Gila County Medicare Advantage Plans

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  • Medicare Advantage plans in Gila County, Arizona, are all in one medical coverage benefits known as Part C plans that include vision and dental benefits.

Medicare is a health insurance program designed for people 65 years and over and who may have disabilities or permanent kidney failure that requires on-going dialysis treatment. Medicare Advantage plans are designed to provide Medicare Part A (hospital insurance) and Part B (medical insurance) participants an alternative to Original Medicare. They are often referred to as Part C or MA Plans offered by private insurers. Medicare Advantage plans offer the same level of coverage as Original Medicare, plus dental and vision benefits. 

A Medicare Advantage Prescription Drug (MAPD) plan includes prescription drug benefits and is called Medicare Part D. It offers all the coverage of original Medicare (Parts A and B). There are 10 MAPD plans in Gila County and 3,793 participants enrolled. More than 45 million adults who are 65 years and older rely on the Medicare Advantage Prescription Drug Plan for their prescription drug costs. 

Average Cost of Medicare Advantage Plans in Gila

In Gila County, the average Medicare Advantage plan premium is about $30 per month in 2021. The average drug prescription deductible — the amount for the drug coverage portion of Medicare Advantage Prescription Drug Plans — is $310 for the year. The typical in-network out-of-pocket spending in Gila County is about $5,245, and 17% of the plans are rated 4 stars or higher by Medicare. The out-of-pocket limit is the amount Gila County participants are responsible for covering in a year before their plan covers everything 100%. 

Learn More About Medicare Advantage Prescription Drug Plans

Medicare Advantage Prescription Drug plans — known as Part D plans — help cover the costs of a prescription drug benefit, including recommended shots or vaccines. Participants can enroll in a standalone Part D plan that offers the prescription benefit in combination with Original Medicare. It can also be added to a Medicare Advantage plan with an Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO).

The most common types of Medicare Advantage Plans are Health Maintenance Organization (HMO), Medicare Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS) and Special Needs Plans (SNPs). Health Maintenance Organization (HMO) Plans allow beneficiaries to receive their care and services from providers in the plan’s network. There are exceptions, such as emergency care, out-of-area urgent care and out-of-area dialysis. Prescription drugs are covered in HMO plans under Medicare Part D. 

Medicare Preferred Provider Organization (PPO) Plans are similar to Medicare Advantage Plan (Part C) offered by private insurers. Participants can get health care from any doctor, hospital or medical center. Drug benefits are included under these types of plans under Medicare Part D. A Private Fee-for-Service (PFFS) Plan, offered by private insurers, determines how much participants pay for health care services, hospital care and doctor visits. Special Needs Plans (SNPs) are similar to a Medicare Advantage plan, except the benefits are customized to meet special needs of the participants they serve.