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6 Tips on How to Choose a Medicare Advantage Plan in Arizona

Medicare’s Annual Election Period (AEP) begins in just a couple of days! If you are currently on a Medicare Advantage plan or want to enroll in one for the first time, you can begin looking at plans in your area now and start your enrollment on October 15. 

Medicare Advantage plans in Arizona offer extensive medical benefits and often have many extra benefits you won’t find in Original Medicare (Parts A and B). Depending on where you live, you could have MANY plans to choose from. So, how do you know which one to pick? We’ve got six tips to help you determine which Medicare Advantage plan is right for you.

woman frustrated on choosing a medicare advantage plan

1. Search for Plans in Your Zip Code

With AEP looming, you’ve probably seen an increase in those Medicare commercials that use celebrities to tell you about all the great benefits you can get with a Medicare Advantage plan. Money back on your Social Security checks! No premiums! Free everything! It sounds too good to be true, right? It is.

There are plans that do offer the benefits proclaimed by those celebrities. In fact, most Medicare Advantage plans are premium-free. The problem with the commercials is that they take the greatest benefits seen throughout the country and talk about them like they’re all on one plan. Unfortunately, that’s not how it works.

Medicare Advantage plans are based on service areas or zip codes. You can only enroll in a plan that is offered in your area of residence. Some people only have a couple of plans to choose from, while others have many. We’ve got a bonus tip for you at the very end to make this process easier, but if you’d like to see the plans available in your area, you can check

2. Consider Provider Networks

The next thing you’ll need to do is look at the plan’s provider network. Medicare Advantage plans use networks based on your zip code. Some plans offer coverage outside the network, while others do not. Either way, it’s always best to use contracted providers to minimize your costs.

If you love your current physicians, doctors, dentists, etc., you should check to see if they participate with any of the Medicare Advantage plans. Either choose a plan they work with or consider changing your healthcare team. You should also be sure the facilities and pharmacies in your area accept your plan.

3. Determine the Type of Medicare Advantage Plan You Want

Many people don’t realize there are several types of Medicare Advantage plans. The one you pick will greatly impact how your coverage works. For example, an HMO (Health Maintenance Organization) plan will not offer any coverage outside the network. On the other hand, a PPO (Preferred Provider Organization) plan will have some out-of-network benefits.

Other kinds of Medicare Advantage plans include:

  • PFFS (Private Fee-for-Service)
  • SNP (Special Needs Plans)
  • HMO-POS (Point of Service)
  • MSA (Medicare Medical Savings Accounts)

Take the time to learn a little about each kind of plan so you can decide which one will best fit you.

4. Check the Drug Formulary

Not all Medicare Advantage plans include prescription drug coverage. Unless you have drug coverage through another source, like Veteran’s Affairs (VA) benefits, you should consider choosing a Medicare Advantage plan that includes prescription coverage. These plans are often abbreviated as MAPD plans.

Check the plan’s drug formulary. The formulary is the list of medications covered by the plan, organized by tiers. Drugs in higher tiers cost more than those in lower tiers. Be sure that the plan covers all your prescriptions, so you aren’t surprised at your next pharmacy visit.

If you enroll in a Medicare Advantage plan without drug coverage, you are not always allowed to purchase a separate Part D prescription drug plan. You may only do this if you enroll in a PFFS or MSA plan. The other options do not allow you to add a separate Part D plan. Enrolling in one will likely disenroll you from the Medicare Advantage plan. 

5. Compare Premiums and Cost-Sharing

By now, you might have your choices narrowed down to just a few options. You can start comparing their premiums, deductibles, and other important numbers. It’s important that you not choose a $0 premium plan just for the premium. Be sure to consider the other out-of-pocket costs.

Benefit summaries for Medicare Advantage plans can be quite lengthy, so begin by taking a look at some of the more common cost-sharing amounts. Compare the deductibles, maximum out-of-pocket (MOOP) amounts, inpatient hospital copays, primary care and specialist copays, surgical coinsurance, and lab services.

6. Compare Extra Benefits

Lastly, take a look at the extra benefits offered by each plan. Just like the premiums, you should never enroll in a Medicare Advantage plan strictly because you like the extra bells and whistles. But, if you’re trying to decide between two plans, the extra benefits may help you make that choice.

Most plans include gym memberships, over-the-counter stipends, dental, vision, and hearing care, and meal delivery services. More and more plans are also offering a flex card, which can be used to pay for dental, vision, and hearing care.

Bonus Tip!

It’s not a bad idea to research Medicare options on your own. It can help you know what’s out there and help you understand how Medicare Advantage works. But when it’s time to enroll, the easiest way you can ensure you’ve picked the right plan is by enlisting the help of a local Medicare advisor.

The advisors at Local Medicare Specialists are all independent insurance agents. What that means is that they can compare plans across many insurance companies to make sure you’re getting the coverage you need at a competitive rate. They know the ins and outs of the Medicare Advantage plans in your zip code and will make sure your providers and prescriptions are included in the plan’s network.

The best part? There is absolutely no cost to use our services! Call the Local Medicare Specialists today and speak with a local agent near you.

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area which are United Healthcare, Aetna, Humana, Cigna, Blue Cross Blue Shield of Arizona, Centene, Devoted, and Scan. Please contact, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

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