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Medicare Advantage in Arizona Overview for 2022

For many seniors, Medicare Advantage plans in Arizona for 2022 can simplify the confusion that comes with making sure they have the appropriate health care coverage. A Medicare Advantage plan in Arizona combines Medicare Part A (hospital) Medicare Part B (outpatient and medical) coverage into one plan. Advantage plans frequently include Medicare Part D (prescription drug coverage), too.

Medicare Advantage is enjoying a rise in popularity among Medicare beneficiaries. Private insurance companies provide the benefits and handle customer service. But it’s important to remember the following about an Advantage:

  • You’re still in the Medicare program
  • You still get Part A and Part B coverage
  • You still have the rights and protections of Medicare
  • You must continue paying your Part B premium. The standard monthly Part B premium is $170.10 in 2022. The annual deductible for Medicare Part B beneficiaries are $223 in 2022

Medicare Advantage in Arizona

Medicare Advantage in Arizona is another way to receive your Medicare benefits. When you sign up for Medicare, you’re asked to choose how you want to receive coverage:

  • Original Medicare (Medicare Part A and Part B)
  • Medicare Advantage (called Medicare Part C)

The Centers for Medicare and Medicaid Services oversees both programs. If you choose Original Medicare, you can buy additional coverage through a Medicare Supplement plan (Medigap plan) to help with out of pocket costs. You’ll also need a Part D plan for prescription drug coverage.

If you choose an Medicare Advantage plan, you’ll get all of your benefits through one plan. Here’s how it works:

  • Most Advantage plans use an approved network of providers, but plans are required to cover emergency care outside of the network service area.
  • Most MA health plans include Part D coverage. These are called MAPD plans, or Medicare Advantage Prescription Drug plans.
  • Advantage plans usually include extra benefits such as wellness programs, over-the-counter medicine coverage, vision and fitness programs.
  • MA plans have a cap on out-of-pocket spending. Once you reach that limit, you won’t pay anything for covered care.

What is the best Medicare Advantage plan in Arizona?

Best network freedom: Medicare Advantage PPO

  • PPO’s typically has a larger network
  • Doesn’t require specialist referrals
  • Monthly premiums range from $0 to $100.

Best for lowest out-of-pocket: Medicare Advantage HMO Plan

  • HMO plans typically offer low or no deductibles
  • Lower out-of-pocket expenses because it uses referral network
  • Premiums generally $0

Best for low income or health conditions: Medicare Advantage D-SNIP

  • Care plan targeted toward a specific chronic condition
  • Beneficiaries can have Medicare and Medicaid, which lowers out of pocket costs for copayments and premiums.

Arizona enrollment:

Medicare Advantage plans are a good fit for many Arizona Medicare beneficiaries. Nationally, enrollment in MA insurance plans continues a steady growth, increasing by 9.6% over last year. At the same time, enrollment in Original Medicare declined by 2.6%. We think the future looks bright for Medicare Advantage in Arizona.

  • Number enrolled in Advantage in Arizona: 572,322
  • Number enrolled by plan:
    Local HMO: 348,945
    Local PPO: 35,338
    Regional PPO: 7,541
  • Medicare beneficiaries enrolled in Advantage in Arizona: 42%
  • Number enrolled in Medicare nationwide: 29.5 million
  • Medicare beneficiaries enrolled in Medicare Advantage nationwide: 42%

How much does Medicare Advantage in Arizona cost?

Monthly premiums for an Arizona Medicare Advantage plan will vary based on location and whether it’s an HMO or PPO. HMO premiums are typically lower than PPOs. The average price for an Arizona Advantage plan that includes drug coverage is $18.00.

When can you enroll in a Medicare Advantage plan?

Eligibility for a Medicare Advantage plan hinges on being enrolled in Medicare Parts A and B.

Following are the enrollment periods for Medicare Advantage:

Initial Enrollment Period

Your Initial Enrollment Period is a seven-month time span that starts three months before you’re first eligible for Medicare and ends three months after.

  • Eligible due to age: the month you turn 65
  • Eligible due to disability: the 25th month of receiving disability payments
  • Eligible due to Amyotrophic Lateral Sclerosis (ALS): the first month you receive disability benefits
  • For everyone, the IEP is a one-time event.

Open Enrollment Period – AKA Annual Election Period

  • Oct. 15 – Dec. 7
  • Can sign up for, switch, or leave a Medicare Part C plan
  • Those with end-stage renal disease can join Medicare Advantage during open enrollment.

Medicare Advantage Open Enrollment Period

  • Jan. 1 – March 31
  • Can switch MA plans or leave an MA plan and return to Original Medicare
  • Can enroll in a Part D prescription drug plan if you left Medicare Advantage and returned to Original Medicare

Special Enrollment Periods

  • Periods outside the normal enrollment periods to join Medicare Part B
  • Not tied to a specific time frame
  • Based on circumstances, such as losing job-based health insurance, moving out of plan’s service area, or the insurance company opts out of its contract with Medicare
  • Must sign up for Part B before enrolling in Medicare Advantage

A call to one of our insurance agents will help determine whether you meet the criteria for special enrollment.

5-star Special Enrollment Period

  • Can leave your Advantage plan and change to a plan with a 5 star rating

Special Enrollment Periods if you get “Extra Help”

  • Qualify for Medicare and Medicaid: You can join, drop, or change MA plans once a quarter for the first three quarters of the year. (You cannot use this special enrollment option October through December.)
  • Qualify for help for drug coverage: You can join, drop, or change drug coverage options.
  • State Pharmaceutical Assistance Program: You can join a Medicare Part D drug plan or a Medicare Advantage plan with Part D coverage included if you’re enrolled in or lose coverage through SPAP.

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.   

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Key Take Aways
  • In Arizona, PPO Medicare Advantage Plans are very popular for many Medicare beneficiaries.
  • You can make changes to your Advantage plan each year during the Annual Election Period.
  • You must continue to pay your Medicare Part B Premium with most Medicare Advantage plans.