Medicare Advantage Plans are a series of Healthcare Plans that were created in partnership between Medicare and Private Insurance companies to provide cost efficient healthcare to Medicare-eligible beneficiaries.
When adopting an Advantage Plan, all healthcare charges are billed through the selected Provider, and not directly through Medicare.
There are five types of plans available in Arizona:
Health Maintenance Organization
A group of doctors, hospitals, and other health care providers who agree to give health care to Medicare beneficiaries for a set amount of money from Medicare each month. In an HMO, you usually must get all your care from the providers that are part of the plan and you need a referral from a primary care physician to go to specialists.
Preferred Provider Organization
A managed care plan in which you use doctors, hospitals, and providers that belong to the network. You can receive services outside of the network for an additional cost. You do not need a referral from a primary care physician to go to a specialist.
Private Fee For Service
A private insurance plan that accepts Medicare Beneficiaries. You may go to any doctor or hospital you want. The insurance plan, rather than the Medicare program, decides how much you pay for the services you get. You may pay more for Medicare covered benefits. You may have extra benefits the Original Medicare Plan does not cover.
Medicare Savings Account
This type of health plan has two parts:
- Special type of savings account used for health related expenses only. Medicare deposits a set amount per year into your account. The money can remain in the account if not used by the end of the year.
- High deductible health plan (minimum of $2000)
With this type of plan, Medicare pays the premium for the MSA plan and makes a deposit into the MSA established by the beneficiary. The money in the MSA can be used to pay for health services provided before the deductible is met and for services not covered by the MSA plan. After the deductible is met in a given year, Medicare-covered services are covered by the health plan.
Special Needs Plan
An HMO type plan that limits their membership to people eligible for both Medicare and Medicaid (AHCCCS), who reside in certain long-term care facilities, or who have chronic or disabling conditions. The Special Needs Plan must be designed to provide Medicare health care and services to people who can benefit the most from things like special expertise of the plan's providers, and focused care management.
Please be advised that not all types of plans are available in every County
- Medicare Plan Finder Online
Use this tool to search for and compare coverage options available in your area. A general plan search only requires your zip code. To personalize your search, enter your zip and complete Medicare information.