Maricopa County Medicare Advantage Plans

In this article...
  • Find out the cost of a Medicare Advantage Prescription Drug plan in Maricopa County. We look at average premiums, drug deductibles and out-of-pocket maximums.

Medicare Advantage Prescription Drug (MAPD) plans offer an all-in-one approach to health insurance. In addition to covering hospital stays and physician services, they provide benefits such as vision, dental, hearing and prescription drugs. About 327,490 people in Maricopa County receive their health care coverage through a Medicare Advantage plan. There are 52 different plans to choose from in 2021, with just over one-third rated four stars or higher by Medicare.

Average Cost of Medicare Advantage Plans in Maricopa County

The costs of MAPD plans vary depending on the insurance carrier and the benefits you receive. Medicare Advantage beneficiaries in Maricopa County pay an average of $15.58 per month for their plan in 2021.

In addition to monthly premiums, you must meet certain deductibles and pay out-of-pocket before a plan's coverage begins. The average annual prescription drug deductible for MAPD plans in the county is $105.44. The federal government requires that each plan caps a beneficiary's annual out-of-pocket spending on copays, cost-sharing and deductibles. In Maricopa County, the average in-network, out-of-pocket spending maximum is $4,545.15.

Learn More About Medicare Advantage Prescription Drug Plans

MAPD plans vary in terms of how they provide health care. The main types of plans are:

  • HMO: Health Maintenance Organization (HMO) plans have agreements with a network of hospitals, physicians and other health care providers. In most cases, you must use a provider within the network to be eligible for coverage.
  • PPO: Preferred Provider Organization plans also have a network of health care providers. You can use a provider that's outside of the network but often at a higher cost.
  • PFFS: Private Fee-for-Service plans don't have a network. You may use any Medicare-approved health care provider that accepts the plan's fee system.
  • SNP: Special Needs Plans provide coordinated care to beneficiaries with certain chronic conditions such as end-stage renal disease, HIV/AIDS, heart failure and diabetes.

If you remain in Original Medicare for your health care instead of participating in an MAPD, you won't have prescription drug benefits. However, you can add to your Part A and Part B coverage by purchasing a separate Part D prescription drug plan