Over-the-Counter Benefits
OTC benefits allow beneficiaries to purchase over-the-counter items, non-prescription medications, drugs, and health-related products.
Chronic Condition Management
Chronic condition management includes specialized care for individuals with long-term health problems. Medicare Advantage plans with this benefit are ideal for individuals who require comprehensive healthcare. However, such plans may have a higher premium.
Cost of Medicare Advantage Plans in Arizona
The average monthly premium in 2024 for a Medicare Advantage plan in Arizona is $12. This average monthly premium for Medicare Advantage increased last year from $11.93 (in 2023) to $12.14 in 2024. Thus, Medicare Advantage plans have varying costs depending on the type of coverage and supplemental benefits they offer.
Some Medicare Advantage plans in the State also require you to pay out-of-pocket premiums, deductibles, copayments, and coinsurance.
These additional costs are associated with supplemental benefits and may vary from provider to provider. Therefore, you must familiarize yourself with deductibles, copayments, and coinsurance to avoid higher out-of-pocket premiums.
- Deductibles are expenses that you cover before Medicare provides coverage for health services. Thus, deductibles apply to all Medicare plans, including the standard Original Medicare.
- A copayment is a fixed payment for a doctor’s visit or a prescription drug. This amount is paid after you pay your deductibles, thus covering certain supplemental benefits.
- Coinsurance is a cost-sharing method in which you pay a percentage of the total amount for specific services after paying your deductibles. Your insurance plan covers the rest of the cost.
Medicare Advantage plans usually charge a copayment instead of the 20% coinsurance you pay under Original Medicare.
Also, Medicare Advantage plans significantly vary from provider to provider and plan to plan. Therefore, it is best to look into your plan’s requirements before signing up.
Eligibility and Enrollment for Medicare in Arizona
What makes you eligible for Medicare in Arizona? Medicare has the same eligibility criteria across all the States. You qualify for Medicare plans if:
- You are 65 years old or above
- You have a medical disability
- You have end-stage renal disease (ESRD)
- You have amyotrophic lateral sclerosis (ALS)
In addition, the Social Security Administration must approve you for either your age or disability to be eligible for Medicare plans.
Enrolment Period in Arizona
Medicare has two enrollment periods besides open enrollment: the initial enrolment period (IEP) and the general enrolment period (GEP).
- Initial enrollment period (IEP): The IEP is 7 months long, starting 3 months before your 65th birthday and ending 3 months after you turn 65. You can enroll during this period if you haven’t had Medicare before.
- General enrolment period (GEP): If you miss your IEP, you can access Medicare by applying for it during the general enrollment period (GEP) between January 1 and March 31 every year. You can choose Original Medicare, Medicare Advantage, Medigap, or Part D. During this period, you can also change your current Medicare plans. For example, if you have Original Medicare and you want to switch to a Medicare Advantage plan, you can do so during this period.
- Open enrollment period (OEP): From October 15 to December 7 each year, you can join, switch plans, or drop your coverage plans.
Why Is Medicare Vital for Arizona Residents?
Arizona, the sixth largest State in the US, has over 1.5 million residents aged 65 and above. This means that approximately 1 in 8 Arizonans are aged 65. These demographics deem healthcare services necessary in the region.
Programs such as Medicare provide comprehensive healthcare coverage to Arizona residents. Moreover, the State’s arid climate with hot summers presents unique health implications for senior residents. Heat strokes, cardiovascular problems, respiratory conditions, and skin problems are common in Arizona.
Diseases such as Valley fever also affect immunosuppressed individuals. To address these health challenges, Medicare Advantage plans in the region provide bundled coverage options to senior adults. These plans manage the high costs associated with healthcare, hospitalization, and specialized care.
To enhance the quality of life for senior adults, routine checkups are medically necessary. Services such as Medicare Advantage plans in Arizona safeguard the elderly population by providing a holistic approach to managing healthcare costs in the region.
Resources for Medicare in Arizona
A number of organizations across Arizona help resolve Medicare queries and streamline the complex enrollment process. Let us look into the various organizations that you can contact to resolve your Medicare queries.
| Organization | How you can get help | Website & Contact Info |
| Arizona Department of Economic Security | The Arizona Department of Economic Security administers Medicare assistance programs such as SHIP and SMP. This department’s primary aim is to help Arizona’s senior residents achieve their full potential, which encompasses providing access to resources for making informed healthcare decisions, including those related to Medicare. | Website | (877) 600-2722 |
| Senior Medicare Patrol | The Arizona Department of Economic Security provides access to the Senior Medicare Patrol (SMP), a program designed to help you prevent, detect, and report healthcare fraud. The SMP delivers outreach, counseling, and education to senior adults through trained volunteers. | Website | (800) 432-4040 |
| Area Agency on Aging | There are eight Area Agencies on Aging in Arizona, covering every region in the State. These organizations can link you to one of their regional agencies, each offering a broad range of services tailored for senior adults. These agencies aim to help individuals aged 60 and above preserve their health and independence. This includes providing resources to help you understand the Medicare enrollment process, with counselors on hand to help you fully understand the benefits available. | Website | (602) 264-4357 |
Compare Medicare Advantage Plans With Silveredge in Arizona
The State of Arizona has numerous healthcare facilities to assist older residents. One such facility is Medicare, which aims to lower healthcare bills and provide comprehensive inpatient and outpatient care coverage.
With over 150 plans in the region, enrolling yourself into a plan ideal for all your healthcare needs becomes challenging. You can break down this complex process by comparing Arizona’s various Medicare Advantage plans.
Services such as Silveredge are a one-stop solution to all your Medicare queries. Professional help through licensed advisors can help you choose a plan that suits all your medical needs. Make an informed decision through unbiased advice by contacting Silveredge today!
