How Medicare Advantage works in Arizona
As in other states, medicare advantage arizona is available from private, Medicare-approved health insurance companies. Medicare Advantage plans are required by law to offer at least the same benefits as Original Medicare, Part A and Part B (except hospice care, which Part A covers). Medicare Advantage beneficiaries are covered through their individual health plans and not directly through Original Medicare (except for hospice care).
Arizona Medicare Advantage plans are available through private insurance companies that contract with Medicare. They often come with additional benefits, like routine vision, hearing, and dental coverage, depending on the plan. Most Medicare Advantage plans include prescription drug benefits.
To qualify for a Medicare Advantage plan, you need to:Be enrolled in Original Medicare, both Part A and Part B.
Live in the coverage area of the plan you want to enroll in.
Not have end-stage renal disease (ESRD). There are exceptions, so if you have ESRD and want to sign up for a Medicare Advantage plan, you can ask your plan, or Medicare, about exceptions. Medicare’s contact information is at the end of this article.
You can enroll in a Medicare Advantage plan during your Initial Coverage Election Period (ICEP):.
If you sign up for Medicare Part A and Part B when you first qualify for Medicare, you can enroll in Medicare Advantage at that time as well. Your ICEP is usually a seven-month period that starts three months before the month where you turn 65, and runs through your birth month, and continues for the three months after that.
If you delay enrollment in Medicare Part B (for example, if you’re covered through an employer’s plan), your ICEP is the three-month period before your Part B start date. For example, if you enrolled in Part B during the General Enrollment Period (January 1 to March 31), your Part B start date would be July 1, so your ICEP would be April 1 to June 30.
If you don’t sign up for Medicare Advantage during your ICEP, you can enroll in a Medicare Advantage plan during the Annual Election Period. It runs from October 15 to December 7 each year. You can add, switch, or drop Medicare Advantage plans during the Annual Election Period; your new coverage will start on January 1 of the following year.
Medicare has special provisions to help you deal with certain situations. Some examples of these situations include moving to a new address, losing your current health coverage, qualifying for a different type of coverage, and experiencing changes in your current plan that affect your health benefits. You can switch health plans during Special Enrollment Periods if your situation qualifies you to do so.
Arizona Medicare Advantage beneficiaries who decide to opt out of Medicare Advantage and switch back to Original Medicare, Part A and Part B, can do so during the Medicare Advantage Disenrollment Period, which lasts from January 1 to February 14 each year. The only other change you can make at this time is to add a stand-alone Medicare Part D Prescription Drug Plan.
Medicare resources in Arizona.
Arizona offers no-cost, unbiased resources to help residents who have questions about their Medicare coverage.
Arizona Medicare Savings Programs: If your income is lower than the government set limit, you may be able to receive help with out-of-pocket expenses that Medicare doesn’t cover, including copayments, deductibles, and premiums. You can apply through the Arizona Medicaid department.
Arizona State Health Insurance Counseling and Assistance Program (SHIP): In Arizona, Medicare beneficiaries can contact the Division of Aging and Adult Services and be connected with a counselor who can provide information about programs that are best suited for you. Arizona has local SHIP offices located in counties throughout the state.
Source: Statistical data from the Centers for Medicare & Medicaid Services, “Medicare Enrollment Dashboard,” from the CMS Office of Enterprise Data & Analytics, February 2019.