Pinal County Medicare Advantage Plans

In this article...
  • Learn how much residents in Pinal County are paying for Medicare Advantage plans, including premiums, annual drug deductibles and out-of-pocket spending limits.

If you're looking for a health plan that offers benefits beyond the federal government's Original Medicare program, you may want a Medicare Advantage Prescription Drug (MAPD) plan. MAPD plans are offered by private insurers and cover medically necessary services such as hospital stays, physician visits and diagnostic tests. These plans also provide various additional benefits, including dental, vision and prescription drugs. Residents in Pinal County can choose from 30 different MAPD plans. Medicare rates 35% of them as four or five stars based on high quality of care and service. About 38,458 county residents are enrolled in a Medicare Advantage plan.

Average Cost of Medicare Advantage Plans in Pinal County

The amount you pay for your health insurance varies. While some plans have no premium, the average Medicare Advantage plan in Pinal County costs about $14.24 per month in 2021.

You must also pay for prescriptions until you reach your plan's annual drug deductible. The average annual drug deductible for MAPD plans in Pinal County is $117.60, which is one of the lowest among counties in Arizona.

There are additional costs in terms of copays and cost-sharing, but Medicare requires private insurers to cap your out-of-pocket spending. Once you reach this maximum, the plan must cover all out-of-pocket costs for in-network services. The average out-of-pocket maximum in Pinal County is $4,403.27.

Learn More About Medicare Advantage Prescription Drug Plans

Choosing a plan involves more than just comparing costs. The type of plan can impact what your health care looks like. Here are the four main kinds of Medicare Advantage plans.

  • HMO: A Health Maintenance Organization offers you a network of physicians, specialists and hospitals. The plan has negotiated fees with these providers so you may find costs are lower, but you're restricted to staying in-network for your care.
  • PPO: A Preferred Provider Organization also has a network of providers. You're usually covered if you use non-network providers but it's less costly to use doctors and hospitals in the network.
  • PFFS: A Private Fee-for-Service plan lets you see any Medicare-approved health care provider that accepts the plan's fees. You must confirm your doctor or hospital accepts the different service fees each time you get treatment, unless the PFFS has a network that you know you can always use.
  • SNP: A Special Needs Plan is customized to meet the needs of those with specific chronic conditions. For example, there are SNPs for people with chronic lung, heart, kidney and liver disease.

You can stay in Original Medicare if it's a better fit for your needs and then opt for a separate Part D prescription drug plan. These stand-alone plans can be added to the federal government's Medicare coverage to help pay for the medication that you need.