Medicare Advantage in Arizona

For Arizona seniors who feel traditional Medicare doesn’t provide the value they need, Medicare Advantage is a great alternative to consider. Also referred to as Plan C, Medicare Advantage is offered through private insurance companies rather than the federal government. These companies are required to offer the same coverage as Medicare plans A and B at a minimum but are given freedom to decide on any additional benefits that may be included.

Because these insurance companies compete with each other to enroll eligible seniors, these plans often include extra coverage for prescriptions, vision, dental, hearing or even additional preventative care like fitness programs. When a senior is enrolled in Original Medicare, prescriptions are only covered if they choose to also enroll in Plan D, which adds a separate premium to their monthly expenses. Because Medicare Advantage coverage is all bundled under one plan, seniors only have to pay one premium, creating a more budget-friendly option without sacrificing needed benefits.

The trade-off for the benefits of Medicare Advantage, which often includes coverage for additional services, is typically the restriction of care to a designated network of facilities and providers. Plan C emphasizes this network-based approach, requiring enrollees to use specified facilities and providers for full coverage, with the option to seek care outside the network at higher costs. This network is typically confined within state borders, making Original Medicare coverage more advantageous for seniors frequently traveling across the country. As of July 2023, out of 1,449,611 eligible Arizona seniors, 49% have enrolled in Medicare Advantage, marking a 3.96% increase from the same period in 2022 and slightly surpassing the national enrollment average of 48%.

This guide is a starting point to learn more about Medicare Advantage, including eligibility guidelines and information to help compare Arizona options to make an informed decision about coverage.

The Top 10 Medicare Advantage Plans in Arizona

There are 157 Medicare Advantage Plans available to Arizona seniors, and each offer slightly different benefits and premiums. Every county in Arizona has a $0 premium Plan C option, so affordability is a strong selling point to consider, but there are other factors that can help narrow the selection pool.

The table below lists the 11 most popular Medicare Advantage providers in Arizona based on enrollment numbers. Cost information is provided in a range to cover multiple plan options offered by the same providing company. As of July 2023, the data in the table below is correct. For additional details on Plan C providers, Medicare.gov has the most up-to-date information.

How Medicare Advantage Plans Work in Arizona

Medicare Advantage providers offer several types of plans, all of which have different rules regarding how members access care. Some plans require referrals, but others are a little more flexible. Certain plans also provide some coverage for out-of-network services. The graphic below provides details about the four most common types of Medicare Advantage Plans in Arizona.

What Medicare Advantage Plans Cover in Arizona

Medicare Advantage covers all medically necessary services covered by Original Medicare, including doctor visits, hospital care, X-rays, lab tests and preventive care. The only exception is hospice care, which is covered by Original Medicare instead of Medicare Advantage. Some providers even offer extra benefits to make their plans more attractive to Medicare-eligible residents of Arizona.

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Arizona

To enroll in a Medicare Advantage Plan, an Arizona resident must live in the plan’s service area, have Medicare Part A and Part B coverage and meet other basic eligibility requirements. Medicare is available to U.S. citizens and lawful immigrants who are at least 65 years old or qualify for Medicare at a younger age due to end-stage kidney failure, amyotrophic lateral sclerosis (ALS) or another type of disability. Like other types of insurance, Medicare Advantage doesn’t offer year-round enrollment. Therefore, it’s important to plan carefully when enrolling in Medicare Advantage for the first time or switching plans. The list below provides important details about enrollment timing for Medicare Advantage.

• Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
• Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
• Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Arizona

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources