Hollay Ghadery Last Updated On: August 22, 2023

Your Questions About Medicare Plans in Arizona Answered Here

Insurance is complicated. But complicated insurance helps consumers receive coverage for their complicated lives. 

Our lives have a lot of moving parts. In order to keep up, insurance companies offer a wide range of coverage options. And we understand it can be difficult to wrap your head around what all these options mean. 

If you’re an Arizona resident who’s on the verge of tearing out their hair trying to comprehend their Medicare plan, take a deep breath. You’re in the right place. 

Keep reading to have all your questions about Medicare coverage in Arizona answered.

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Table of Contents

What Is Medicare?

Starting with the basics: Medicare is a government-sponsored health care plan for individuals over the age of 65 and for those younger than 65 with specific disabilities. Medicare is specifically designed to be an affordable option for those who need health coverage the most. 

The plan consists of four parts: 

  • Part A: Covers inpatient hospital expenses.
  • Part B: Helps cover medical expenses (or “outpatient care”) from a health practitioner. 
  • Part C: More commonly called “Medicare Advantage Plans,” this coverage is a customizable insurance plan that is sold through a private provider. 
  • Part D: Offers coverage for prescription medications. 

These four parts make up comprehensive health care coverage and help give you peace of mind throughout your 60s, 70s, and beyond.

What Is Medigap Coverage?

Medigap is supplemental coverage available for purchase in addition to your existing Medicare. 

Medigap is not the same as Medicare Advantage. 

Medigap coverage exists to fill in the “gaps” left by Medicare. Things like copays and coinsurance on your Medicare policy will add up over time, but Medigap will help you combat those sneaky costs. 

If you’re able, it’s a good idea to look into a Medigap plan to cover what Medicare is missing. In Arizona, Medigap has ten standardized supplemental plans that are labeled by letters from A to N. Each plan has slight variations in terms of price and coverage. Consulting with an insurance expert to understand which plan will work best for you can help you make sense of all of your options.

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What Does “Original Medicare” Mean?

There are four parts to every Medicare policy, and a Medicare plan won’t necessarily contain all of them.  The state’s baseline for Medicare plans is called “Original Medicare.” And Original Medicare includes Part A and Part B only. 

Original Medicare only covers hospital and medical expenses. No customizable additional coverages, no drug coverage, and no gap coverage.

Who Is Eligible for Medicare Plans in Arizona?

Medicare is available for any American citizen or permanent resident who meets either one of the following criteria:
  • Are 65 years of age or older 
  • Have received Social Security Disability Insurance (SSDI) for two or more years due to a disability such as End Stage Renal Disease or Amyotrophic Lateral Sclerosis (ALS)
In Arizona, the conditions are the same. If you meet one of the above criteria, you’re eligible for Medicare.

How Do I Get Medicare?

Obtaining your Medicare coverage in Arizona is rather simple. All you need to do is apply, which can be done via an online portal or by contacting your local social security office. 

But the timing of when you apply is important. You can’t apply for Medicare at just any time of the year. 

Rather, you must apply during an appropriate enrollment period. Here’s a breakdown of how those work:

  • Initial Enrollment Period: This seven-month period consists of the three months prior to your birth month, your birth month itself, and three months following your birth month. At any time during this period, you can apply for Medicare.
  • General Enrollment Period: If you miss the Initial Enrollment Period, it’s okay. The General Enrollment period runs from January 1st to March 31st of each year and anyone can apply within this window. 
  • Medicare Advantage Open Enrollment Period: Also running from January 1st to March 31st, people are able to make changes to their Medicare Advantage (Part C) plans during this period. 
  • Open Enrollment Period: This period runs from October 16th to December 7th each year. Within this window, people can join, switch, drop, or change their Medicare coverage. 
  • Special Enrollment Period: Those who recently lost another form of health insurance or those whose eligibility changed can qualify for a special enrollment period. 

Keeping track of when you can enroll in Medicare is important so that you have the coverage you need when you need it.

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Does Automatic Enrollment in Medicare Exist?

Enrollment in Medicare is only automatic if an individual starts receiving social security or Railroad Retirement Board (RRB) benefits at least four months before turning 65. 

In these specific cases, your Medicare coverage would start automatically. So, you would not need to worry about any enrollment periods.

Are There Penalties for Late or Missed Enrollment?

Unfortunately, yes there are penalties for late enrollment. In Arizona, these penalties take the form of additional charges and fees. 

If you miss the enrollment periods for Part A, Part B, or Part D, you will be penalized. However, there is no such penalization for Medicare Advantage plans.

No one wants to pay more than they need to for insurance, so be sure to enroll as soon as you become eligible, within an appropriate period.

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What Is Medicare Like in Arizona?

The bulk of information given thus far is a broad explanation of Medicare. This form of health insurance is run by the federal government, so the information applies across all 50 states. 

That said, there are some distinctive factors that Arizonians should know about their Medicare coverage in Arizona.  

Location plays a large role in both the pricing of your Medicare, and which health care providers are within the accepted network.

What’s the Average Price of Medicare Plans In Arizona?

Good news! Medicare in Arizona is very affordable. Arizona residents pay roughly 11% less than the national average for Medicare coverage.

Here’s a breakdown of what the average Arizona resident pays for Medicare:

  • Original Medicare: While hospital care in Part A is typically free, the medical care in Part B runs an average monthly premium of $164.90. Original Medicare in Arizona generally covers 80% of any hospital bills. 
  • Medicare Advantage: The average monthly cost of Medicare Part C is $12 monthly. 
  • Part D: The price for Medicare drug coverage in Arizona starts at just $5.40 per month. Part D can be purchased either alongside Medicare or through an independent provider, (Arizona has 28). There are seven providers in the state that use a Seniors Savings Model to reduce the charge of drugs such as insulin. 
  • Medigap: These plans vary depending on a consumer’s individual profile, and the type of gap plan purchased. For example, gap plan G for a 65-year-old non-smoking female is between $99 and $471 per month. 

Medicare insurance in Arizona is meant to be affordable. Getting the coverage you need as you age is important, so that you can stay in peak health through retirement and beyond. Find more retirement planning tips here to help you sail off into the sunset with ease.

Where Should I Go for Health Care in Arizona?

If you have Medicare, you are able to see any health care provider anywhere in the United States that accepts Medicare patients. However, not every office accepts Medicare patients, so it’s important to check with the health care services that you’re using. 

Also, if you have a Medicare Advantage plan, you may need to look for practitioners within the specified network of healthcare providers. But this only applies if you have a plan that specifies such a network.

Medicare Insurance in Arizona: Key Takeaways

We’ve just thrown a lot of information at you. But getting you the information you need to make the right decisions for your health and wallet are crucial. At ConsumerCoverage, we want to help consumers like you understand your insurance better. 

Whether you’re looking to plan ahead or need coverage now, we’ve got you covered. Get access to free quotes now so you can explore your Medicare options and decide what’s right for you. 


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