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Medicare and Medicare Advantage Plans in Arizona

Medical and health insurance is one of the most basic needs, not only for the elderly but for people from all age groups. Even while looking for employment, many people look at the health care packages provided by a company before making a decision. While there is no limitation to the age to get sick and disease or disability can strike anyone at any time, the elderly are at a much greater risk because of the several changes that take place in human body as it ages. For the elderly, a good medicare coverage plan along with reasonable medicare supplement plans is the best option.

Who is Eligible for Medicare?

First of all, let’s discuss what is a medicare plan? Medicare is a Federal health insurance plan that can be availed by people aged 65 or above. However, certain younger individuals who carry disabilities may be entitled to avail medicare plans as well.

Apart from this, people who have end-stage renal diseases are also eligible. This means any individual who has a permanent kidney failure and requires a regular dialysis or a kidney transplant is also eligible for medicare plans in Arizona even if they are younger than 65.

Now, the next question is: can anyone avail a medicare plan? The answer is yes for anyone who is a citizen of the US and meets the requirements of lawful presence and residency.

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When can I apply for Medicare?

Once you know that you are eligible for medicare, the next question that arises is: when to apply for medicare? For elderly, the initial enrollment period is the first chance where one can apply for medicare. When does it start? It starts 3 months prior to your 65th birthday which includes the month you are born in and the 3 months after the month of your birthday. It ends afterwards.

What is included in Medicare Plans?

Generally, medicare covers different services such as visits to a doctor, different tests, surgeries, and other required supplies. However, there are two types of medicare plans.

  1. Part A.

Part A generally covers the services related to hospital. This includes hospital care, nursing, hospice care, and home health services.

  1. Part B

Par includes 2 different types of services.

The first one is limited to the services necessary to diagnose or treat a medical condition. This includes the required medical supplies as well.

The second part is quite different from the first type. Instead of treating or diagnosing a medical condition, it focuses on taking cautionary steps to prevent some disease. This includes services like clinical and medical research, ambulance services, medical equipment. It also includes limited outpatient prescription drugs.

These two parts are called “original medicare” together. However, there are Part C and Part D of the healthcare as well which include medicare advantage and medicare prescription drug plan respectively.

What is Medicare Advantage?

While these plans sound good and helpful, there are times when one wishes that one had more – perhaps a more comprehensive medicare coverage, especially if one is elderly. To tackle this problem, several medicare advantage plans were created through a partnership between medicare and private insurance companies. This helped bring efficient healthcare to the eligible beneferiacies in a cost effective manner.

The medicare advantage, or the Part C, are available in five different types of plans in Arizona.

  1. Health Maintenance Organization (HMO)

In HMO, a group of doctors or hospitals agree to give health care services to a person by in exchange of a monthly premium. Generally, the beneficiary gets all the care from the plan providers. However, to see a specialist, you would require a referral from a physician.

  1. Preferred Provider Organization (PPO)

In PPO, your plan provider provides you a complete managed care plan. Your complete managed care plan would include doctors, hospital, and providers. Under this plan, unlike HMO, you would not need a physician’s referral to see a specialist. However, you must pay extra if you wish to receive services outside of your original network.

  1. Private Fee for Service (PFFS)

If you are a medicare beneficiary, then the PFFS is a private insurance plan for you. Under this plan, you are free to visit any doctor or hospital of your choice. However, the cost of it is decided by your insurance plan provider. While you may have to pay more for the benefits that are covered under your medicare, this plan also provides extra benefits that are not covered by the original medicare plan.


  1. Medicare Savings Account (MSA)

Under this plan, your medicare pays a premium for your MSA, which then covers your medicare costs by making appropriate deductions, particularly for those which are not covered under your medicare plan. This plan is of two types.

The first type is the saving accounts where your medicare would deposit the annual premium. If you do not use the money by the end of the year, it would remain in your account. Under the second, type, you require a minimum of $2000.

  1. Special Needs Plan (SNP)

This plan is only limited to the people eligible for both medicare and Medicaid. The people wishing to avail this plan must be living in long-term healthcare facilities. Those who have some chronic condition or disability are also eligible for this plan. The plan focuses on fulfilling the needs of those who can benefit from focused care management services, or those who require special expertise of the plan providers.

In short, when it comes to the medicare and medicare supplements in Phoenix,  AZ the options are limitless. However, one must do proper research on plans offered by different private healthcare insurance providers and select a plan regarding medicare supplements that best matches their needs.

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