Arizona Medicare Supplement Plans (Medigap)
Arizona Medicare Supplement Plans were designed to coincide with Traditional Medicare. These insurance policies are sold by private insurance carriers all across your state. Their sole purpose is to provide coverage for what’s not covered by Original Medicare.
Out of pocket (OOP) costs associated with deductibles, copayments and coinsurance are what is included in a Medicare Supplement Plan. Medicare Supplement Plans aka Medigap Plans and Original Medicare are separated into parts and plans and will be further explained here.
Arizona Medicare Plans Explained
- Hospital Coverage – Medicare Part A: This is your hospital coverage. It includes any hospitalizations, inpatient services like bloodwork, diagnostic imaging, medications or DME.
- Outpatient Coverage – Medicare Part B: This includes your doctor’s visits and other outpatient medical expenses. Such as diagnostic imaging, blood work, any outpatient procedures and ER visits.
- Medicare Part C: aka Medicare Advantage or Medicare Replacement Plan. This plan replaces both Medicare Part A and B. It has the same coverage as Traditional Medicare and in some cases includes additional coverage. This plan does come certain policy limitations.
- Prescription Drug Plans – Medicare Part D: aka PDP. This provides coverage for you prescription medications.
- Medicare Supplement Plans: These plans work in conjunction with Traditional Medicare. They pick up the remaining cost leftover from what Medicare won’t cover.
What Benefits Does Medicare Cover in Arizona
Whether you are using Medicare Part A or Medicare Part B, both coverage is only at 80%
This leaves the remaining 20% coinsurance up to the beneficiary to pay for the services rendered.
This is where a Medicare Supplement Plan comes in handy. They help cover the gap in insurance that isn’t covered therefore, leaving less OOP expenses.
How to Qualify for Arizona Medicare Supplement Plans
Eligibility for the Medicare Supplement Plans start once you are 65 and currently enrolled in Medicare Part B. Medicare beneficiaries then have a total of seven months, called your Open Enrollment Period or OEP, to obtain supplement insurance.
If you fail to enroll during this time there is a Part B penalty. Based on how long you went without the insurance will determine how much additional cost will be added to your $134.00 a month Part B premium.
Arizona Medicare Benefits for the Disabled under 65
If you currently have SSDI or have certain Railroad Retirement Benefits after 24 months, you’re eligible and automatically enrolled in Medicare Part A and Medicare Part B. Federal law does not require the individual, private insurance carriers to offer Medigap Plans.
However, some state laws do. Unfortunately, Arizona is one of those states that supplement plans aren’t required. If you’re currently disabled and under the age of 65 in AZ, give us a call for more information concerning plans available to you.
When to Sign Up for a Medicare Supplement Plan in Arizona
You have a total of 7 months to apply in which you are granted something called the Guaranteed Issue (GI) right.
The benefit of having the GI is that regardless of any pre-existing medical conditions the carriers cannot deny coverage or increase your premium rates. To forgo the underwriting process it is imperative to enroll during your OEP.
Medicare Supplement Plan Prices in Arizona
Each individual state’s private insurance carriers determine the premium cost. Your age, sex and location factor into what you will be charged. A gentleman living in Greenville, AZ will pay a different premium price than a lady living in Scottsdale, AZ.
Additionally, there are 3 different pricing methods used when considering premium costs. Your state will either use community rated pricing, issue-age rated pricing, or attained-age-rated pricing and you can click here for more info.
The Best medicare Supplements in Arizona
There are 10 letter plans offered with the Medigap Plans. The supplement insurance is offered by private insurance companies and regardless of the carrier, the insurance benefits are the same. The difference between the carriers will be the premium cost. Of the 10 letter plans the most popular are Plans F, G and N.
- Plan F: 1: provides complete coverage of the deductibles associated with Medicare Part A and Medicare Part B. Additionally, it covers the remaining 20% coinsurance for any hospital or outpatient services not covered by Original Medicare. It even includes foreign travel emergency coverage. Plan F has the best coverage making it the most popular of all the Medicare Supplement Plans..
- Plan F High Deductible: In addition to Plan F, there is a high deductible version that includes the exact same benefits just with lower premiums and with a deductible. This is a popular plan as it is cheaper than Plan F.
- Plan G: Includes the same coverage as Plan F with the exception of no coverage of Medicare Part B’s deductible. After your $183.00 deductible has been met then you get the same great benefits as Plan F.
- Plan N: includes less benefits but is a more affordable plan. Medicare Part A’s deductible is only covered with this plan and copays are required for doctors office and ER visits. Additionally, Plan N has no excess charge coverage however, this will not affect AZ residents as your state doesn’t allow physicians to charge extra.
Medicare Advantage Plans in Arizona
Medicare Advantage plans are also offered by private insurance carriers. Often referred to as a Medicare Replacement Plan, an Advantage Plan will completely replace coverage for both Part A and Part B with Traditional Medicare.
Medicare Advantage Plans are typically cheaper which is why a lot of seniors choose this plan. The downside of an Advantage Plan though is the restrictions that come along with it. This can include coverage limitations, treatment with only in-network physician and cancellation restrictions.
While this seems like a good option based on benefits and cost, overtime your OOP expenses can be higher than that of a Medicare Supplement Plan.
Medicare Part D Prescription Drug Plans in Arizona
With none of the Medicare Supplement Plans or Traditional Medicare having any prescription drug coverage a Prescription Drug Plan (PDP) is necessary to control your OOP costs. A Part D Plan will help with the deductible and initial cost concerning medications.
Failing to obtain valid prescription drug coverage by the time you qualify for Traditional Medicare will result in a Part D penalty.
Once your IEP passes and depending on the length of time went without coverage will determine the penalty fee. The penalty charge will then be added onto your monthly premium
Compare Medicare Supplement Plans in Arizona
With Medicare only providing 80% coverage on inpatient and outpatient services the 20% coinsurance left for the beneficiary to pay can quickly add up. A Medicare Supplement Plan can help with the extensive OOP costs for Arizonian’s.
To compare Medicare Supplement Plans or answer any questions fill out our online form or call us today. Our licensed insurance agents are standing by and are always happy to help!
Arizona Medicare Savings Program
There is financial help available for the federal Medicare program for seniors on a fixed income or disabled individuals part of a low income working family. There are state programs that provide free counseling and financial aid for those who need help.
State Health Insurance Assistance program orSHIP can provide local help for people with Medicare, Medicare Advantage, Medicare Supplement Plans or PDP Plans in AZ. Centers for Medicare and Medicaid is another organization that can be beneficial with financial assistance.
Arizona State Health Facts
- The total number of Medicare beneficiaries in 2015 in the state of Arizona was over 1.1 million. That’s 17% of the entire state population
- In 2013, 14% of recipients were disabled, the other 86% reached the age of 65
- 0.8% of those receiving benefits from Medicare in 2013 were diagnosed with End Stage Renal Disease
- Does Blue Cross Blue Shield AZ have Medicare Supplement Plans? Yes, you can see BCBS Medicare Supplement Plan benefits here AZBlue or call us today to compare the various supplement plans.
- Does the Mayo clinic accept Medicare in Arizona? Unfortunately they don’t. You can find out more about what insurance the Mayo Clinic accepts here.
- What is the Medicare age in Phoenix AZ? Medicare eligibility for seniors is age 65 and up.