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Looking forward to retirement in sunny, warm Arizona? If you’re like many retirees, one of your biggest struggles may be navigating health care once you leave your full-time job. Learn how Medicare works and find the best choices for Medicare in Arizona.
The Best Medicare in Arizona:
- Best Overall in Arizona: Humana
- Most Affordable in Arizona: WellCare
- Best for Provider Networks: BCBS of Arizona
- Best for Plan Choices: Bright Health
- Best for Special Needs Plans: Cigna
What is Medicare?
Medicare is a federal health insurance program that helps older Americans cover health care costs as they age. The program is mostly funded by taxes from employers, employees and self-employed individuals. Medicare helps retirees pay for health care costs, such as doctor visits or hospital stays, once you leave the workforce.
To qualify for Medicare, you must meet certain eligibility requirements:
- You’re 65 or older
- You’re under age 65 but have a qualifying disability
- You have end-stage renal disease, which is permanent kidney failure that requires dialysis or a transplant
In addition to age or disability requirements, you must also be a U.S. citizen or a permanent legal resident for the last 5 years.
Medicare vs. Medicaid
It’s easy to confuse Medicare and Medicaid, the 2 government health insurance programs. Medicare covers health insurance costs for seniors. You pay into the Medicare program over your working years through a tax in your paycheck. At age 65, you’re eligible to join the Medicare program, regardless of income.
Medicaid, on the other hand, is the federal health insurance program for low income or moderate-income households. The specific income requirements vary between states, but the program’s design helps people with very limited resources get health care.
How does Medicare Work?
Coverage for different health care services is broken down into Medicare parts. The different parts detail what health care services are covered under each part.
Medicare parts include:
Part A: Medicare Part A, or hospital coverage, covers inpatient hospital or skilled nursing facility stays. It also covers some portion of home health care and hospice care.
Part B: Medicare Part B is known as medical coverage, and is similar to the benefits you expect from a non-Medicare health insurance plan. Part B covers doctor visits, outpatient hospital visits, ambulance services and preventive services. Your Part B plan has a monthly premium, or cost to have the plan. The combination of Part A and Part B is known as Original Medicare.
Part C: Medicare Part C is technically Medicare Advantage. This is a health insurance plan from a private health insurance provider that offers benefits of Part A and Part B in one plan. Medicare Advantage plans often also offer some benefits of Part D. The plans also usually offer additional benefits not offered by Original Medicare, such as dental or vision coverage.
Part D: Medicare Part D plans offer prescription drug coverage through private insurance companies.
Additional coverage: Medicare parts don’t always cover all of your health care needs. You can add a Medicare Supplemental Insurance plan to your Medicare coverage to help fill in the gaps.
Legalities of Medicare in Arizona
The Department of Health and Human Services oversees and regulates the Medicare program through the Centers for Medicare and Medicaid Services (CMS). The Social Security Administration helps you enroll in Medicare.
The federal government partners with approved private health insurance companies for Medicare Part C and Part D. Private companies must follow certain rules to maintain approval by Medicare.
Late Enrollment Penalty
You can choose not to sign up for Medicare Part A or Part B once you’re eligible. If you later decide you want coverage, you may have to wait for the next enrollment period. You’ll also pay a late enrollment penalty for waiting.
Late enrollment penalties for Part A eventually disappear from your Medicare Part A premium. The penalty does not go away for Part B. If you enroll late in Part B, you’ll pay the penalty as long as you have Part B coverage.
These penalties can be avoided. The easiest way is to sign up right away when you’re eligible for Medicare. You can also avoid the penalty if you have health insurance coverage from your employer when you reach age 65. Check with your employer to make sure your plan meets Medicare requirements.
Types of Medicare Advantage Plans
Medicare Advantage Plans in Arizona give you access to plans that combine coverage for Medicare Part A and Part B. Most of the Medicare Advantage plans are either a health maintenance organization (HMO) or a preferred provider organization (PPO). Both types of plans use a network of doctors and health care facilities that partner with the insurance company.
HMO: A health maintenance organization (HMO), requires you to visit a doctor within the network. If you see a doctor who’s out of network, your Medicare Advantage Plan may not cover the costs. Some HMOs require you to choose a primary care physician for your health needs. When you need to see a specialist, you have to get a referral from your primary doctor.
PPO: PPO plans do not require you to visit doctors within the insurance provider’s network. You can go to any doctor you choose. Choosing an in-network doctor costs less than an out-of-network provider. You also won’t need to choose a primary care physician or get a referral to see a specialist. The flexibility of a PPO plan usually comes with higher premiums than most HMO plans.
How to Sign Up for Medicare in Arizona
You might start to wonder how you enroll in Medicare as you get close to age 65. Unfortunately, the government doesn’t automatically enroll you when you reach the eligible age. You must enroll in the program on your own.
When Can I Enroll in Medicare?
You can actually enroll in Medicare a few months before you turn 65. You have a 7-month period to enroll in the program. This period starts 3 months before the month you turn 65. You then have the 3 months following the month you turn 65 to sign up as well.
How Do I Enroll in Medicare?
To enroll in Medicare during your 7-month enrollment period, follow these steps:
Choose your coverage. You’ll need to decide if you want Original Medicare (Part A and Part B) or to enroll in a Medicare Advantage plan, which bundles coverage offered by Parts A and B.
Research private plans. Research plans from private health insurance companies if you plan to get a Medicare Advantage plan or Part D coverage.
Sign up. There are several ways you can sign up for Medicare:
- Register online at Medicare.gov.
- Call Medicare at 1-800-633-4227 or 1-877-486-2048.
- Go through the Arizona Department of Economic Security.
- Complete a paper application for your plan.
- Contact your plan provider to sign up.
Average Cost of Medicare Advantage Plans in Arizona
You’ll pay 2 premiums a month after you enroll in Medicare Advantage — one for your Medicare Advantage plan and another for Medicare Part B coverage. You can search for plans and enroll online at Medicare.gov. We took a look at Medicare Advantage plans available in Arizona to give you an idea of the costs you might have per year.
|Plan Name||Company||Plan Type||Health & Drug Costs|
|BluePathway Plan 2||BlueCross BlueShield of Arizona||HMO||$3,955|
|Aetna Medicare Platinum Plan||Aetna||PPO||$4,639|
|Bright Advantage Flex Plus||Bright Health||PPO||$4,015|
These annual costs are only estimates. Your individual costs depend on your health, location and plan. Contact the insurance company for a better idea of benefits and costs for the plan you’d like.
Best Medicare Insurance Providers in Arizona
It’s important to do your research when you look for Medicare insurance providers. We took the time to make your search a little easier. Check out our picks for the best Medicare insurance companies in Arizona.
1. Best Overall in Arizona: Humana
Humana offers several Medicare plans in Arizona, which can give you a lot of options. Choose from $0 monthly premium plans or plans with more coverage and benefits.
Humana ranks 3rd in the 2019 J.D. Power Medicare Advantage Study and is the highest-ranking provider in Arizona.
The company was rated among the best in categories including communication, billing process and overall customer satisfaction.
2. Most Affordable in Arizona: WellCare
Many providers in Arizona offer a $0 premium plan.
These plans often come with fewer benefits and high health care costs. WellCare helps you save on premium and retain great coverage from your Medicare Advantage plan.
The company’s affordable plans also offer vision, dental and hearing benefits. You’ll also get access to fitness benefits for gym memberships and wellness programs.
3. Best for Provider Network: BlueCross BlueShield of Arizona
BlueCross BlueShield is one of the largest health insurance providers in the country. BlueCross BlueShield of Arizona operates locally in Arizona to bring the benefits of a large provider to you.
The network includes over 9,000 doctors and health care facilities in the Phoenix area alone.
Medicare Advantage customers can also enjoy benefits like a free fitness facility membership and an allowance for over-the-counter health products.
4. Best for Plan Choices: Bright Health
Bright Health has several Medicare Advantage plan options in Arizona.
This range of plan options means you can find a plan that works best for you. Many of the Bright Health plans have a $0 premium so you can save on your monthly health care costs.
One of our favorite parts is the added benefits — for example, you can upgrade standard dental coverage to a more comprehensive plan.
5. Best for Special Needs Plans: Cigna
Special Needs Plans (SNP) limit enrollment to those who have certain chronic illnesses or disabilities. Cigna offers some of the best options for SNPs in Arizona.
For example, Cigna has an SNP specifically if you have diabetes. Coverage and benefits center around helping you manage your condition.
Cigna ranks among the best for customer service in the 2019 J.D. Power Health Plan Satisfaction Survey for the Southwest.
Get Medicare Coverage in Arizona
The right health insurance can make retirement more enjoyable. Research Medicare insurance providers and plans in Arizona before you turn 65. Choose a few plans you like so you can sign up right away when you reach your enrollment period.
Frequently Asked Questions
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.
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