Medicare Eligibility in Arizona
Eligibility for Medicare in Arizona considers U.S. citizenship/residency status, current age, and disability benefits.
Medicare is a U.S. health insurance program designed for adults 65 or older. Eligibility for Medicare in Arizona considers U.S. citizenship/residency status, current age, and disability benefits. Although Medicare is a federal program, states vary in the availability and pricing of alternative Medicare health plans.
How Do I Apply for Medicare in Arizona?
Medicare enrollment is automatic if you:
- Receive Social Security (SS) or Railroad Retirement Board (RRB) benefits
- Are younger than 65 and have received 24 months of SS disability benefits or certain RRB benefits
- Have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, and have begun receiving Social Security Disability Income (SSDI)
Regardless of age, you may apply for Medicare benefits if you have end-stage renal disease (ESRD) and meet other eligibility requirements, including the need for regular dialysis or having undergone a kidney transplant.
If eligibility for automatic enrollment does not apply, sign up for Medicare coverage through Social Security. You can access the online application for Parts A and B on the SS website.
Medicare Plan Options in Arizona
Original Medicare is comprised of:
- Medicare Part A: hospital insurance for inpatient care in a hospital, skilled nursing facility or hospice
- Medicare Part B: medical insurance for outpatient care, physician health services, durable medical equipment, and preventive services
Prescription drug coverage (Medicare Part D) is optional. However, suppose you miss enrollment for prescription drug plans during your initial Medicare eligibility period. In that case, you are subject to a late enrollment fee should you change your mind and sign up for Part D later.
Most people have premium-free Medicare Part A, based on credits earned by paying Medicare taxes over a working lifetime. However, you are responsible for deductibles, coinsurance, copayments, and the Part B premium.
Here are options that may help you reduce out-of-pocket Medicare costs:
- Medicaid is a federal program that defrays Medicare costs for qualified low-income Medicare beneficiaries.
- Medigap insurance plans cover all or part of the coinsurance and copayments, depending on your plan.
- Medicare Advantage plans usually cap annual out-of-pocket costs and may offer extra benefits not covered by Original Medicare.
Medigap Open Enrollment is the six-month window that begins on the first day of the month you turn 65 or older. Unlike most states, Arizona does not require private insurance companies to sell Medigap insurance plans to applicants under 65 with a disability or ESRD.
Medicare Advantage (MA or Part C)
There are several types of Medicare Advantage plans, including HMO and PPO. Some MA plans do not require a monthly premium. Medicare premiums for Part B are still required. However, the benefits offered by MA plans are generally contingent upon using the plan’s network providers. You qualify for enrollment in an MA plan during your initial Medicare eligibility period. You can also join during the annual open enrollment period (October 15 to December 7).
Following are state and national Medicare resources where you can find more information about Medicare plan options:
- Arizona Department of Economic Security: Here, you can find contact information for State Health Insurance Assistance Program (SHIP) and Senior Medical Patrol (SMP) offices throughout Arizona.
- Arizona State Retirement System (ASRS): This state agency is contracted with United Healthcare to offer Medicare Advantage plans in Arizona.
- Medicare: This is the official U.S. government website.
- Social Security Administration: This web page is where you can start an online application for Medicare enrollment.
Ready to learn more?
Choosing between Medigap insurance plans is not an easy decision. However, educating yourself about the differences between the two types of insurance coverage, comparing different plans and policies, and talking to a licensed insurance agent will help you make the right choice.