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Your Local Guide to Arizona Medicare: Personalized Plans for You

Navigating Arizona Medicare can be overwhelming, but as a local insurance broker, I’m here to help. Understanding the types of plans available, considering your healthcare needs, researching Medicare Advantage and Medigap plans, and seeking expert guidance is essential.

Contact me for a free consultation, and let’s find the right plan. With my personalized support, you can have peace of mind knowing you have the coverage you need for a secure and healthy future.

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Understanding Medicare in Arizona

Arizona Medicare health insurance brokers free consultationMedicare is a federal health insurance program in the United States primarily serving individuals aged 65 and older and certain younger individuals with disabilities or specific medical conditions. In Arizona, more than 1.4 million people are enrolled in Medicare, accounting for nearly 20% of the state’s population.

Eligibility Criteria

Generally, individuals are eligible for Medicare if they meet any of the following criteria:

– Aged 65 or older

– Already receiving Social Security or Railroad Retirement Board (RRB) benefits

– Diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease)

– Under age 65 and permanently disabled, having received Social Security disability payments for at least 24 months

Medicare Coverage in Arizona

Medicare coverage in Arizona consists of Original Medicare (Part A and Part B) and private Medicare plans, such as Medicare Advantage (Part C) and Medicare Part D (prescription drug coverage). Original Medicare is a federal program that does not vary from state to state, while the availability and pricing of private Medicare coverage can differ.

As of March 2023, about 49% of Arizona Medicare beneficiaries were enrolled in Medicare Advantage plans instead of Original Medicare. Medicare Advantage plans offer additional coverage for essential needs, such as prescription drugs, dental, and vision care. In 2018, 991,830 Medicare beneficiaries in Arizona were enrolled in Part D coverage.

Understanding Medicare in Arizona is crucial for individuals seeking coverage, as it helps them make informed decisions about their healthcare options.

Medicare Enrollment Process

Enrolling in Medicare involves several steps and can vary depending on an individual’s circumstances. Here’s a detailed look at the process:

Automatic Enrollment

Some individuals are automatically enrolled in Medicare. This typically includes those already receiving Social Security or Railroad Retirement Board (RRB) benefits when they turn 65 or those who have received Social Security disability benefits for at least 24 months.

If you’re automatically enrolled, you’ll receive a Medicare card in the mail three months before your 65th birthday or your 25th month of disability.

Manual Enrollment

Not automatically enrolled can sign up for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) when they first become eligible, usually when turning 65.

There are several ways to sign up for Medicare:

– **Online**: This is the easiest and fastest way to sign up. You can apply online at the Social Security website.

– **By Phone**: You can call Social Security at 1-800-772-1213 to sign up.

– **In Person**: You can visit a local Social Security office to sign up.

Enrollment Periods

There are specific times when you can sign up for Medicare:

– **Initial Enrollment Period (IEP)**: This is a 7-month period that begins three months before you turn 65, includes the month you turn 65, and ends three months after you turn 65. If you’re eligible due to disability, this period begins three months before your 25th month of disability payments, includes the 25th month, and ends three months after.

– **General Enrollment Period (GEP)**: If you missed your IEP, you can sign up between January 1 and March 31 each year. Coverage will start the month after you sign up.

– **Special Enrollment Period (SEP)**: In certain situations, like if you’re covered under a group health plan based on current employment, you might have a chance to sign up for Medicare during a Special Enrollment Period.

Assistance in Arizona

The State Health Insurance Program (SHIP) and the Senior Medicare Patrol (SMP) are available to assist with Medicare in Arizona. These programs can help answer questions about specific individual Medicare plan benefits or plan selection assistance.

Understanding the enrollment process is crucial for individuals seeking Medicare coverage in Arizona, as it helps them navigate the system and make informed decisions about their healthcare options.

Medicare Coverage Options in Arizona

In Arizona, there are several Medicare coverage options available to beneficiaries. These include Original Medicare, Medicare Advantage (Part C), Medigap, and Medicare Part D.

 Original Medicare

Original Medicare is a federal program that provides health coverage for individuals aged 65 and older and certain younger individuals with disabilities or End-Stage Renal Disease (ESRD). Part A (hospital insurance) and Part B (medical insurance). Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and home health care. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Advantage (Part C)

Medicare Advantage, or Part C, is an alternative to Original Medicare. Private insurance companies approved by Medicare offer these plans and must provide at least the same level of coverage as Original Medicare. However, many Medicare Advantage plans offer additional benefits such as prescription drug coverage, dental care, vision care, and wellness programs. In Arizona, 157 Medicare Advantage plans are available, and 100% of people with Medicare have access to a $0 monthly Medicare Advantage plan premium.

Medigap

Medigap, also known as Medicare Supplement Insurance, is private insurance that helps cover some healthcare costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles. In Arizona, Medigap policies are standardized and regulated by state laws. The most popular and comprehensive Medigap plans in Arizona are Plans F and G. The cost of a Medigap plan in Arizona can range from about $75 to $471 each month, depending on several factors, including your age, gender, the insurer, and your state of residence.

Medicare Part D

Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. It helps cover the cost of prescription medications. In Arizona, beneficiaries can enroll in a stand-alone prescription drug plan or choose a Medicare Advantage plan with drug coverage.

Understanding these different Medicare coverage options in Arizona is crucial for beneficiaries to make informed decisions about their healthcare. It allows them to choose the plan best suits their needs and preferences.

Costs and Premiums

Medicare plans come with various costs, including premiums, co-payments, and deductibles. These costs can vary depending on the specific Medicare plan and the individual’s circumstances.

Medicare Part A

For Medicare Part A, the premium can cost $0, $278, or $506, depending on how long you or your spouse worked and paid Medicare taxes. The Part A hospital inpatient deductibles and coinsurance are as follows:

– $1,600 deductible for each benefit period

– Days 1-60: $0 coinsurance for each benefit period

– Days 61-90: $400 coinsurance per day of each benefit period

Medicare Part B

The standard monthly Medicare Part B premium is $164.90 in 2024, and the Part B deductible is $226. Once the deductible is met, you usually pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment.

Medicare Part C (Medicare Advantage)

The average cost of an Arizona Medicare Advantage Plan is $12.00 in 2023. Some plans start as low as a zero premium. To qualify for Medicare Advantage, you must stay enrolled in Medicare Part A and Part B and continue paying your monthly Part B premium. You’ll also need to pay any premium the Medicare Advantage plan may charge.

Medicare Part D

Medicare Part D costs can vary based on the specific plan and the individual’s medications.

Assistance for Medicare Costs

Several assistance programs are available for individuals who may struggle to afford these costs.

– **Medicare Savings Programs**: These programs can help pay for Medicare Part B premiums, Medicare Part A and B cost-sharing, and in some cases, Part A premiums. There is no asset limit for these programs in Arizona.

– **Arizona Health Care Cost Containment System (AHCCCS)**: This program can help individuals qualify to have their Medicare premiums, co-payments, and deductibles paid. Eligibility is based on income limits.

– **State Health Insurance Assistance Program (SHIP)**: This program provides free health benefits counseling services for Medicare beneficiaries. It can help individuals make informed health insurance decisions that optimize access to care and benefits.

– **Specified Low-Income Medicare Beneficiary (SLMB) Program**: This program pays the member’s Medicare Part B premium.

These programs can provide significant financial relief for eligible individuals. It’s essential to research each program and apply to those that you may qualify for.

Choosing a Medicare Plan

When choosing a Medicare plan in Arizona, consider the following:

Coverage: Ensure the plan covers the healthcare services you need. This includes hospital care, doctor visits, prescription drugs, and additional services like vision, dental, or hearing care.

Cost: Consider the cost of premiums, deductibles, copayments, and out-of-pocket maximums. Also, check if the plan offers cost-saving benefits, such as wellness and health care planning, reduced cost-sharing, and rewards and incentives programs.

Provider Network: If you have preferred doctors or healthcare providers, ensure they are in the plan’s network. Some plans may require you to use network providers or charge more for out-of-network care.

Quality of Care: Check the plan’s quality ratings. Medicare rates plan on a 5-star scale, with 5 stars being the highest quality.

Prescription Drugs: If you take prescription medications, ensure the plan covers them. Also, check the cost of the drugs under the plan. You can compare Medicare plans in Arizona using tools like the Medicare Plan Finder on Medicare.gov or other comparison tools. It’s also a good idea to consult with a Medicare specialist or advisor to help you understand your options and make an informed decision.

Role of Insurance Brokers

Insurance brokers, such as the Arizona Blake Insurance Group, play a crucial role in helping individuals navigate the complex world of Medicare. They act as a link between people needing Medicare plans and the companies that offer them, working with clients and insurance companies.

Benefits of Working with a Broker

 **Medicare Expertise**: Brokers deeply understand Medicare, having undergone extensive training and education. They are up-to-date with the latest Medicare industry news and have access to important information.

**Personalized Attention**: Brokers provide personalized Medicare quotes based on factors unique to each individual, such as age, location, gender, and health issues. They take the time to understand your needs and budget, helping you find cost-effective options for Medicare Advantage (Part C), Prescription Drug Plans (Part D), and Supplemental Insurance Plans (Medigap).

**Access to Multiple Providers**: Independent brokers, like those at the Blake Insurance Group, can provide options from various carriers. They do not work for any insurance company, allowing them to help you find the most cost-efficient plan.

**Time-Saving**: Brokers can save time on research and plan comparison, especially if Medicare coverage is new to you. They can help you narrow your options efficiently and guide you to the coverage that fits your circumstances.

**No Extra Cost**: There are no fees to pay for using the services of an insurance broker. The broker’s commission is included in your premium.

Working with an insurance broker like the Arizona Blake Insurance Group can provide numerous benefits, including personalized advice, access to multiple providers, and assistance finding the best plan for an individual’s needs.

Transitioning to Arizona Medicare

Transitioning to Arizona Medicare involves several steps and considerations. Here’s a detailed guide on the process and what to keep in mind:

Original Medicare

Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance), is a federal program. Therefore, your coverage will not change when you move to Arizona or any other state. The only step you need to take is to update your address with the Social Security Administration. If you receive Railroad Retirement Board benefits, you should update your address with them.

Medicare Advantage (Part C)

If you have a Medicare Advantage plan, you should inform your plan before you move. These plans are specific to certain service areas; typically, they won’t cover you in another state. If you move out of your plan’s service area, you qualify for a Special Enrollment Period (SEP) that allows you to change your Medicare Advantage plan. The SEP begins the month before you move and ends two months after you move if you notify your plan before moving. If you notify your plan after moving, your SEP begins during the month you notify the plan and lasts for two more months.

Medigap

Medigap, also known as Medicare Supplement Insurance, helps cover some healthcare costs that Original Medicare doesn’t cover. If you have a Medigap plan, you only need to change your address with your plan’s carrier. This could result in a change of premium depending on your new location. You may also be eligible for Guaranteed Issue Rights to enroll in a new plan if allowable by your new state.

Medicare Part D

If you have Medicare Part D prescription drug coverage, you will be eligible for a Special Enrollment Period (SEP) when you relocate. This SEP offers you the opportunity to enroll in the plan that is offered in your new location.

Other Considerations

Before moving, it’s essential to research the Medicare options available in Arizona. As of March 2023, Arizona had 1,444,389 residents with Medicare, amounting to nearly 20% of the state’s population. About 49% of Arizona Medicare beneficiaries had Medicare Advantage plans instead of Original Medicare. 41 insurers offer Medigap plans in Arizona for individuals age 65 or older.

In Arizona, you can also get help paying for Medicare if you have low income and resources. Arizona’s Medicaid program called the Arizona Health Care Cost Containment System (AHCCCS), offers health insurance for people 65 or older who are Arizona residents, US citizens, and under income limits. Arizona also has Medicare Savings Programs for residents on Medicare who have low income and resources.

Remember to update your mailing address with Medicare once you’ve moved, so bills, correspondence, Medicare Summary Notice, and other statements go to the correct address. You can update your information in your My Social Security account, call 800-772-1213, or contact a Social Security office.

Lastly, contacting the State Health Insurance Assistance Program (SHIP) is recommended for any questions regarding specific individual Medicare plan benefits or plan selection assistance.

Medicare companies Arizona

In Arizona, several providers offer Medicare Advantage plans with different ratings and plan offerings.

Providers and Ratings

The Centers for Medicare & Medicaid Services (CMS) awards every Medicare Advantage plan a star rating on a scale of 1 to 5, with 5 being a top-rated plan. For the 2024 plan year, there are no 5-star-rated plans available in Arizona. However, several companies offer plans rated 4.5 and 4 stars by CMS.

4.5-Star Plans

The companies that offer 4.5-star plans in Arizona include:

– Humana

– UnitedHealthcare

4-Star Plans

The companies that offer 4-star plans in Arizona include:

– Aetna Medicare

– Blue Cross Blue Shield of Arizona (AZ Blue)

– Cigna

– Devoted Health

– Humana

– UnitedHealthcare

Plan Offerings

Different providers offer a variety of plans. For instance, Devoted Health sells four plans in Arizona: Choice, Core, Giveback, and Select. The Choice, Core, and Giveback plan cost $0 per month, while the Select plan has a monthly rate.

Humana offers several plans, including HumanaChoice and Humana Value Plus, with varying premiums and out-of-pocket limits.

UnitedHealthcare’s Medicare Advantage plans are available in every county in the state, ensuring that everyone eligible for Medicare in Arizona has access to a UnitedHealthcare plan.

Other Providers

Other Arizona providers offering Medicare Advantage plans include Alignment Health Plan, Amerigroup (called Wellpoint in 2024), Banner Medicare, EternalHealth, Gold Kidney Health Plan, Molina Healthcare of Arizona, and SCAN Desert Health Plan.

UnitedHealthcare

UnitedHealthcare offers a range of Medicare Advantage plans in Arizona, including HMO and PPO. These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing. UnitedHealthcare also offers Medigap plans to help cover the costs that Original Medicare doesn’t cover.

– UnitedHealthcare offers a variety of Medicare Advantage plans in Arizona, including both HMO and PPO plans.

– These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing.

– UnitedHealthcare also offers Medigap plans, designed to help cover the costs that Original Medicare doesn’t cover.

– private insurance carriers provide Medicare Advantage plans offered by UnitedHealthcare.

– These plans include everything Original Medicare covers and additional benefits.

It’s important to note that the specific details and availability of Medicare Advantage plans can vary by location and year. It’s recommended to contact UnitedHealthcare directly or speak with a licensed insurance agent specializing in Medicare to get the most up-to-date and accurate information about the Medicare Advantage plans they offer in Arizona.

Humana health insurance ArizonaHumana Medicare Arizona

Humana offers several Medicare Advantage plans in Arizona, including HMO and PPO plans. These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing. Humana also offers Medigap plans to help cover the costs that Original Medicare doesn’t cover.

– Humana offers 21 Medicare Advantage plans in Arizona, including both HMO and PPO plans.

– These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing.

– Humana also offers Medigap plans, designed to help cover the costs that Original Medicare doesn’t cover.

– Some Humana Medicare Advantage plans have a $0 premium in certain areas.

– Many Humana Medicare Advantage plans offer prescription drug coverage, vision, and dental benefits.

– Humana offers a variety of Medicare Advantage plans, including HMO, PPO, and PFFS plans.

– Humana also offers a stand-alone prescription drug plan with a Medicare contract.

– Humana has partnered with TruHearing to offer hearing care and hearing aids within select Medicare Advantage plans in Arizona, Arkansas, Nevada, and other states.

It’s important to note that the specific details and availability of Medicare Advantage plans can vary by location and year. It’s recommended to contact Humana directly or speak with a licensed insurance agent specializing in Medicare to get the most up-to-date and accurate information about the Medicare Advantage plans they offer in Arizona.

Blue Cross Blue Shield of Arizona

Blue Cross Blue Shield of Arizona offers several Medicare Advantage plans in Arizona, including HMO and PPO plans. These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing. Blue Cross Blue Shield of Arizona also offers Medigap plans to help cover the costs that Original Medicare doesn’t cover.

– Blue Cross Blue Shield of Arizona offers several Medicare Advantage plans in Arizona, including both HMO and PPO plans.

– These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing.

– Blue Cross Blue Shield of Arizona also offers Medigap plans, designed to help cover the costs that Original Medicare doesn’t cover.

– Some Blue Cross Blue Shield of Arizona Medicare Advantage plans have a $0 premium in certain areas

– Many Blue Cross Blue Shield of Arizona Medicare Advantage plans offer prescription drug coverage, vision, and dental benefits.

– Blue Cross Blue Shield of Arizona offers a variety of Medicare Advantage plans, including HMO and PPO plans.

– Blue Cross Blue Shield of Arizona also offers a stand-alone prescription drug plan with a Medicare contract.

It’s important to note that the specific details and availability of Medicare Advantage plans can vary by location and year. It’s recommended to contact Blue Cross Blue Shield of Arizona directly or speak with a licensed insurance agent specializing in Medicare to get the most up-to-date and accurate information about the Medicare Advantage plans they offer in Arizona

arizona medicare health insurance brokers free consultationWellcare

Wellcare offers several Medicare Advantage plans in Arizona, including HMO and PPO plans. These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing. Wellcare also offers Medigap plans to help cover the costs that Original Medicare doesn’t cover.

– Wellcare offers Arizona’s several Medicare Advantage plans, including HMO and PPO plans.

– These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing.

– Wellcare also offers Medigap plans, designed to help cover the costs that Original Medicare doesn’t cover.

– Wellcare’s Medicare Advantage plans are offered through private insurance carriers.

– Wellcare’s Medicare Advantage plans may include additional benefits such as transportation services, fitness programs, and over-the-counter allowances.

– Wellcare’s Medicare Advantage plans may have a $0 premium in certain areas.

– WellCare’s Medicare Advantage plans may offer prescription drug coverage, vision, and dental benefits

– Wellcare’s Medicare Advantage plans may offer additional benefits such as hearing aids and transportation services.

It’s important to note that the specific details and availability of Medicare Advantage plans can vary by location and year. It’s recommended to contact WellCare directly or speak with a licensed insurance agent specializing in Medicare to get the most up-to-date and accurate information about the Medicare Advantage plans they offer in Arizona.

Alignment Health

Alignment Health offers several Medicare Advantage plans in Arizona, including HMO and PPO plans. These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental, vision, and hearing. Alignment Health also offers Medigap plans to help cover the costs that Original Medicare doesn’t cover.

– Alignment Health offers Medicare Advantage plans in select Arizona, California, and Texas counties.

– Medicare Advantage plans from Alignment Health may include enhanced benefits for LIS- and dual-eligible beneficiaries.

– These plans provide additional benefits beyond Original Medicare, such as prescription drug coverage, dental care, eyeglasses, and gym or fitness benefits.

– Alignment Health offers Medicare Advantage plans with $0 premiums in Pima and Maricopa counties in Arizona.

– Members of the Alignment Health Plan have access to supplemental benefits that go beyond traditional Medicare coverage.

– Alignment Health is focused on providing value, access, and flexibility to Medicare-eligible adults.

It’s important to note that the specific details and availability of Medicare Advantage plans can vary by location and year. It’s recommended to contact Alignment Health directly or speak with a licensed insurance agent specializing in Medicare to get the most up-to-date and accurate information about the Medicare Advantage plans they offer in Arizona.

Medicare FAQ

Medicare FAQ

What is Medicare health insurance?

Medicare health insurance is a federal program in the United States that provides medical coverage for individuals 65 years old or older or for certain individuals with disabilities. It helps cover various healthcare services, including hospital stays, doctor visits, and prescription drugs.

What are the 4 types of Medicare?

The four types of Medicare are:

  • Medicare Part A: Hospital Insurance
  • Medicare Part B: Medical Insurance
  • Medicare Part C: Medicare Advantage Plans
  • Medicare Part D: Prescription Drug Coverage

Each part of Medicare covers different healthcare services and has specific eligibility criteria and associated costs.

How much do I have to pay for Medicare when I turn 65?

The cost of Medicare varies depending on the specific parts you enroll in. Here's a general overview:

  • Most people do not pay a premium for Medicare Part A if they or their spouse have paid Medicare taxes while working.
  • Medicare Part B has a standard premium of $148.50 per month (as of 2021) for most individuals. However, higher-income individuals may pay a higher premium based on their income.
  • Medicare Part C (Medicare Advantage) and Part D (Prescription Drug Coverage) have varying costs depending on your specific plans and coverage.

It's important to review the costs and coverage options for each part of Medicare to determine the expenses you may incur.

Do I automatically get Medicare when I turn 65?

If you're already receiving Social Security or Railroad Retirement Board benefits when you turn 65, you will typically be automatically enrolled in Medicare Part A and B. You will receive your Medicare card in the mail about three months before your 65th birthday. However, suppose you're not receiving these benefits. In that case, you must sign up for Medicare during your Initial Enrollment Period (IEP), which begins three months before your 65th birthday and lasts seven months.