Medicare Supplement insurance in Arizona

How Medigap fits alongside Original Medicare

Original Medicare, meaning Parts A and B, pays most of the cost of covered hospital and medical care but not all of it. For many Part B services, Medicare usually pays 80% of the Medicare-approved amount after you meet the Part B deductible, leaving 20% coinsurance. Part A has separate deductibles and coinsurance. A Medigap policy helps with specified costs according to its plan letter, but it does not make every Medicare-covered or non-covered service free. You also pay a monthly policy premium.

Because a Supplement works alongside Original Medicare rather than replacing it, you keep Original Medicare’s nationwide access. This plan allows you to see any doctor who accepts Medicare anywhere in the country, which matters if you travel, spend part of the year outside Arizona, or want to keep a specialist who is not in a local network.

What the plan letters mean

Medigap uses standardized plan letters, each with a different set of benefits. The key point that surprises most people: the required basic benefits within a given letter are the same no matter which company sells the policy. Not every insurer offers every letter, and premiums, pricing methods, discounts and service can vary.

That standardization is what makes shopping worthwhile. Since the coverage inside a letter is standardized, useful comparisons include the premium, pricing method, available discounts, rate history and service. An independent broker can compare options from the insurers it represents in your Arizona ZIP code. Ask which carriers are included in any comparison.

Prescriptions are separate

Part D prescription plans are not covered with Medigap plans, so you will need a separate Part D plan as well. Which Part D plan is right depends on your actual prescription list, because formularies differ between plans and change annually. See how Part D works for the details, including the late-enrollment penalty.

Why re-shopping matters

Medigap premiums can increase over time, so it can be useful to compare your current premium with other policies offering the same plan letter. But Medigap does not have a new protected open-enrollment window each fall. Outside your one-time six-month Medigap Open Enrollment Period, an insurer may ask health questions, charge more or decline your application unless you have a guaranteed-issue right or another state protection.

Apply for and review the new policy before canceling your current one. If approved, you generally have a 30-day period to decide whether to keep the new Medigap policy. A licensed agent or the Arizona Department of Insurance can help you determine whether underwriting or a guaranteed-issue protection applies to your situation.

Supplement or Medicare Advantage?

These are two different structures, not two grades of the same thing. A Supplement works alongside Original Medicare and helps pay specified costs; most policies offer broad nationwide provider access, while Medicare SELECT policies may use a network. You pay a monthly premium and obtain Part D separately. Medicare Advantage is another way to receive Part A and Part B benefits through a private plan; many plans add dental, vision or hearing benefits, most include drug coverage, and provider rules vary. Our side-by-side comparison of Medicare Advantage and Medigap walks through which situations point which way.