Medicare Help
Medicare Advantage Plans in Phoenix
Medicare Advantage (also called Part C) is a way to get your Medicare benefits through a private insurance company approved by Medicare. Here's how it works, explained simply.
In short
A Medicare Advantage plan replaces how you receive Original Medicare (Parts A and B). Most plans also include Part D drug coverage. Plans usually use a network of doctors and hospitals and have a yearly limit on what you pay out of pocket for covered, in-network services.
How Medicare Advantage works
When you join a Medicare Advantage plan, you're still in Medicare — but the plan, not Original Medicare, handles most of your coverage. You'll use the plan's card for doctor visits and hospital stays.
- Covers everything Original Medicare covers, except hospice care, which Original Medicare still covers.
- Most plans include prescription drug coverage (Part D).
- Usually uses a network. HMO plans generally require you to use in-network providers. PPO plans let you go out of network, usually at a higher cost.
- Has a yearly out-of-pocket maximum for covered in-network services. The amount varies by plan.
- May include some extra benefits, such as certain dental, vision, or hearing coverage. What's included varies by plan and area.
What you'll still pay
You generally keep paying your Part B premium, and you may also pay:
- A monthly plan premium (some plans have one, some don't)
- Copays or coinsurance when you get care
- Deductibles for medical care or prescriptions, depending on the plan
Look at the whole picture
A low monthly premium doesn't always mean the lowest total cost. It helps to look at the copays for the care you actually use, your prescriptions, and the out-of-pocket maximum.
Is Medicare Advantage a good fit for me?
It depends on your health, your doctors, your budget, and how you like to get care. People often consider these questions:
- Are my doctors, specialists, and preferred hospitals in the plan's network?
- Are my prescriptions covered, and at what cost?
- Do I travel or spend part of the year outside Arizona?
- Am I comfortable with referrals or prior authorization for some services?
- How would my costs add up in a year where I need a lot of care?
Who can join
To join a Medicare Advantage plan, you generally need to have Medicare Parts A and B and live in the plan's service area. Plans available in Phoenix may differ from plans in other parts of Maricopa County or Arizona.
When you can join or switch
- When you're first eligible for Medicare (your Initial Enrollment Period).
- Annual Enrollment Period: October 15 – December 7, for coverage starting January 1.
- Medicare Advantage Open Enrollment Period: January 1 – March 31, if you're already in a Medicare Advantage plan (one change allowed).
- Special Enrollment Periods for certain life events, like moving.
Learn more about enrollment periods
How I can help
I'll look up your doctors and prescriptions, explain the plans available in your ZIP code from the companies I represent, and point out the trade-offs — so the decision is yours and it's an informed one.
Common questions
Is a $0-premium Medicare Advantage plan really free?
Some plans have no monthly plan premium, but you'll usually still pay your Part B premium, plus copays, coinsurance, or deductibles when you get care. Availability of $0-premium plans depends on where you live.
Can I have Medicare Advantage and a Medicare Supplement at the same time?
No. Medigap policies don't work with Medicare Advantage plans, and it's generally illegal for someone to sell you a Medigap policy if you're in a Medicare Advantage plan.
What happens if I travel?
Most plans cover emergency and urgent care anywhere in the U.S. Routine care outside the network or service area may not be covered, or may cost more. Check each plan's rules.
This page is general educational information, not personal advice. Medicare rules, costs, and plan options change and depend on your situation. For official information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).
Have questions? Let's talk them through.
A no-cost, no-obligation conversation with a licensed local agent. Bring your questions — we'll go at your pace.