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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:  Talk to an independent agent.  An independent insurance agent is an essential resource when purchasing insurance.  An independent agent works with multiple different carriers, which is different from captive agents who can only sell insurance from the carrier they work for.  Working with an independent agent can help make sure that you are getting the best coverage, for the best price.

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.

Good to know:  Want to really know the particulars concerning a health care plan?  Request the "evidence of coverage" document associated with the plan.  The evidence of coverage document is what you need if you want to understand in perfect detail, exactly what a health care plan covers.  You will find a thorough explanation of benefits, exceptions, and exclusions.  The evidence of coverage document provides details that may not be listed in that glossy plan brochure, or any online verbiage detailing plan benefits.  In most circumstances, this document is legally required to be associated with most any health plan policy.  It is available to consumers.  You need only to ask.
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:  It's never too late to negotiate a bill.  Many patients think once a bill has gone to collections it's game over, but that's not true.  Call the healthcare provider first, not the collection agency, to see if you can negotiate directly with them.  They have much more of an interest to negotiate the debt down than the collection agency.
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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