Medicare is the federal health insurance program for people 65+ and other vulnerable younger individuals.

The good news about Medicare is that it pays for the majority (but not all) of most senior’s medical bills. Unfortunately, the not so good news is that it typically does not pay for about 20% of senior medical bills (which can be a very big number). As a result, many income-challenged, chronically ill seniors, find accessing quality healthcare difficult or impossible.

Fortunately, in addition to Medicare, there are several low-cost and possibly no-cost healthcare insurance options.

Option 1: Original Medicare

Original Medicare is made up of two parts: Medicare Part A covers hospital insurance, and Medicare Part B covers medical expenses such as doctor visits, lab work and some medical equipment.

Original Medicare typically covers about 80% of Part A and Part B expenses. You are responsible for the remainder of your medical expenses including prescription.

If you select Original Medicare, you will probably want to select an additional private insurance plan to provide Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Medigap plans fill the “gaps” in hospital and medical costs that Original Medicare does not cover. Medigap offers 10 different levels of supplementary insurance in groups called Medigap A, B, C, D, F, G, K, L, M or N. Each sequential level provides higher coverage in exchange for a higher cost.

Option 2: Medicare Advantage

Medicare Advantage plans can be a low-cost, or in some cases almost free insurance alternatives to Original Medicare. The most common are HMO and PPO Plans.

  • An HMO, or Health Maintenance Organization is a group of doctors, hospitals, and other health care providers who agree to give health care to beneficiaries for a fee that the government pays them. In an HMO, you usually must get all your care from the providers that are part of the plan and you need a referral from a primary care physician to go to specialists.
  • A PPO, or Preferred Provider Organization is a managed care plan that provides you with services from doctors, hospitals and other providers that belong to a network. You have the option of receiving services from providers outside the network at additional cost. You do not need a referral from a primary care physician to go to a specialist.

Both HMO and PPO plans generally include prescription drug coverage through a Medicare Advantage Prescription Drug Plan (MAPD).

Read more about Medicare Advantage.

Option 3: Medicaid

Medicaid is government funded health insurance that provides low-cost and possibly free healthcare coverage for very low-income Arizona seniors. Medicaid coverage is potentially available to approximately 200,000 individuals (age 65+) who have incomes that are at or below 138% of the federal poverty level.

Read more about how Medicaid enrollment works.

Request Help

Nonprofit ACCESSMed Foundation can help you make sure that you are receiving the Medicare, Medicaid and possibly Medicare Advantage benefits that you are entitled to and deserve. Request help by clicking on the GET MEDICARE AND MEDICAID HELP button below.