Medicare, a private health insurance company based in the United States, administered by the US Federal Government, is funded by the General Revenue and Federal Insurance Contributions Act.
This fee-for-service health insurance program provides coverage for almost 1.4 million people in Arizona, significantly lowering hospital bills for senior adults.
Medicare services are available for all legal US citizens aged 65 and above, those with certain disabilities, and people with end-stage renal disease (ESRD).
Hence, Medicare works as an all-in-one healthcare insurance program providing medical coverage for prescription drugs and inpatient and outpatient care.
In Arizona, different Medicare programs are available for beneficiaries. Let us look into Medicare plans in Arizona.
Medicare Plans in Arizona
Arizona ranks 12th highest in percent of population aged 65 years and older in the United States, with over 1.5 million residents aged 65 and above.
Since Arizona boasts the 12th highest proportion of senior residents, services like Medicare become vital for covering healthcare bills in the State. The rise in inflation and skyrocketing hospital bills have made it challenging to manage health care expenses.
Most people across Arizona have Medicare plans to manage the costs associated with healthcare. Arizona alone has about 1.4 million Medicare beneficiaries. This significant 18.92% of the total population utilizes Medicare plans to lower their out of pocket healthcare expenses.
Beneficiaries can enroll themselves in different types of Medicare plans in Arizona such as Original Medicare, Medicare Advantage plans, Medigap, etc. Let us look into these plans and what they offer to Arizona residents.
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 |
Medicare in Arizona by the Numbers
According to the 2024 demographics, the total number of Medicare beneficiaries in each plan in Arizona is as follows.
| Total number of people enrolled in Medicare | Medicare Advantage plans | Medicare Supplement Plan (Medigap) | Medicare Part D (Prescription Drug Coverage) |
| 1.4 million | Nearly 45% (630,000) of all Arizona residents with Medicare are enrolled in private Medicare Advantage plans. | 25% of beneficiaries purchased a Medicare Supplement plan. | More than 1.1 million people have Part D coverage in Arizona, including those with stand-alone Part D plans. |
Type of Medicare Plans in Arizona
Medicare programs vary from plan to plan. In Arizona, the two primary types of Medicare plans are Original Medicare and Medicare Advantage plans.
Besides this, beneficiaries enroll themselves in Medicare supplement plans (Medigap) and Part D prescription drug coverage. Let us explore the available Medicare plans in Arizona and how you can enroll yourself in 2024.
If you fulfill the eligibility criteria, you can enroll yourself into the following Arizona Medicare plans.
- Original Medicare (Part A and Part B)
- Medicare Advantage (Part C)
- Medicare Part D (Prescription Drug Coverage)
- Medicare Supplement Plan (Medigap)
Original Medicare (Part A and B)
The standard Medicare plan is called Original Medicare which is a fee-for-service insurance plan comprising two parts. Original Medicare Part A and B help lower hospital bills and out of pocket expenses incurred at inpatient and outpatient care.
Medicare Part A is hospital insurance that provides coverage for inpatient care, including hospital stays, skilled nursing facilities, hospice, home healthcare, etc. Part A premium primarily covers expenses related to your hospital and medical needs such as meals, medications, access to semi-private rooms, etc.
This insurance covers 80% of your medical costs, and you’re responsible for paying the remaining 20% as deductibles, copays, and coinsurance. Part A is premium free but if you haven’t paid Medicare taxes, it may cost up to $506 per month.
In contrast, Medicare Part B is medical insurance, providing coverage for outpatient care, including doctors’ visits, emergency care, lab tests, diagnostic testing, medical supplies, medical equipment, and preventive care. Part B may also cover screening for tumors, cancer, or other related medical issues. Part B premium is income-based; thus, it varies from person to person.
Enrolling yourself in Original Medicare requires you to pay deductibles along with the cost incurred from inpatient and outpatient care. You must also remember that it’s best to enroll yourself in Original Medicare if you’re looking for a flexible plan, as it allows you to consult any healthcare physicians that collaborate with Medicare in your region.
Medicare Advantage (Part C)
As of 2024, nearly 45% of all Medicare beneficiaries are enrolled in Medicare Advantage plans. Medicare Advantage plan also called Part C consolidates the benefits of Part A and B coverage with additional benefits including hearing, vision, and dental care.
Most of these plans work as an alternative to Original Medicare but also provide prescription coverage and gym memberships with other benefits.
Overall, Medicare Advantage plans work as a bundled coverage program for people seeking an all-in-one healthcare coverage solution for various medical needs.
There are 157 Medicare Advantage Plans available to Arizona residents, and each plan offers slightly different benefits to enrollees. However, Medicare Advantage plans do come with one limitation—a restricted choice of healthcare providers.
Since Medicare Advantage plans have contracts with specific service providers and hospitals, beneficiaries cannot seek treatment outside of their chosen network.
To consult a specialist outside of the chosen network, beneficiaries need prior authorization or referrals from their primary healthcare providers. This limitation isn’t ideal for Arizona enrollees who often travel out of State.
Types of Medicare Advantage Plans in Arizona
In Arizona, there are four types of Medicare Advantage plans. You can enroll yourself into any of the following plans.
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Special Needs Plans (SNPs)
- Private Fee-For-Service Plans (PFFS)
Rating of Arizona Medicare Advantage Plans
| 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 |
Medicare Part D (Prescription Drug Coverage)
Medicare Part D also called prescription drug coverage was introduced to lower costs associated with prescription medicines as Original Medicare doesn’t come with a drug coverage plan.
Arizona beneficiaries can access Part D coverage plans along with Original Medicare or with their Medicare Advantage plan to lower out-of-pocket expenses for drugs. There are about 28 Arizona prescription drug coverage plans, but all of them have different pricing.
If you don’t require prescription drugs, you can still enroll yourself into a low premium Part D plan to avoid late enrollment penalties later. Since Part D prescription coverage is a complex program, you can consult Silveredge’s licensed advisors to seek guidance regarding your Medicare plans.
Medicare Supplement Plan (Medigap)
Arizona Medicare plans include ten different Medigap plans, also known as Medicare supplement plans. These are optional plans that provide coverage for what’s not covered under Original Medicare. These plans provide additional insurance to lower out of pocket expenses.
But you must remember that these plans are standardized by the government. As a result, the plans differ from provider to provider. Therefore, it’s crucial to look into your provider’s Medigap plan to know the additional benefits you’d acquire on enrolment.
Another critical aspect of Medigap plans is that the pricing may differ, but the same type of plans offer the same benefits. For example, all Plan Ns offer the same coverage. Similarly, all types of plan G come with the same coverage options.
In Arizona, plan G is considered the best Medigap plan because it eliminates your out-of-pocket costs. You only have to pay your Part D deductible, while Medicare looks after the remaining costs incurred from inpatient or outpatient care.
The best time to enroll in a Medigap plan is during the Medigap Open Enrollment Period (OEP). Your Medigap OEP occurs for six months after your Medicare Part B effective date. During this period, you can apply for any Medigap plan.
Cost of Medicare Plans in Arizona 2024
The cost of Medicare plans in Arizona varies depending on the type of coverage you choose.
Generally, Part A of Original Medicare has premiums, deductibles, and coinsurance rates set federally, while Part B is income-based.
In contrast, Medicare Advantage plans have varying costs depending on the type of coverage and supplemental benefits it offers.
The average monthly premium for Medicare Advantage increased last year from $11.93 (in 2023) to $12.14 in 2024.
Let us look into the estimated costs for Medicare plans in Arizona.
| Original Medicare | Medicare Advantage | Medigap | Part D |
| Part A premium: $0 to $506 per month. Deductible: $1,600 for each benefit period. Part B premium: Standard premium of $164.90 per month. Deductible:$233 for each plan period. | Average monthly premium in 2024 for a Medicare Advantage plan in Arizona is $12. | Plan G cost for a non-smoking person aged 65 is $122 to $425. | The lowest monthly premium starts at $5.40. |
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)
Besides this, you must also be approved by the Social Security Administration for either your age or disability to be eligible for Medicare plans.
Enrolment Period for Medicare Plans in Arizona
Medicare has two enrollment periods besides open enrollment. These are your initial enrolment period (IEP) and a general enrolment period (GEP).
- Initial enrollment period (IEP): The initial enrollment period is 7 months, starting 3 months before your 65th birthday and ends 3 months after you turn 65. If you haven’t had Medicare before, you can enroll during this period.
- 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 make changes to 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): You can join, switch plans, or drop your coverage plans from October 15 to December 7 each year.
Applying for Medicare in Arizona
Applying for Medicare in Arizona is a simple procedure. You can apply online, through mail, or by visiting the nearest Social Security Office.
Plus, you’d be delighted to know that if you have been receiving your Social Security benefits, you automatically get enrolled in Medicare Part A and B.
You receive your Medicare ID in the mail before your 65th birthday.
However, if you’re new to Medicare, you can sign up during your initial enrollment period right before you turn 65.
You can also streamline this process by seeking professional help from Medicare-licensed advisors at Silveredge.
Resources for Medicare in Arizona
Making Medicare decisions may seem daunting. However, numerous organizations across Arizona can help resolve your Medicare queries and streamline this complex process for you.
Organizations such as the State Health Insurance Program (SHIP) aim to provide counseling to senior residents in Arizona regarding Medicare coverage. 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 |
Making Healthcare Decisions in Arizona With Silveredge
With growing age, healthcare needs tend to increase, resulting in Medicare coverage being vital to lower out-of-pocket costs. This can provide you and your loved ones with peace of mind and safeguard your health.
At this age, it’s pivotal to assess your health status to enroll yourself into the right plan. If you need assistance comparing plans in your region, Sillveredge is one step away!
With our licensed Medicare advisors, you can navigate the complex programs to select a coverage option that suits all your needs. Let’s step towards a healthy and fulfilling future today with Silveredge!
