Zero premium Medicare Advantage plans in Arizona? Sounds too good to be true, doesn’t it? How is that possible? And if it is, why doesn’t everyone have one?
That’s no marketing gimmick - it’s the truth! Most Medicare beneficiaries have access to at least one zero premium Medicare Advantage plan in Arizona, especially if you reside in a more urban area. Now, this doesn’t get you out of paying the Part B premium, but you really can get a Medicare Advantage plan for a $0 premium.
So, what’s the catch? Before you go running to sign up for one of these plans, it’s best to understand how they work and where the costs come into play.
We get many clients asking us how Medicare Advantage plans can possibly be free. The truth is, they’re not entirely free. Just because you can get a $0 Medicare Advantage plan does not mean there won’t be other associated costs. Still, let’s first explain how they can offer the $0 premium.
The federal Medicare program pays Medicare Advantage plan providers a fixed fee for each beneficiary that enrolls in their plan. In return, that carrier must cover your medical claims that would have otherwise been sent to Original Medicare - Parts A and B. Some carriers feel that the money they receive from the government is enough to cover your claims, so they pass that savings onto you by offering you a $0 premium plan.
The healthcare services you receive while covered by the Medicare Advantage plan are not necessarily free. Each plan has different benefits, but generally speaking, you’ll have a copay for most medical treatments. For example, you may have a copay for every doctor’s visit, every inpatient hospital admission, diagnostic images, etc.
You may also have annual deductibles, so be sure to find out what those are with any Medicare Advantage plan you’re considering. Also, be aware that there are different kinds of Medicare Advantage plans, and each of them works differently when it comes to provider networks. Going outside of the plan’s network could cause you to pay more for services or even lose coverage completely.
The good news is that all Medicare Advantage plans are required to set a maximum out-of-pocket cap. In 2024, that limit cannot be any higher than $8,850 for the calendar year. Once your out-of-pocket costs reach that amount, the plan must cover any additional costs at 100%. Take a look at the “MOOP” on each Medicare Advantage plan and make sure you have that much money saved for any unexpected healthcare costs. The good news is that it is very rare for beneficiaries to hit that number. Still, it’s best to be prepared!
Since the $0 premium still gives many people pause, we also get asked if plans with higher premiums offer better benefits. That answer really depends on which plans are offered in your ZIP code.
Almost nothing in Medicare is cut and dry. To answer this question for your area, you’d have to spend some time comparing plans with your Medicare advisor. Sometimes, a higher premium plan will have better benefits. Other times, their copays are just the same as the $0 plans.
Arizona has great options when it comes to Medicare Advantage plans. Almost all our residents have access to a zero premium Medicare Advantage plan. If you’re interested in learning more about Medicare Advantage or other Medicare plan options, give Local Medicare Specialists a call today!
Schedule a FREE Medicare plan consultation with an agent in your neighborhood.
LocalMedicareSpecialists.com is privately owned and operated by LMS Insurance LLC. LocalMedicareSpecialists.com is a non-government resource for those who depend on Medicare, providing Medicare information in a simple and straightforward way.
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 Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.