Navajo County Medicare Advantage Plans

In this article...
  • Find information on Medicare Advantage plans in Navajo County, including average premium and deductible costs. We explain the types of MAPD Plans and Medicare Part D.

Medicare Advantage (MA) Plans provide health coverage for 5,277 beneficiaries in Navajo County. There are four plans available that can be purchased from private insurance companies as an alternative to Original Medicare. However, MA plans must provide the same benefits as Original Medicare. Beneficiaries often pay some costs for these plans, such as a small monthly premium, but the federal Medicare program also reimburses insurance companies.

Beneficiaries enjoy the convenience and advantages of having their Medicare benefits bundled into one plan, and Medicare Advantage Prescription Drug (MAPD) Plans include prescription drug coverage. Like private health insurance, MAPD Plans cover routine medical care, hospital stays and medication costs under one plan. Some also offer dental, vision and hearing benefits. 

Average Cost of Medicare Advantage Plans in Navajo County 

Medicare Advantage Plans do require the payment of a small monthly premium as well as annual deductibles. In Navajo County, the average monthly premium for one of these plans is $26. Plan subscribers pay an average yearly drug deductible of $420 before Navajo County MAPD Plans cover medication costs. The average annual in-network out-of-pocket maximum is $3,175. This maximum is the amount beneficiaries must pay each year before their plan will cover 100% of in-network expenses. 

Learn More About Medicare Advantage Prescription Drug Plans

A few types of Medicare Advantage Plans are available, each tailored to different needs and preferences. There are four main types of MAPD Plans: HMO, PPO, PFFS and SNP. Private insurance companies also offer standalone Medicare Part D Plans as an optional part of Medicare to help with prescription drug costs. 

Under an HMO plan, one company provides most medical services, and beneficiaries must see their primary care physicians for most care. Preferred Provider Organizations (PPOs) usually allow beneficiaries to select from a variety of in-network doctors. Care from an out-of-network provider may be covered, although the plan beneficiary may be responsible for a greater portion of the cost. 

Private Fee-for-Service (PFFS) plans offer flexibility but only pay hospitals and doctors who agree to the policy rates. Finally, Special Needs Plans (SNPs) serve beneficiaries with particular medical needs or chronic conditions.