Graham County Medicare Advantage Plans

In this article...
  • Learn about Medicare Advantage plans in Graham County, Arizona, including average monthly premiums, out-of-pocket spending limits and annual drug deductibles.

The federal government's Original Medicare plan only covers services such as physician visits, lab tests and hospital stays. For additional benefits like dental, vision and hearing, you need to choose a Medicare Advantage Prescription Drug (MAPD) plan. There are 11 MAPD plans offered in Graham County in 2021, with 29% of plans earning four stars or higher through Medicare's rating system. About 2,445 Graham County residents are opting for MAPD plan coverage.

Average Cost of Medicare Advantage Plans in Graham County

The average Graham County resident pays a monthly premium of $28.90 for a Medicare Advantage plan. It's important to consider additional costs such as deductibles, cost-sharing and copays. For example, some plans with low or no monthly premiums may have higher costs when you use the plan.

Medicare limits the out-of-pocket costs that plans may charge. The average in-network out-of-pocket spending maximum for an MAPD plan in Graham County is $5,181.82 in 2021. If you reach this limit, the plan must cover all of your additional costs.

Each MAPD plan also sets its own deductibles, which is your share of costs before the plan begins to pay. In 2021, Graham County residents are paying an average annual drug deductible of $338.57 before their plan kicks in.

Learn More About Medicare Advantage Prescription Drug Plans

In addition to these costs, you should consider how you want to receive your health care when you're comparing plans. Some Medicare Advantage plans restrict which providers you can use.

Here are the most common types of MAPD plans:

  • HMO: Health Maintenance Organization plans require you to have a primary care doctor within their network and to use in-network health care providers. Your doctor must provide a referral for you to see a specialist.
  • PPO: Preferred Provider Organization plans let you use health care services both within and outside of their network. Costs are lower if you use an in-network provider. You may see a specialist without a referral.
  • PFFS: Private Fee-for-Service plans set the fees they're willing to pay for services. You may visit any Medicare-approved doctor, specialist or hospital that accepts the plan.
  • SNP: Special Needs Plans are customized for chronic conditions and coordinate care among specialist physicians and health care facilities in the service area. There are SNPs for conditions such as diabetes, autoimmune disorders, lung disease, chronic heart failure, stroke, and end-stage liver and kidney disease.

Prescription drug coverage is still available if you remain in Original Medicare. You can choose a separate Part D prescription drug plan through a private insurer to receive drug benefits.