Medicare Advantage (Part C) Plans in Arizona
The main advantage of Medicare Advantage plans is that they limit the amount of money you have to pay out of your own pocket for health care. Under most Part C plans, there’s a formal limit to how much you have to pay out-of-pocket each year for in-network medical services normally covered under Medicare Parts A and B. This limit is called the “maximum out-of-pocket amount for in-network medical services.” In Arizona, during 2012, the most you have to these services ranges between $3,400 and $5,000. (Under a POS plan that allows you more flexibility about the doctors or hospitals you choose, the out-of-pocket maximum is usually higher. In 2012, it is closer to $8,000.) An important note, related to out-of-pocket maximums: Once you’ve reached the maximum, most Arizona Part C plans prohibit providers from mixing in additional separate charges—sometimes called “balance billing”—that they send to you directly. This prohibition applies even if the plan pays a provider less than the provider charges for a service or if there’s some other dispute between the plan and the provider.