Yavapai County Medicare Advantage Plans

In this article...
  • Learn about the cost of a Medicare Advantage plan in Yavapai County, including average premiums, annual drug deductibles and out-of-pocket spending caps.

If you want more choice in your Medicare coverage beyond what the federal government provides, you can opt for a health plan with a private insurance provider. Medicare Advantage Prescription Drug (MAPD) plans include the same coverage as Original Medicare, as well as benefits such as dental, vision and prescription drugs. There are 27 different MAPD plans available in Yavapai county in 2021, with 41% of them rated as four- or five-star plans by Medicare. About 26,994 residents in the county are enrolled in Medicare Advantage.

Average Cost of Medicare Advantage Plans in Yavapai County

MAPD plans don't cover all of your health care expenditures. You must still pay premiums, deductibles, co-pays and other out-of-pocket costs. You'll need to compare your options to find the plan that's most cost-effective based on your health needs and how you'd use the benefits.

The average monthly premium for a MAPD plan in Yavapai County in 2021 is $23.56. The annual drug deductible, which is the total you must pay for prescriptions before the plan begins to cover the costs, averages $235.48.

MAPD plans also have different limits for out-of-pocket costs. Once you've reached this cap, you aren't required to pay additional cost-sharing for your health care. The average maximum on out-of-pocket costs for in-network services in Yavapai County is $5,392.52. 

Learn More About Medicare Advantage Prescription Drug Plans

There are four main types of Medicare Advantage plans, each with different policies regarding which health care providers you can see.

  • Health Maintenance Organization (HMO): HMO plans have agreements with a network of hospitals, physicians and health care facilities. These plans require you to use in-network providers unless you pay for the services yourself. You need a primary care doctor to oversee your care and determine if you need a specialist.
  • Preferred Provider Organization (PPO): PPO plans also have agreements with a network of providers but are more flexible than HMO plans. You can usually see any provider you like, but it's less expensive to stay within the PPO's network.
  • Private Fee-for-Service (PFFS): PFFS plans have a pre-established fee for each service. You can coordinate your own care and use any health care provider registered with Medicare, but need to determine in advance if they accept the service fee.
  • Special Needs Plan (SNP): Enrollment in SNPs are limited to those with certain chronic conditions. The plans typically have a network of health care providers specializing in the field. Some conditions covered by SNPs include chronic heart failure, end-stage renal disease, neurologic disorders, stroke and HIV/AIDS.

Private insurance companies also offer separate Part D prescription drug plans. These are designed to provide drug coverage if you wish to stay in the federal government's Original Medicare program instead of enrolling in a Medicare Advantage plan.