What Medicare is
Medicare is a federal health insurance program. It covers people 65 and older, people under 65 who have received Social Security disability benefits for 24 months, and people with end-stage renal disease (permanent kidney failure) or ALS. The rules, the coverage and the standard costs are the same in Arizona as in every other state. What changes from place to place is the private coverage you can add to it, and that is where living in Arizona matters.
Two federal agencies handle different jobs. The Social Security Administration signs you up, decides your eligibility and collects most premiums. The Centers for Medicare & Medicaid Services (CMS) runs the program, sets the rules and approves the private plans sold in each county.
The four parts of Medicare
Part A: hospital insurance
Inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice and some home health care. Most people pay no Part A premium because they or a spouse worked and paid Medicare taxes for at least 10 years. More on Part A.
Part B: medical insurance
Doctor visits, outpatient care, lab tests, imaging, durable medical equipment, ambulance and many preventive services. Part B has a monthly premium ($202.90 standard in 2026) and a yearly deductible. More on Part B.
Part C: Medicare Advantage
Private plans approved by Medicare that provide your Part A and Part B coverage, and usually Part D drug coverage too, through a network of providers. More on Medicare Advantage in Arizona.
Part D: prescription drugs
Private drug plans that cover outpatient prescriptions. In 2026 your out-of-pocket drug costs are capped at $2,100 for the year. More on Part D in Arizona.
Original Medicare or Medicare Advantage
Once you have Parts A and B, you choose one of two ways to get your benefits.
Original Medicare
With Original Medicare you can see any doctor or hospital in the country that accepts Medicare, without referrals. You pay the Part B deductible and generally 20% of the Medicare-approved amount for doctor and outpatient care, and there is no yearly cap on those costs. Most people who choose this path add two things:
- A Medigap (Medicare Supplement) policy to cover some or most of the deductibles and coinsurance. See Medigap in Arizona.
- A Part D drug plan, because Original Medicare doesn't cover most outpatient prescriptions.
This path suits many Arizonans who travel or split the year between two states, because Original Medicare and Medigap aren't tied to a local network. Our page on snowbirds and seasonal residents covers this in detail.
Medicare Advantage (Part C)
A Medicare Advantage plan replaces Original Medicare as the way you get your Part A and B benefits. Plans use networks (HMO or PPO), set their own copays and coinsurance, and must cap your in-network out-of-pocket costs for Part A and B services, up to $9,250 in 2026. Most include Part D drug coverage. Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
You can't use a Medigap policy with a Medicare Advantage plan. If you choose Medicare Advantage and later want to switch back to Original Medicare with Medigap, in many cases Medigap insurers in Arizona can turn you down or charge more based on your health once your Medigap open enrollment period has passed, unless you have a federal guaranteed-issue right. See when you can buy Medigap in Arizona.
How choice differs across Arizona's 15 counties
Medicare Advantage and special needs plans are approved county by county, so your choices depend on where you live. For 2027 coverage, CMS plan data shows:
| County | Medicare Advantage plans open to everyone | Companies offering them |
|---|---|---|
| Maricopa (Phoenix area) | 52 | 16 |
| Pima (Tucson area) | 52 | 15 |
| Yavapai | 20 | 6 |
| Greenlee | 8 | 5 |
| Apache | 7 | 5 |
The gap reflects how many doctors and hospitals a plan can build a network around. In the Phoenix and Tucson metro areas there are many; in Apache, Greenlee and other rural counties, long distances and fewer providers mean fewer plans. Many residents of rural northern and eastern Arizona also get care through Indian Health Service, tribal or urban Indian health programs, which work alongside Medicare (see tribal nations and IHS).
Original Medicare, Medigap and Part D work in every county. If you live in a county with few local plans, or you travel often, check whether your doctors and nearest hospital are in a plan's network before you choose it. To look up your county, see Medicare by Arizona county, or see plans in your ZIP code.
How Arizonans get started
- Check whether you'll be enrolled automatically. If you already get Social Security retirement or disability benefits, you're usually enrolled in Parts A and B and your card arrives in the mail. See Medicare eligibility.
- If not, sign up with Social Security. Your Initial Enrollment Period is the 7 months around your 65th birthday: the 3 months before, your birthday month and the 3 months after. Apply online at ssa.gov, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or in person. Social Security has field offices around Arizona; use the office locator at ssa.gov to find the one that serves your ZIP code and check whether you need an appointment.
- Decide about Part B if you're still working. If you or your spouse has job-based coverage from a current employer, you may be able to delay Part B without a penalty. See working past 65.
- Choose how you'll get your coverage. Original Medicare with Medigap and Part D, or a Medicare Advantage plan. Know your enrollment periods; for 2027 coverage the Annual Enrollment Period runs October 15 to December 7, 2026.
- Check whether you can get help with costs. AHCCCS, Arizona's Medicaid program, runs the Medicare Savings Programs that can pay the Part B premium, and Extra Help lowers drug costs. See Medicare costs in 2026.
Don't miss your window. If you don't sign up for Part B when you're first eligible and don't have qualifying job-based coverage, you may pay a late enrollment penalty of 10% for each full 12 months you waited, for as long as you have Part B.
Where to get help in Arizona
- Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048), 24 hours a day, for coverage questions and to see your plan options.
- Social Security: ssa.gov or 1-800-772-1213, for enrolling, your Medicare card, premiums and income-related adjustments.
- AHCCCS: Arizona's Medicaid agency, for Medicare Savings Programs, AHCCCS coverage and ALTCS long-term care. Apply at healthearizonaplus.gov. See AHCCCS and Medicare.
- Arizona Department of Insurance and Financial Institutions (DIFI): the state regulator for Medigap policies and insurance agents, and where to file a complaint about an insurance company or agent.
- Area Agencies on Aging: the Arizona Department of Economic Security's Division of Aging and Adult Services works with regional Area Agencies on Aging for services such as meals, caregiver support and legal help for older adults.
- A licensed insurance agent: a licensed insurance agent with Benefits Life can explain options from the companies they work with, at no cost to you: (602) SENIORS (602-736-4677), TTY 711. You can also find a licensed insurance agent in Arizona.
For phone numbers and addresses in one place, see Arizona Medicare contacts. Unfamiliar terms are explained in our glossary.
Sources
- Medicare.gov — Get started with Medicare
- Medicare.gov — Parts of Medicare
- Medicare.gov — Medicare costs
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- CMS — CY2027 Medicare Advantage and Part D Landscape file
- Social Security Administration — Medicare
- Social Security Administration — Office locator
- AHCCCS — Health-e-Arizona Plus
- Arizona Department of Insurance and Financial Institutions
- Arizona Department of Economic Security — Area Agencies on Aging
Frequently asked questions
Is Medicare the same as AHCCCS?
No. Medicare is the federal health insurance program run by the Centers for Medicare & Medicaid Services, mostly for people 65 and older. AHCCCS is Arizona's Medicaid program, based on income and other rules. Some Arizonans qualify for both, and then Medicare pays first and AHCCCS can help with costs Medicare leaves.
Do I have to sign up for Medicare at 65 if I already get Social Security?
No. If you already get Social Security retirement benefits, you're usually enrolled in Parts A and B automatically, and your Medicare card arrives in the mail about three months before your 65th birthday. If you don't get Social Security yet, you sign up yourself at ssa.gov, by phone, or at a Social Security office in Arizona.
What does Original Medicare not cover?
Original Medicare doesn't cover most routine dental care, routine eye exams and glasses, hearing aids, or long-term custodial care, and it has no yearly limit on what you pay out of pocket. It also doesn't include outpatient prescription drugs; for those you add a Part D plan or choose a Medicare Advantage plan that includes drug coverage.
Why do people in rural Arizona counties have fewer plan choices?
Medicare Advantage plans are approved county by county, and companies decide where to offer them. Plans depend on networks of doctors and hospitals, so populated counties such as Maricopa and Pima usually have many more plans than sparsely populated counties such as Apache or Greenlee. Original Medicare works the same everywhere in Arizona.
How much does Medicare cost in 2026?
Most people pay no premium for Part A. The standard Part B premium is $202.90 a month in 2026, with a $283 yearly deductible, and higher-income people pay more. Medigap, Part D and Medicare Advantage plans can have their own premiums.
