medicare plans in arizona
Medigap in Arizona
Original Medicare beneficiaries who want help paying some or all of their out-of-pocket costs can purchase Medigap plans (also known as Medicare supplement plans). Medigap plans are issued by private insurers, but are standardized under federal rules, with ten different plan designs (differentiated by letters, A through N).
The standardization makes it fairly easy to compare plans– plans can differ in price and in things like customer service, but the benefits offered by Plan A, Plan C, Plan F, etc. are the same regardless of which insurer offers the coverage.
284,584 Arizonans were enrolled in Medigap plans as of 2016, according to data collected by AHIP. There are 60 insurers licensed to sell Medigap plans in Arizona According to an analysis conducted by Business Insider, the average cost for Medigap Plan F (the most popular plan) in Arizona in 2016 was about $143/month.
Unlike Medicare Advantage and Medicare Part D plans, there is no annual open enrollment period for Medigap plans. Instead, federal regulations allow for a six-month guaranteed-issue window that begins when a person is 65 and enrolled in Medicare Part B. After a person’s enrollment period ends (and unless the person qualifies for one of the limited guaranteed-issue rights), Medigap insurers can use medical underwriting to determine whether an applicant is eligible for coverage, and if so, at what price.
Federal rules do not grant a guaranteed issue open enrollment period for Medigap if the applicant is under 65 and enrolling in Medicare as a result of a disability. The majority of the states have implemented rules ensuring at least some access to Medigap plans for enrollees who are under the age of 65, but Arizona is not among them.
In 2009, the Arizona Department of Insurance announced that out of 53 insurers offering Medigap plans, five were offering coverage to disabled beneficiaries under the age of 65. But as of 2019, there were 60 insurers licensed to sell Medigap plans in the state, and none of them were offering coverage to people under the age of 65.
Arizona residents who are Medicare-eligible prior to 65 as a result of a disability do have the option to enroll in a Medicare Advantage plan (unless they are eligible for Medicare due to end-stage renal disease, as Medicare Advantage insurers are not required to allow ESRD patients to join their plans). Medicare Advantage plans do have built-in out-of-pocket caps, so they may appeal to some disabled Medicare beneficiaries who would otherwise have Original Medicare without any caps on out-of-pocket costs.
Disabled Medicare beneficiaries qualify for a Medigap open enrollment period once they turn 65. At that point, they can enroll in any Medigap plan available in their area, without medical underwriting.
Medicare Part D in Arizona.
Original Medicare does not cover prescription drugs. Some beneficiaries have employer-sponsored coverage to supplement their Medicare, and others have supplemental Medicaid, both of which can provide prescription coverage. But enrollees without either of those options need to obtain coverage under a Medicare Medicare Part D plan. Part C coverage can be purchased on its own, as a stand-alone plan, or as part of a Medicare Advantage plan that includes Part D prescription drug coverage.
In 2019, insurers in Arizona are offering 28 stand-alone Part D plans with premiums ranging from about $12 to $98/month.
468,268 Arizona Medicare beneficiaries had stand-alone Part D plans as of late 2018, and another 471,171 had Part D coverage as part of their Medicare Advantage plans.