As Arizona’s most populous county, Maricopa County offers an extensive selection of Medicare Advantage plans to meet the diverse healthcare needs of its residents. Whether you’re in Phoenix, Scottsdale, Mesa, or Glendale, there’s a plan designed to fit your lifestyle. Here’s what you need to know about Medicare Advantage in Maricopa County for 2025.
Overview of Medicare Advantage in Maricopa County
Medicare Advantage plans in Arizona combine hospital, medical, and often prescription drug benefits into one convenient package. Here’s a quick summary of what’s available in Maricopa County.
- Total Companies Offering Plans: 17
- Total Plans Available: 94
- Plan Type Breakdown:
- HMO: 28.7%
- PPO: 21.3%
- HMO-POS: 13.8%
- HMO C-SNP (Chronic Special Needs Plans): 9.6%
- HMO D-SNP (Dual Special Needs Plans): 9.6%
- HMO-POS C-SNP: 7.4%
- HMO I-SNP (Institutional Special Needs Plans): 3.2%
- HMO-POS D-SNP: 2.1%
- Regional PPO: 2.1%
- PPO I-SNP: 1.1%
- HMO-POS I-SNP: 1.1%
Whether you’re in zip code 85032 (Phoenix), 85260 (Scottsdale), or 85308 (Glendale), there’s a plan available that meets your specific needs.
Types of Medicare Advantage Plans
In Maricopa County, you’ll find a variety of plan types to suit your healthcare requirements and budget.
Health Maintenance Organization (HMO)
- Requires you to use a local network of doctors and hospitals.
- Referrals are required for specialists.
- Features lower premiums and out-of-pocket costs.
HMOs are an excellent choice for those who want to stay within a robust network of providers, like those in central Phoenix or Chandler (85225).
Preferred Provider Organization (PPO)
- Offers the flexibility to see out-of-network providers at a higher cost.
- No referrals needed for specialists.
PPOs are ideal for residents who enjoy traveling or who split time between Maricopa County and other locations.
HMO-POS (Point-of-Service)
- Provides the affordability of an HMO with the flexibility of a PPO.
- Perfect for those who occasionally need out-of-network care.
Special Needs Plans (SNPs)
- Designed for individuals with chronic conditions, dual Medicare-Medicaid eligibility, or those residing in nursing homes.
These plans are especially useful for residents in areas like Sun City (85351) who need specialized care and additional support.
Costs and Maximum Out-of-Pocket Limits
Medicare Advantage plans in Maricopa County include maximum out-of-pocket (MOOP) limits to protect you from excessive healthcare expenses. Here’s how the costs break down:
- $0–$3,000: 12% of plans
- $3,001–$4,500: 28% of plans
- $4,501–$6,000: 38% of plans
- $6,001–$9,350: 22% of plans
Residents in Mesa (85201) often appreciate the affordability of plans with lower MOOP limits, while those with fewer healthcare needs may prefer higher limits for lower premiums.
Local Tips for Enrolling in Medicare Advantage Plans
If you’re ready to enroll, here’s how to get started in Maricopa County:
Work with a Local Insurance Agent
Since 1996, Medicare Health Benefits has been a trusted partner for Arizona residents, including those in Maricopa County. Our licensed agents are well-versed in local healthcare options and can help you find the perfect plan. Call (520) 760-6223 to schedule a consultation.
Visit a Local Social Security Office
If you need help with Medicare enrollment or eligibility questions, you can visit a nearby Social Security office:
- Phoenix Social Security Office
Address: 16241 N Tatum Blvd, Phoenix, AZ 85032
Phone: 1-800-772-1213
This location is convenient for residents across Maricopa County.
Enroll Online
Visit Medicare.gov to explore available plans in your zip code. Comparing options online is a great first step before consulting with a local expert.
Ask Around
In retirement-focused communities like Sun City West (85375), neighbors and local groups are often excellent resources for feedback on their experiences with Medicare Advantage plans.
Common Questions About Medicare Advantage in Maricopa County
What Are the Copayments for Doctor Visits?
Copayments vary by plan. Many HMOs in Scottsdale or Tempe (85281) feature low or no copays for primary care visits.
Do Plans Include Dental and Vision Coverage?
Yes! Many plans in Maricopa County include additional benefits like dental, vision, and hearing coverage, which are popular among retirees in Peoria (85345).
Can I Switch Plans Later?
You can make changes during the Annual Enrollment Period (AEP) or if you qualify for a Special Enrollment Period (SEP). For example, moving to a new county where your current plan is not available, you may adjust your plan.
Why Choose Medicare Advantage in Maricopa County?
Maricopa County’s Medicare Advantage plans offer something for everyone, from low-cost options for those on a budget to plans with enhanced benefits for active retirees. Whether you’re in the heart of Phoenix, relaxing in Sun City, or enjoying the charm of Mesa, there’s a plan that fits your healthcare needs.
For personalized help, contact Medicare Health Benefits, a trusted resource in Arizona since 1996. Our local agents ensure you’ll find the right plan for 2025. Call (520) 760-6223 or visit our office to get started today!
