Three Ways To Utilize Medicare Coverage

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• Original Medicare: Part A (Hospital Coverage) and Part B (Medical Coverage).
• Part A: Includes a $1,716 inpatient hospital deductible per 60 benefit period. It covers only hospital charges, not physician charges in the hospital.
• Part B: In 2026, includes a standard $202.90 monthly premium (more for higher incomes). Part B has a $288 yearly deductible and then you pay 20% co-insurance (NO LIMIT). If you miss your deadline for enrolling in Part B and you don’t have creditable coverage, you face a life-time late penalty.
• *Part D: Available only from Medicare approved, private insurance companies. The yearly deductible is $615. If you miss your deadline for enrolling in Part D and you don’t have creditable coverage, you face a life-time late penalty.

• The Supplement plan, also called Medigap, fills in the 20% gap left by Original Medicare. It protects against the liability of having Original Medicare only.
• Must have Medicare Part A & B and be age 65 or older in Arizona.
• Original Medicare is the primary insurer.
• These plans are regulated by the government and provide identical coverage from carrier to carrier but costs vary.
• There are no networks - a beneficiary can go to any provider, medical group, hospital or facility that accepts Medicare billing (no referrals needed on most procedures).
• Medigap or Medicare Supplement Open Enrollment is a 6-month period that begins the first day of the month that you are both 65 or older and begin Medicare Part B and has no medical underwriting.
• Guaranteed issue Medigap periods or rights are specific situations where insurance companies must sell you a policy, charge the best available rate, and cover pre-existing conditions without medical underwriting.
• When there is not a Medigap Open Enrollment period or a Guaranteed Issue period, then medical underwriting is required.
• Supplements DO NOT include Part D prescription drug plans. It’s recommended to add a separate stand-alone prescription drug plan to avoid a life-time late penalty.

*See above for further information.

• Medicare Advantage plans are also known as an MAPD or Part C.
• Part C= Part A + Part B + Part D.
• Private insurance companies pay for Hospital, Medical, and Prescription coverage. They charge the beneficiary a copay (a set dollar amount) or a coinsurance (a percentage).
• These plans offer out-of-pocket maximums, with some added benefits not offered with Original Medicare.
• HMO plans require a primary care physician on file and restrict coverage to the network.
• PPO plans cover out-of-network care, but at a higher cost.
• Most carriers provide a local network, as well as global emergency and nationwide urgent care coverage.