Medicare in Arizona runs on federal rules, but the state adds free SHIP counseling, AHCCCS savings programs, and a large Medicare Advantage market in the Phoenix metro and Sun City corridor. This guide covers Medicare in Arizona for 2026: what each part costs, how plan choices vary by region, and the programs that lower the bill.
In This Guide
- Key Takeaways
- Original Medicare: Parts A and B
- Medicare Advantage in Arizona (Part C)
- Medicare Part D: Prescription Drugs
- Medigap in Arizona
- Help Paying for Medicare in Arizona
- Medicare Enrollment Periods
- Free Medicare Help: Arizona SHIP
- Frequently Asked Questions
About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or Arizona SHIP at 1-800-432-4040.
Original Medicare: Parts A and B
Original Medicare is administered directly by the federal government and is identical in Arizona and every other state. It splits into two parts covering different care settings.
Part A (Hospital Insurance)
Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.
| Cost | Amount |
|---|---|
| Monthly premium | $0 for most people (40+ quarters of work history) |
| Hospital deductible | $1,736 per benefit period |
| Hospital coinsurance, days 61-90 | $434 per day |
| Lifetime reserve days | $868 per day |
| SNF coinsurance, days 21-100 | $217 per day |
The hospital deductible is per benefit period, not per calendar year. A benefit period begins when you're admitted and ends 60 days after discharge. Get readmitted after that gap and the deductible applies again.
Part B (Medical Insurance)
Part B covers doctor visits, outpatient services, preventive care, durable medical equipment, and mental health care. It does not cover routine dental, vision, or hearing.
- Monthly premium: $202.90 (higher under IRMAA if your 2024 income exceeded $109,000 single or $218,000 married)
- Annual deductible: $283
- After the deductible: 20% coinsurance on the Medicare-approved amount for most services
Declining Part B when you're first eligible carries a penalty of 10% added to your premium for each 12-month period you went without it, and you pay that surcharge for as long as you keep Part B. The exception is if you had creditable employer coverage during that time. See Medicare enrollment periods for the rules.
Medicare Advantage in Arizona (Part C)
Medicare Advantage plans are offered by private insurers and cover everything Parts A and B do (except hospice, which Original Medicare keeps covering), usually bundled with Part D drug coverage and extras like dental, vision, and hearing.
Arizona is a large Medicare Advantage market. The Phoenix metro area and the Sun City retirement corridor (the string of retirement communities west of Phoenix) offer among the widest plan selections in the state, with multiple competing insurers, $0-premium options, and robust supplemental benefits. Tucson generally sees solid competition as well. Rural counties in eastern and northern Arizona tend to have fewer plans and narrower networks, so beneficiaries in those areas should check carefully what is actually available at their address.
How These Plans Work
- You keep paying the Part B premium ($202.90) on top of any plan premium. The average Medicare Advantage premium for 2026 is about $14 a month nationally; many plans charge $0 extra.
- Plans run on networks (HMO or PPO). Confirm your current doctors and preferred hospitals are in-network before you enroll.
- Most plans require prior authorization for certain services or supplies. Original Medicare generally does not.
- Every plan caps your annual in-network out-of-pocket spending at a federally set limit of $9,250 in 2026; many plans set it lower. Original Medicare has no annual out-of-pocket cap.
You cannot hold a Medigap policy and a Medicare Advantage plan at the same time.
Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. An Arizona SHIP counselor can go through the results with you at no cost.
Medicare Part D: Prescription Drugs
Part D covers outpatient prescription drugs, available as a standalone plan paired with Original Medicare or built into a Medicare Advantage plan.
The Inflation Reduction Act eliminated the old coverage gap (the donut hole), so that middle phase is gone. Part D now moves through three phases:
- Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
- Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
- Catastrophic: once your out-of-pocket spending hits $2,100, you pay $0 for covered drugs the rest of the year.
The $2,100 cap (up from $2,000 in 2025) is the most significant change for high-cost drug users. The average standalone Part D premium for 2026 is about $46.50 a month, though plan premiums vary widely. Every Part D and Medicare Advantage drug plan must also offer the Medicare Prescription Payment Plan, which lets you spread out-of-pocket costs into capped monthly payments across the year rather than paying in full at the pharmacy. People who qualify for Extra Help often pay much less, sometimes nothing.
For a deeper look at plan choices and the redesign, see our guide on Medicare Part D drug coverage.
Medigap in Arizona
Medigap policies are sold by private insurers to cover the gaps Original Medicare leaves open: deductibles, coinsurance, and copays. They work only with Original Medicare, not with Medicare Advantage.
Arizona offers the full set of federally standardized plans, labeled A through N. They're regulated by the Arizona Department of Insurance. Arizona has no state-specific Medigap switching rule (no birthday rule or anniversary window like some other states), so the standard federal mechanics apply.
Plans C and F, which covered the Part B deductible, are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the popular option for newly eligible beneficiaries: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing facility coinsurance, leaving only the $283 Part B deductible unpaid.
The Federal Open Enrollment Period
Your best window to buy Medigap is the federal Medigap Open Enrollment Period: the six-month window that begins when you're 65 and enrolled in Part B. During it, an insurer must sell you any plan at the standard rate, with no health screening. Outside that window, Arizona insurers may use medical underwriting, which means they can review your health, charge more, or decline you. Arizona has no state law that creates a second guaranteed-issue window after the federal OEP closes.
Medigap or Medicare Advantage?
You can't hold both. Medigap keeps you on Original Medicare with no network restrictions and the ability to see any Medicare-accepting provider nationwide, at a higher monthly premium. Medicare Advantage trades some of that flexibility for a network structure and usually a lower upfront cost. For a side-by-side look, see our guide to Original Medicare vs. Medicare Advantage.
For more on Medigap plan mechanics, see our Medigap guide.
Help Paying for Medicare in Arizona
If you're on a limited income, two programs can cut your Medicare costs substantially.
Medicare Savings Programs (AHCCCS)
AHCCCS, the Arizona Health Care Cost Containment System, is Arizona's Medicaid agency and administers the state's Medicare Savings Programs under the standard federal QMB/SLMB/QI-1 labels. These programs pay some or all of your Medicare premiums and cost-sharing based on income and resources.
| Program | Individual monthly income | Couple monthly income | What it pays |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Up to about $1,350 | Up to about $1,824 | Part A and B premiums, deductibles, coinsurance |
| SLMB (Specified Low-Income Medicare Beneficiary) | Up to about $1,596 | Up to about $2,164 | Part B premium |
| QI-1 (Qualifying Individual) | Up to about $1,796 | Up to about $2,435 | Part B premium |
QMB is the most valuable: it covers your Part B premium plus all Medicare deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for any of that cost-sharing. For all three programs, the 2026 resource limit is $9,950 for one person and $14,910 for a couple. The income figures track the Federal Poverty Level and update each April.
Arizona residents apply online at healthearizonaplus.gov or through an AHCCCS office. Enrolling in any of these programs automatically qualifies you for Extra Help with Part D.
Extra Help for Part D
Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024 the partial-subsidy tier is gone, so everyone who qualifies now gets the full subsidy.
- Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
- Resource limits: $16,590 for an individual, $33,100 for a married couple
- QMB, SLMB, or QI-1 enrollment triggers automatic Extra Help qualification
Apply through Social Security at ssa.gov or call 1-800-772-1213.
Medicare Enrollment Periods
Missing a deadline can mean coverage gaps or a permanent penalty. These are federal dates and apply uniformly in Arizona as in every other state.
| Period | Dates | What you can do |
|---|---|---|
| Initial Enrollment | 7 months around your 65th birthday | Sign up for Parts A, B, and D; pick Medicare Advantage or Medigap |
| Annual Open Enrollment | Oct 15 - Dec 7 | Switch Medicare Advantage plans, move between MA and Original Medicare, change Part D |
| MA Open Enrollment | Jan 1 - Mar 31 | Switch MA plans or drop MA for Original Medicare (only if already in MA) |
| General Enrollment | Jan 1 - Mar 31 | Sign up for Part B if you missed your initial window |
| Medigap Open Enrollment | 6 months from age 65 + Part B | Buy any Medigap plan at the standard rate, no health screening |
Changes made during Annual Open Enrollment take effect the following January 1. If you're already receiving Social Security before 65, Parts A and B enroll automatically; if not, you sign up through Social Security.
See our full Medicare enrollment periods guide for timing details, late-penalty rules, and special enrollment windows.
Free Medicare Help: Arizona SHIP
You don't have to work through this alone, and you don't have to pay a broker. Arizona runs its State Health Insurance Assistance Program (SHIP) through the Arizona Department of Economic Security (DES). Counselors are trained to give free, unbiased help and are not selling insurance.
An Arizona SHIP counselor can help you:
- Understand what Parts A, B, C, and D each cover
- Compare Medicare Advantage and Part D plans side by side
- Evaluate whether Medigap makes more sense than Medicare Advantage for your situation
- Apply for AHCCCS Medicare Savings Programs and Extra Help
- Work through claims, coverage denials, and appeals
Call the statewide SHIP line at 1-800-432-4040 to reach Arizona DES Medicare Assistance and get connected to counseling or referrals to local help.
Frequently Asked Questions
Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the national average for standalone plans is about $46.50 a month), and many Medicare Advantage plans in the Phoenix metro charge no extra premium. Your total depends on which plan you choose and the care you use.
No. Arizona follows the standard federal rules: a six-month Open Enrollment Period when you turn 65 and enroll in Part B, during which any insurer must sell you any Medigap plan at the standard rate. Outside that window, medical underwriting applies. Arizona has no birthday rule or other state-created switching window.
AHCCCS, the Arizona Health Care Cost Containment System, administers the programs under the standard federal QMB/SLMB/QI-1 labels. Apply online at healthearizonaplus.gov. The 2026 resource limit is $9,950 for one person and $14,910 for a couple, and income limits update each April with the Federal Poverty Level.
Arizona SHIP is housed in the Arizona Department of Economic Security. Call 1-800-432-4040 for free, unbiased Medicare counseling. Counselors don't sell insurance and can help you compare plans, apply for savings programs, and sort out claims issues.
Plan availability depends heavily on your county. The Phoenix metro and Sun City corridor offer among the widest selections in the state, with multiple competing insurers and common $0-premium options. Rural areas in eastern and northern Arizona generally have fewer plans and narrower networks. Use the Medicare Plan Finder at medicare.gov to see exactly what is available at your address.
Learn More
- Medicare: The National Guide
- Original Medicare vs. Medicare Advantage
- How Medigap Works
- Medicare Part D Drug Coverage
- Medicare Enrollment Periods
Find personalized help comparing your Medicare plan options in Arizona at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.