Medicare benefits can help cover many of the costs associated with medical care, making it easier for you to afford your medical needs. However, as you apply for Medicare, it's important to understand the coverage you can receive, what coverage options you have, and how you can ensure that you have the right plan for your needs. In this article, we’ll answer common questions about Medicare in Arizona.
Yes. Medicare is available to all who quality in Arizona because it's a federal program.
There are approximately 6.2 million Medicare beneficiaries and 4.6 million Prescription Drug Plan beneficiaries in Arizona. While the majority of Medicare users in Arizona are over the age of 65, some younger individuals are eligible due to qualifying disabilities or conditions.
Since Medicare is a federal program, eligibility qualifications are mostly consistent throughout the United States. Most people qualify to enroll in Medicare when they turn 65, but in order to qualify, you must be a U.S. citizen or permanent legal resident who has been in the U.S. for at least five years. Younger individuals with qualifying disabilities and individuals with end-stage renal disease may be eligible for Medicare before they turn 65. For more on Medicare eligibility, check out this guide on who qualifies for Medicare.
Your Medicare premiums may depend on how much you have paid into Medicare before you become eligible. You can receive premium-free Medicare Part A if you already receive benefits from either the Social Security board or the Railroad Benefit Board, or if you are already eligible for those benefits, but have not yet applied. You can also qualify if you have received Social Security or Railroad Retirement Board benefits for at least 24 months.
Part B premiums, on the other hand, may depend on your income. In 2022, the monthly premium for Medicare Part B is $170.22. Medicare Advantage programs may have different costs depending on the specific Medicare Advantage plan you choose and the type of coverage you need through your plan.
You may also pay additional fees if you add a Medicare Part D plan to your coverage. Medicare Part D is used to cover prescription drug costs, which are typically not included under Original Medicare. You may also add prescription drug coverage to Medicare Advantage plans, or choose a Medicare Advantage plan that offers prescription drug coverage.
See the latest information on changes to Medicare in 2022.
You have three options for applying to Medicare:
If you have already applied for Social Security benefits after turning 65, typically, you will automatically qualify for Medicare. You also have the option to change your Medicare plan every year during open enrollment. If you do not apply for Medicare within a few weeks of turning 65, and you choose to make use of those benefits later in the year, you may have to pay additional fees or penalties to ensure that you have the coverage you want, so it's important to start considering your insurance needs early and to take care of your application as soon as possible.
Medicare Advantage is an alternative to Original Medicare. Rather than offering government-funded Medicare insurance coverage, Medicare Advantage uses private-sector health insurers to provide coverage to individuals who otherwise quality for Medicare benefits.
Many users find that Medicare Advantage can offer a wide range of benefits. In some cases, private healthcare providers who will not accept Original Medicare coverage will accept Medicare Advantage coverage. Medicare Advantage plans may also cover things that Original Medicare simply does not cover, including vision, hearing, and dental services. It may also cover some fitness programs. Furthermore, some Medicare Advantage plans cover things like transportation to doctor visits and even over-the-counter medications designed to treat ongoing ailments. Medicare Advantage does have many of the same advantages as an Original Medicare plan.
In order to determine which Medicare Advantage plan is right for you, make sure you ask these key questions:
What do the premiums, deductibles, and copay amounts for the plan you're considering look like? For many Medicare users, whether you're applying as you reach age 65 or you're applying due to significant disability, budget is a key determining factor in which Medicare plan will best fit your needs.
What services do you need to have covered? Often, by the time you apply for Medicare Advantage, you may have specific health problems or disabilities that you need to have covered. You may need to carefully consider what your Medicare Advantage options may offer. Do you need Medicare to cover the cost of vision or hearing treatment? What about dental services? If you have other medical insurance options, you may want to take that into consideration as you determine which Medicare Advantage plan is right for you.
Furthermore, consider the additional services that you might benefit from as you apply for Medicare Advantage. For example, if you need help covering the cost of transportation to your medical appointments, you may want to make sure that it's covered under your specific Medicare Advantage policy. If you need assistance with general health, wellness, and fitness coverage, you may want to look for a plan that includes discounts, reimbursement, or assistance paying for those services.
Are there specific providers that you need your Medicare Advantage plan to cover? You may have specific providers or practices who are familiar with your symptoms and your treatment and want to remain with that program for as long as possible. When you sign up for Medicare Advantage, you may want to make sure that those practices are covered by your insurance provider. If you have a preferred hospital, you may also want to make sure that it's in your network.
What rules does the plan have for covering treatment? Depending on the Medicare Advantage plan you use, you may need to follow specific steps in order to have your treatments and medical costs covered. For example, you may have to have a referral to see a specialist, or you may need to have some types of procedures approved ahead of time in order to ensure that your insurance will cover them.
You should also check to see whether your insurance will pay for emergency treatment with out-of-network providers.
Choosing the right Medicare plan for your needs is an important decision. While you can revisit that decision each year during open enrollment, ideally, you want to find a plan that you can stick with: one that meets your unique medical and financial needs. Whether you choose Medicare Advantage or prefer to use an Original Medicare plan, we can help you choose the plan that's right for you. Contact us to speak with a licensed insurance agent.