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How Do Medicare Advantage Plans Work in Arizona?



Mountain Vista Medical Center - health insurance
Mountain Vista Medical Center
1301 S Crismon Rd
Mesa, AZ 85209
Telephone: (480) 358-6100
Plus Code: 99RQ+H5 Mesa, Arizona




Until recently, there was only one way to go when it came to Medicare coverage.  First you would acquire Medicare coverage.  You would then supplement your coverage by purchasing a Medicare Supplement plan.  A stand-alone Medicare plan contains "gaps" in coverage that can lead to significant out-of-pocket costs for several possible medical circumstances.  There are a variety of Medicare supplement health plan options that provide different levels of supplement protection.  The various plan types are designated by letters of the alphabet (A-N).  Generally, the more comprehensive the coverage, the higher the cost of the supplement plan.

Good to know:  Do the math.  When shopping for health insurance, most people focus on the monthly premiums, but you also need to take a close look at deductibles.  For example, if you have a choice between a lower silver plan premium of $345 a month for a plan with a $5,500 deductible, and a higher gold plan premium at $465 a month with a $1,750 deductible, you may be better off with the second plan if you anticipate needing more than $1,500 in medical care.  With the second plan, your total annual cost for the premium and deductible comes to $7,330, a $2,310 savings over the lower premium plan.

In Arizona, Medicare Advantage Plans are an "all in one" alternative to the Original Medicare / Supplement plan arrangement.  These plans are offered by private companies approved by Medicare.  If you join a Medicare Advantage Plan, you still have Medicare.  These "all in one" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Medicare Advantage Plans cover all services covered by original Medicare.  In addition, Advantage plans are required to offer at least the same level of coverage as the Original Medicare Part A and Part B coverage.  In almost every case, Advantage plans feature several attractive additional benefits that are not covered by original Medicare.  Dependent upon which Arizona advantage plan you choose, these benefits may include coverage for vision care, hearing aids, dental care, prescription drug coverage, transportation to and from medical facilities, and even fitness center membership.  The end result is a very comprehensive medical insurance plan.

If you enroll in a Medicare Advantage plan, you continue to pay your Medicare Part B premium.  The private insurer determines what the Medicare Advantage plan premium will be.  This premium amount will vary from one plan style to another.

Medicare Advantage plans tend to be significantly less expensive than Medicare Supplement coverage.  Some Medicare Advantage plans may have premiums as low as $0.

Copay costs may also be less with a Medicare Advantage plan.  For, example, if you visit a primary care physician under a Medicare Advantage plan, you may pay a copayment of $10.  However, if you visit a primary care physician under Original Medicare, you may have a coinsurance of 20%, which could be significantly more than $10.

A Medicare Advantage plan will limit your maximum out-of-pocket expense.  Once you have spent that maximum, you pay nothing for covered medical services for the remainder of the year.

Medicare Advantage Rules and Guidelines

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans.  In turn, these companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different Out-of-pocket costs.  They can also have different rules for how you get services – for example:

  • Whether you need a referral to see a specialist.
  • What shared medical costs you are responsible for.


Which Medicare Avantage Plan Carriers Are Available in Arizona?

Following is a list of some of the insurance companies that offer Medicare Advantage plans in Arizona:

  • Bright Advantage - Arizona. (Several plan variations)
  • Aetna - Arizona . (Several plan variations)
  • Cigna - Arizona.
  • Allwell - Arizona. (Several plan variations)
  • Humana. (Several plan variations)
  • Blue Medicare Advantage. (Several plan variations)
  • UnitedHealthcare. (Several plan variations)
  • AARP. (Several plan variations)

Good to know:  If there is a deadline associated with your health insurance purchase, be sure you know exactly when it is.  Make specific note of the timeline for enrollment, and give yourself plenty of time to research your plan choices before the deadline arrives.  Let's face it.  It's easy to put off a purchase such as health insurance - largely because there is no immediate impact if you delay.  So, commit to finishing the task early.  You don't want to be scrambling for answers at the last minute.

For more information concerning Medicare Advantage, Medicare Supplement or Medicare Prescription Drug Plans, please give us a call.


Other articles:
Medicare Supplement Insurance Rates in Arizona.
Medicare Supplement Vs Medicare Advantage Plans.
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