If you’ve started looking into your Medicare options, you’ve probably seen the alphabet soup of plans: Plan G, Plan N, Plan F, and more. It’s easy to feel overwhelmed, but there’s a key piece of information that makes it all much simpler. Medigap plans are standardized by the federal government. This means a Plan G from one company has the exact same basic benefits as a Plan G from another. This allows you to make a true apples-to-apples comparison. Your decision really comes down to two things: choosing the lettered plan that fits your needs, then finding the right company. We’ll explain how to compare Arizona Medigap plans to find the best value.
Key Takeaways
- Shop around for the best price, not the best benefits: Since Medigap plans are standardized, a Plan G is a Plan G no matter which company sells it. The real difference is the monthly premium, so comparing quotes from different insurance carriers is the key to finding the best value.
- Your Open Enrollment Period is your golden ticket: This one-time, six-month window guarantees your right to buy any Medigap plan without answering health questions. Missing it can result in higher premiums or being denied coverage based on your health history.
- Decide between predictable costs or a lower premium: The choice between Plan G and Plan N comes down to your financial preference. Plan G offers more comprehensive coverage for a higher monthly cost, while Plan N has a lower premium in exchange for small, predictable copays.
What Is a Medigap Plan in Arizona?
If you’re enrolled in Original Medicare (Part A and Part B), you know it covers a lot of your healthcare costs—but not all of them. That’s where a Medigap plan, also called Medicare Supplement insurance, comes in. Think of it as a partner to your Original Medicare. It’s a private insurance policy that helps pay for some of the remaining costs that Medicare doesn’t cover on its own.
These out-of-pocket expenses, like deductibles, copayments, and coinsurance, can add up quickly, creating financial uncertainty just when you need it least. A Medigap plan is designed to fill those financial “gaps,” giving you more predictable healthcare spending and peace of mind. In Arizona, just like in most states, these plans are standardized by the federal government. This means that a Plan G from one company has the exact same basic benefits as a Plan G from another. The only real difference is the price you pay for the monthly premium and the company’s customer service reputation. This standardization makes it easier to compare plans apples-to-apples, so you can focus on finding the right coverage level and a trusted insurer. The main goal is to reduce what you have to pay out-of-pocket when you receive medical care, making your budget much easier to manage.
How Medigap Supplements Original Medicare
So, how does this work in practice? As its name suggests, a Medigap plan supplements your existing Original Medicare coverage. For example, Medicare Part B generally covers 80% of the cost for medically necessary services like doctor visits or outpatient care. Without a supplement, you’d be responsible for the remaining 20%.
If you have a Medigap plan, it can cover that 20% for you. Depending on the specific plan you choose, it can also help pay for your Part A hospital deductible or the copayments you might face for a hospital stay. This makes your healthcare costs much more predictable, as you’re protected from many of the variable expenses that can arise after a doctor’s visit or medical procedure.
Filling the Gaps in Your Medicare Coverage
While Medigap plans are incredibly helpful, it’s just as important to understand what they don’t cover. These plans are designed to work with Original Medicare, so they only help pay for services that Medicare covers in the first place. One of the biggest things to remember is that Medigap plans sold today do not include prescription drug coverage. For that, you will need to enroll in a separate Medicare Part D plan.
Additionally, Medigap policies do not pay for services like long-term care (such as help in a nursing home), routine dental, vision, or hearing care. Understanding these limitations is key to building a complete Arizona Medicare Supplement plan that truly meets all of your healthcare needs without any surprises down the road.
Which Medigap Plans Can You Get in Arizona?
When you start looking at Medigap plans in Arizona, the first thing you’ll notice is a sea of letters. While it might seem confusing, there’s good news: these plans are standardized. This means that the basic benefits for each lettered plan are the same, regardless of which insurance company sells it. A Plan G from one carrier offers the same fundamental coverage as a Plan G from another.
This setup is a huge help because it allows you to make a true apples-to-apples comparison. Instead of getting lost in confusing benefit details, you can focus on what really differs between companies: the monthly premium and the quality of their customer service. Your job is to find the lettered plan that best fits your health needs and budget. In Arizona, you have up to 10 different Medigap plan options to choose from, each designed to cover different portions of your out-of-pocket costs from Original Medicare.
An Overview of Plans A Through N
In Arizona, you can find Medigap plans designated with the letters A, B, C, D, F, G, K, L, M, and N. Because these plans are standardized by the federal government, their core benefits don’t change from one insurance company to the next. This standardization simplifies your decision-making process significantly.
Think of it this way: you first decide which plan letter (like G or N) has the right level of coverage for you. Once you’ve picked a letter, you can then shop around for that specific plan among different insurance carriers to find the best price. This lets you focus on a company’s financial stability and customer service record, knowing the Medigap policy benefits will be identical.
What Each Medigap Plan Covers
Medigap plans exist to help pay for the costs that Original Medicare (Parts A and B) doesn’t cover. These out-of-pocket expenses are often called “gaps” in coverage and include things like your Part A hospital deductible and the 20% coinsurance for most doctor services. Each lettered plan fills these gaps in slightly different ways.
Two of the most popular options for new Medicare members are Plan G and Plan N. Plan G is known for its comprehensive coverage; once you’ve paid your annual Part B deductible, it covers nearly all of your remaining costs. Plan N is another excellent choice that typically has lower monthly premiums. In exchange, you’ll pay small copays for some doctor and emergency room visits and it doesn’t cover Part B excess charges.
Which Plans Are No Longer Available?
You may have heard friends or family members talk about their Plan F or Plan C. For years, these were extremely popular choices. However, due to a federal law change, Medigap plans sold to new Medicare beneficiaries are no longer allowed to cover the Part B deductible.
As a result, Plans C and F are not available if you became eligible for Medicare on or after January 1, 2020. If your Medicare eligibility started before that date, you may still be able to purchase one of these plans. For everyone else, Plan G and Plan N have become the go-to options, offering robust coverage that is very similar to what Plan F and Plan C provided.
How Much Does a Medigap Plan Cost in Arizona?
Figuring out the cost of a Medigap plan in Arizona isn’t as simple as looking up a single price. The monthly premium you’ll pay is personalized and depends on a mix of factors, from the plan you choose to the company that offers it. While Medigap plans with the same letter offer the same basic benefits no matter which company you buy from, the price for that identical coverage can vary significantly.
Think of it like this: two people living in the same town could have the exact same Medigap Plan G but pay different monthly premiums. Understanding what goes into these calculations is the first step toward finding a plan that fits your budget not just today, but for years to come. We’ll break down the key elements that determine your premium, how insurance companies set their prices, and why the timing of your enrollment matters so much.
What to Expect for Monthly Premiums
Your monthly Medigap premium is based on several personal details. Insurance companies look at your age, gender, and where you live in Arizona. Even your specific ZIP code can make a difference. They will also ask if you use tobacco, as that can lead to a higher rate. On the other hand, some companies offer household discounts if you live with a spouse or partner who is also on Medicare, which can help lower your costs.
Because so many variables are at play, the only way to know your exact cost is to get a personalized quote. The insurance carrier you select is another major factor, as each company sets its own prices for the standardized plans. This is why it’s so important to compare options from different carriers to ensure you’re getting a competitive price for the coverage you need.
What Affects Your Premium Price?
When you enroll in a Medigap plan has a huge impact on your premium. The best time to sign up is during your Medigap Open Enrollment Period. This is a one-time, six-month window that starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this protected period, insurance companies cannot use your health history to set your price.
This means they can’t charge you more or deny you coverage because of any pre-existing health conditions. It’s your golden ticket to getting any Medigap plan sold in Arizona. If you miss this window, you may have to go through medical underwriting. An insurance company can then review your health history, potentially charging you a higher premium or even refusing to sell you a policy altogether, unless you qualify for a guaranteed issue right.
How Insurance Companies Price Your Plan
Insurance companies use one of three methods to price their Medigap plans, which affects how your premium might change over time. It’s important to ask which pricing method a company uses before you buy a policy.
The three pricing methods are:
- Community-rated: Everyone who has the policy pays the same monthly premium, regardless of their age. Premiums may still go up due to inflation or other factors, but not just because you get older.
- Issue-age-rated: Your premium is based on your age when you first buy the policy. Premiums are lower for people who buy at a younger age and won’t increase just because you get older.
- Attained-age-rated: Your premium is based on your current age, so it increases as you get older. These plans often start with the lowest premiums but can become the most expensive over time.
When Can You Enroll in an Arizona Medigap Plan?
Timing is everything when it comes to enrolling in a Medigap plan. While you can apply for a policy at any time, there are specific windows when insurance companies cannot deny you coverage based on your health history. Missing these key periods can make it more difficult or expensive to get the plan you want. Understanding these enrollment periods is the first step toward securing your coverage with confidence and avoiding any surprises down the road.
Your One-Time Medigap Open Enrollment Period
Think of this as your golden ticket for Medigap. Your Medigap Open Enrollment Period is a six-month window that starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this time, an insurance company cannot use medical underwriting to make decisions about your policy. This means they must sell you any Medigap plan they offer, can’t deny you coverage for pre-existing health problems, and can’t charge you a higher premium because of your health status. This is truly the best and easiest time to buy a Medigap policy.
Understanding Your Guaranteed Issue Rights
If your six-month Open Enrollment Period has passed, don’t worry—you may still have options. Certain situations give you guaranteed issue rights, which means insurance companies are required to sell you a Medigap policy. These rights usually apply when you lose other types of health coverage. For example, you might qualify if your employer group health plan is ending or if you move out of your Medicare Advantage Plan’s service area. These rights are time-sensitive, so it’s important to act quickly once you know your other coverage is ending to ensure you don’t miss your window.
Do You Qualify for a Special Enrollment Period?
Special Enrollment Periods typically apply to specific circumstances, like when you decide to switch from a Medicare Advantage Plan back to Original Medicare. It’s important to know that you can’t have both types of plans at the same time. You must first disenroll from your Medicare Advantage Plan before your Medigap coverage can begin. Planning this transition carefully is key to making sure you don’t have any gaps in your health coverage. Understanding the rules for your specific situation will help ensure a smooth change from one plan to another.
Plan G vs. Plan N: A Head-to-Head Comparison
When you start looking at Medigap plans, you’ll quickly notice that Plan G and Plan N are two of the most popular options available. They both offer excellent coverage, but they have a few key differences in how they handle costs. Understanding these distinctions is the first step to figuring out which one might be the better fit for your specific situation. Think of it as choosing between a slightly more expensive all-inclusive pass versus one with a lower entry fee but a few small charges inside. Let’s break down what each plan offers so you can compare them side-by-side.
A Closer Look at Plan G
Medigap Plan G is often considered the gold standard for new Medicare beneficiaries because of its comprehensive coverage. Once you’ve paid your annual Medicare Part B deductible, Plan G covers nearly all of your remaining out-of-pocket costs for Medicare-approved services. This includes coinsurance for hospital stays, doctor visits, and skilled nursing facility care. For many people, this predictability is a huge relief. You pay a higher monthly premium compared to Plan N, but in return, you get peace of mind knowing you won’t face many unexpected medical bills throughout the year. It’s a straightforward plan for those who prefer to budget for a fixed monthly cost rather than variable copayments.
A Closer Look at Plan N
Medigap Plan N provides a similar level of robust coverage as Plan G but with a different cost-sharing structure. In exchange for a lower monthly premium, you agree to pay a small copayment for certain services. This typically means a copay of up to $20 for some doctor’s office visits and up to $50 for an emergency room visit (if you aren’t admitted to the hospital). Like Plan G, you are still responsible for the annual Part B deductible. Plan N can be a great choice if you are in good health, don’t visit the doctor frequently, and are comfortable with occasional small copays to save on your monthly premium.
How to Choose Between Plan G and Plan N
The right choice between Plan G and Plan N really comes down to your personal health needs and financial preferences. If you value predictable costs and want to minimize out-of-pocket expenses for medical care, Plan G is often the best value for the benefits it provides. However, if you’re looking for a lower monthly premium and don’t mind paying small, predictable copays when you do see a doctor, Plan N could save you money. Consider your typical healthcare usage over the past few years. Do you prefer paying more upfront each month for near-complete coverage, or would you rather pay less monthly and handle small costs as they arise? Answering these questions will help you find the right Medigap policy for your life.
Clearing Up Common Medigap Misconceptions
When you start looking into Medigap, you’ll hear a lot of different things. It’s easy for wires to get crossed, and unfortunately, much of the common “knowledge” about these plans is incorrect. Believing these myths can lead you to choose a plan that isn’t the right fit for your health needs or budget. Let’s walk through some of the most common Medigap misconceptions and set the record straight. Getting clear on these points will help you make a much more confident decision.
Myth: Medigap Covers Everything
A big misunderstanding is that a Medigap plan will pick up every cost that Original Medicare doesn’t. While these plans are incredibly helpful for covering expenses like copayments and deductibles, they aren’t a blank check. For instance, Medigap plans sold to new enrollees do not cover prescription drugs; you’ll need a separate Medicare Part D plan for that. They also don’t pay for services like long-term care, dental, or vision. Think of Medigap as a way to fill specific gaps in your Original Medicare coverage, not as an all-inclusive health plan.
Myth: All Plans with the Same Letter Are Identical
This one is tricky because it’s partially true. The government standardizes Medigap plans, so a Plan G from one company must offer the exact same basic benefits as a Plan G from another. Where they differ is the price. Insurance companies can and do charge different monthly premiums for the same lettered plan. One company might be much more expensive than another for identical coverage. Beyond cost, you might also find differences in customer service. This is why it’s so important to compare Medigap policies from various carriers instead of just picking the first one you see.
Myth: Medigap and Medicare Advantage Are the Same
People often use ‘Medigap’ and ‘Medicare Advantage’ interchangeably, but they are two completely different types of health coverage. Medigap plans work with Original Medicare to pay for leftover costs. Medicare Advantage plans (Part C) are an alternative to Original Medicare, where you get your benefits through a private insurance company. You cannot have both at the same time; in fact, it’s illegal for an insurer to sell you a Medigap policy if you have a Medicare Advantage Plan. Understanding the difference between these options is a critical first step in your Medicare journey.
Medigap vs. Medicare Advantage in Arizona
One of the biggest decisions you’ll make when you enroll in Medicare is how you want to receive your coverage. You can stick with Original Medicare and add a Medigap plan, or you can choose a Medicare Advantage plan instead. These two paths are very different, and it’s important to understand the trade-offs.
Think of it this way: Medigap works with Original Medicare, while Medicare Advantage works in place of it. They are not the same thing, and you can’t have both at the same time. In fact, it’s illegal for an insurance company to sell you a Medigap policy if you already have a Medicare Advantage Plan. Let’s break down the key differences in how they handle your coverage, costs, and access to doctors.
How Coverage Differs
Medigap plans, also called Medicare Supplement insurance, are designed to fill the “gaps” in Original Medicare. For example, after you’ve met your deductible, Medicare Part B typically covers 80% of your outpatient medical costs. A Medigap plan picks up the remaining 20% for you. It’s a predictable way to manage the out-of-pocket expenses that come with Original Medicare.
Medicare Advantage plans, or Part C, are an alternative way to get your Medicare benefits. These are private insurance plans that bundle your Part A (hospital) and Part B (medical) coverage into a single plan. Most also include Part D prescription drug coverage and may offer extra benefits like dental or vision. Instead of Medicare paying your claims, the private Advantage plan does.
How Costs Compare
With a Medigap plan, you pay a monthly premium to the private insurance company in addition to your monthly Part B premium to the government. While this means a higher fixed monthly cost, it provides incredible financial predictability. Once your premiums are paid, you can have very few, if any, out-of-pocket costs for Medicare-covered services.
Medicare Advantage plans often have low or even $0 monthly premiums, which can be very appealing. However, your costs come in the form of copayments, coinsurance, and deductibles when you receive care. These plans also have an annual out-of-pocket maximum, which can be several thousand dollars. You generally pay less per month but more when you use your insurance.
Your Freedom to Choose Doctors
This is a major distinction between the two options. When you have Original Medicare and a Medigap plan, your network is nationwide. You can see any doctor or go to any hospital in the country that accepts Medicare. You don’t need referrals to see specialists, giving you complete freedom to choose your providers.
Medicare Advantage plans, on the other hand, typically use local provider networks, like an HMO or PPO. You’ll need to use doctors and hospitals within that network to get the lowest costs. Going out of network can result in much higher bills or no coverage at all, except in an emergency. If you travel often or want the flexibility to see any doctor, this is a critical factor to consider.
How to Choose the Right Medigap Plan for You
With ten standardized plans offered by dozens of different insurance companies, picking the right Medigap plan can feel like a monumental task. But it doesn’t have to be. Making a confident choice comes down to thoughtfully considering three key areas of your life: your health, your finances, and the insurance companies available to you. It’s about finding a balance between what you need for coverage and what you can comfortably afford, both now and in the years to come.
Thinking through these factors helps you move past the noise and focus on what truly matters for your peace of mind. A plan that works perfectly for your neighbor might not be the best fit for you, and that’s okay. Your health needs and financial situation are unique. By breaking the decision down into these three smaller, more manageable steps, you can compare your options with clarity and select a Medigap plan that serves you well for the long haul. Let’s walk through each one.
Assess Your Current and Future Health Needs
First, take an honest look at your health. Medigap plans are designed to fill the coverage gaps in Original Medicare. For instance, after you’ve met your deductible, Medicare Part B typically covers 80% of your outpatient care costs; a Medigap policy can pay for the remaining 20%. Think about your current health status, any chronic conditions you manage, and your family’s health history. While no one has a crystal ball, considering potential future needs can help you choose a more comprehensive plan if you anticipate needing more medical care down the road. It’s also important to remember what Medigap doesn’t cover, such as long-term care or routine dental and vision services.
Review Your Budget and Long-Term Costs
Next, it’s time to look at your finances. The best time to buy a Medigap plan is during your six-month Medigap Open Enrollment Period, which starts the month you’re 65 or older and enrolled in Part B. During this window, insurance companies can’t deny you coverage or charge you more due to your health. The monthly premium you’ll pay is influenced by several factors, including your age, location, and the insurance company you choose. When comparing plans, look beyond the monthly premium. Consider the total potential cost, including deductibles and copayments, to find a plan that fits your budget without sacrificing essential coverage.
Research the Insurance Carrier
While Medigap plans are standardized by the government—meaning a Plan G from one company has the same basic benefits as a Plan G from another—the companies selling them are not. The price for the exact same plan can vary significantly between carriers. Beyond cost, you’ll want to consider a company’s reputation for customer service and its financial stability. Are they known for processing claims efficiently and providing helpful support? Reading reviews and checking financial strength ratings can provide valuable insight. Working with an independent agent can also save you time and money, as they can quickly compare plans and prices from multiple carriers for you.
Where to Find Help Comparing Arizona Medigap Plans
When you start looking at all the Medigap options in Arizona, it’s completely normal to feel a bit overwhelmed. You’re not just picking a letter; you’re trying to find a plan that fits your health needs and your budget, both now and in the years to come. The good news is, you don’t have to figure it all out on your own. There are several excellent resources available to help you gather information, compare your choices, and feel confident in your decision.
The key is to approach it methodically. Start with the big picture to understand the landscape, then narrow your focus to the specific companies and plans available to you, and finally, seek out expert advice to confirm you’re making the best choice. This process ensures you’re not missing any crucial details. For example, while all Plan G policies offer the same basic benefits, the monthly premium can vary significantly between different insurance carriers. Likewise, a company’s reputation for customer service and rate stability is just as important as its price. By using a combination of online tools, direct company information, and professional guidance, you can cover all your bases and find a plan that serves you well for years.
Using the Official Medicare.gov Plan Finder
A great place to begin your research is the official Medicare website. The government provides a helpful plan finder tool that allows you to see which Medigap policies are available in your specific ZIP code. You can get general information about what each plan covers and see a list of companies that offer them. For general questions, you can also call 1-800-MEDICARE. This tool is perfect for getting a basic understanding of the landscape and seeing all your potential options in one place. It helps you build a foundation of knowledge before you start digging into the finer details of pricing and carrier reputations.
State-Specific Carrier Information
While Medigap plans are standardized by the federal government, they are sold by private insurance companies. This means that not every plan is offered in every state, and the companies you can choose from will be specific to Arizona. Once you have an idea of which plan letter (like G or N) seems like a good fit, your next step is to research the carriers that offer it. You can contact insurance companies directly, like Blue Cross Blue Shield of Arizona, to get specific details about their costs and application process. This is where you’ll start to see how premiums can vary from one company to another for the exact same plan coverage.
Working with a Licensed Medicare Advisor
If you want personalized help, talking to a licensed Medicare advisor is an excellent choice. An independent advisor can do the heavy lifting for you. They get to know your unique health situation and financial goals, then compare plans from multiple insurance companies to find the one that truly fits you best. This approach saves you time and provides peace of mind, knowing an expert is looking out for your interests. At The Big 65, our licensed advisors offer this guidance at no cost to you. We’re here to answer your questions and help you make a decision with confidence.
Make Your Arizona Medigap Decision with Confidence
Choosing your healthcare coverage is a significant decision, but you now have the information you need to move forward. The primary purpose of a Medigap plan is to work with your Original Medicare to cover out-of-pocket costs like deductibles, copayments, and coinsurance. For instance, while Medicare Part B generally covers 80% of your outpatient services, a Medigap policy can help pay for the remaining 20%, which can make a huge difference in your budget.
As you finalize your choice, it’s helpful to clear up a few common misunderstandings. While these plans significantly reduce your costs, they don’t cover every single medical expense, so it’s always wise to review the specific benefits of each plan. It’s also crucial to remember that Medigap plans sold today do not include prescription drug coverage. To ensure your medications are covered, you will need to enroll in a separate Medicare Part D plan. You can learn more in our complete guide to Arizona Medicare Supplements.
You don’t have to sort through all of this alone. Some people believe that using an insurance agent is an unnecessary expense, but that’s simply not true. A licensed agent who specializes in Medigap can help you understand the complexities of different plans and may even save you money over time. By doing your research and getting the right support, you can select an Arizona Medigap plan that fits your needs and gives you peace of mind.
Related Articles
- Your Guide to Arizona Medicare Supplements – The Big 65
- A Complete Guide to Arizona Medicare Supplements – The Big 65
- Medicare Insurance Brokers in Arizona You Can Trust
Frequently Asked Questions
If all Plan Gs have the same benefits, why do they have different prices? This is a great question because it gets to the heart of how Medigap works. The federal government standardizes the benefits for each lettered plan, so a Plan G from one company must cover the exact same things as a Plan G from another. However, the insurance companies selling these plans are private businesses. They each set their own monthly premiums based on their own business models and how they assess risk. That’s why it’s so important to compare the same plan across different carriers to find the best price.
What happens if I miss my Medigap Open Enrollment Period? Your six-month Medigap Open Enrollment Period is your golden ticket to get any plan you want without answering health questions. If you miss this window, you can still apply for a plan, but insurance companies can generally require you to go through medical underwriting. This means they can review your health history and potentially charge you a higher premium or even deny your application altogether based on pre-existing conditions.
Do Medigap plans cover my prescription drugs or dental visits? This is a common point of confusion. Medigap plans are designed to supplement Original Medicare Parts A and B, so they only help pay for services that Medicare covers. Since Original Medicare doesn’t cover most prescription drugs, routine dental care, or vision exams, Medigap plans don’t either. For drug coverage, you will need to enroll in a separate Medicare Part D plan.
What’s the main difference between choosing a Medigap plan and a Medicare Advantage plan? The simplest way to think about it is that Medigap works with Original Medicare, while Medicare Advantage works in place of it. With a Medigap plan, you keep Original Medicare and have the freedom to see any doctor in the U.S. who accepts Medicare. With a Medicare Advantage plan, you get your benefits from a private company that typically uses a local network of doctors and hospitals, and you pay copays as you receive care.
How do I decide between a comprehensive plan like Plan G and one with lower premiums like Plan N? The choice really comes down to your personal preference for handling costs. Plan G generally has a higher monthly premium, but once you meet your annual Part B deductible, it covers almost everything else. Plan N offers a lower monthly premium in exchange for you paying small, predictable copayments for some doctor and emergency room visits. If you prefer predictable monthly costs and minimal out-of-pocket expenses, Plan G is often a great fit. If you’d rather save on premiums and are comfortable with occasional small copays, Plan N is an excellent option.