Coconino County Medicare Advantage Plans

In this article...
  • Learn about the types of Medicare Advantage plans you can join and the average premiums and drug deductibles you can expect to pay in Coconino County.

If you live in Coconino County, you can pick from 14 different Medicare Advantage Prescription Drug (MAPD) plans in 2021. These private insurance plans package traditional Medicare coverage for hospital and medical insurance with a mix of benefits such as prescription drugs, vision, dental and wellness. Just over half of Medicare Advantage plans in the county (56%) are rated as four stars or higher by Medicare for their quality and performance. About 3,849 local residents are enrolled in Medicare Advantage. 

Average Cost of Medicare Advantage Plans in Coconino County

The average MAPD plan in the county charges premiums of $23.94 per month. Like most health plans, they also have out-of-pocket costs for cost-sharing and deductibles.

For example, even though a plan covers prescription drugs, you must pay the initial costs of your medications until you reach the plan's annual drug deductible. After you've paid the deductible, the plan kicks in its portion of costs. Residents in Coconino County pay an average annual drug deductible of $303.89 before their prescription drug benefits begin.

Private insurers do cap the amount you spend for deductibles, coinsurance and copays within the network. The average annual out-of-pocket spending limit for MAPD plans in the county is $4,839.14. When you've reached this cap, you no longer have to pay for in-network services. Anything you spend outside of the network doesn't count toward your out-of-pocket limit.

Learn More About Medicare Advantage Prescription Drug Plans

There are different types of MAPD plans you can join. The plans limit which health care providers you can use and whether you need a primary doctor. Here are the most common Medicare Advantage plans:

  • Health Maintenance Organization (HMO) plans require you to see providers within their network. You must have a primary care doctor and get a referral to visit a specialist.
  • Preferred Provider Organizations (PPOs) let you choose any provider approved by Medicare, but it costs less to stay within their network. You typically don't need a primary care doctor or a referral to see a specialist.
  • Private Fee-for-Service (PFFS) plans let you use any Medicare-approved provider that accepts the fees the plan sets for services. You usually don't need a primary care doctor or referral to a specialist.
  • Special Needs Plans (SNPs) are only available to those with certain chronic illnesses such as diabetes, HIV/AIDS and heart disease. These plans coordinate your care, usually through a primary doctor, and have a network of health care providers that may be specialists in the field.

Health insurance companies also offer separate Part D prescription drug plans, which only provide drug coverage. These policies help pay for medication if you get your Medicare coverage through the federal government instead of an MAPD plan.