Simply explained, Medicare Advantage is a program Medicare recipients can choose instead of Medicare Parts A and B. Medicare Part C allows private health insurance companies to provide all of the standard benefits of Medicare Parts A and B within a managed care plan like an HMO or PPO. Medicare Advantage Plans usually provide prescription drug insurance and some may include extras such as gym memberships or vision insurance.
Many of the companies have more than 1 plan which means that you can find the one that best works for you
More About Medicare Advantage Plans
Arizona Medicare Advantage Plans (also known as Medicare Part C) are Medicare plan options that are part of the Medicare program and are not the same as a Medicare Supplement. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. Arizona Medicare Advantage plans are available by county, such as Maricopa, Coconino or Yavapai. This coverage can include Medicare Part D prescription drug coverage.
Arizona Medicare Advantage Plans that are available include:
- Medicare Health Maintenance Organization (HMOs)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service (PFFS) Plans
- Medicare Special Needs Plans (SNP)
- Point of Service (HMO-POS)
Selecting Medicare Advantage Plans in Arizona
Consider these facts in deciding if a Medicare Advantage Plan for hospital and medical coverage is right for you:
- Most Medicare Advantage Plans cover costs & services not covered by Original Medicare.
- Medicare Advantage Plans may have lower deductibles & co-payments than Original Medicare.
- Medicare Advantage Plans usually have low premiums — $0 premium plans are available in Arizona.
- No health question asked. All Medicare beneficiaries, including people on Medicare due to a disability, are guaranteed acceptance regardless of health conditions (except End Stage Renal Disease).
- Special plans with lower or no out-of-pocket costs may be available for “Dual Eligibles” — people enrolled in both Medicare & AHCCCS.
With Medicare Advantage plans acceptance is guaranteed for all Medicare eligibles every year during the appropriate enrollment period regardless of health conditions (except End Stage Renal Disease). Dual Eligibles — people on both Medicare and AHCCCS and those with certain chronic health conditions — can enroll year-round. However, most Medicare Advantage plans require you to pay a co-pay each time you see a doctor, receive medical treatment, or visit a hospital. The maximum out-of-pocket expenses you are required to pay are capped on a per-year basis.
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B, live in the plan’s service area, not have End-Stage Renal Disease (ESRD) with limited exceptions, and be a U.S. citizen or lawfully present in the United States. You must continue to pay your Medicare Part B premium (unless your Part B premium is paid for you by Medicaid or another third party).
