Medicare in Arizona: Plans and Coverage (2026)

Medicare in Arizona runs on federal rules, but the state layers on free SHIP counseling and AHCCCS savings programs, and your Medicare Advantage choices are set county by county. 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.1,2

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 are the CMS figures for calendar year 2026, effective January 1 and in force through December 31, 2026.3 Medicare costs change every year, so for a later year check the CMS fact sheet or medicare.gov. To talk to a person about your own coverage, call 1-800-MEDICARE (1-800-633-4227), staffed 24 hours a day, 7 days a week except some federal holidays; TTY users call 1-877-486-2048.7 Arizona SHIP counselors take calls at 1-800-432-4040.1

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.3

The hospital deductible is per benefit period, not per calendar year. A benefit period begins when you're admitted and ends once you've gone 60 days in a row without inpatient hospital care or skilled care in a SNF. 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.3,8

• 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 services3

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.9 The exception is if you qualify for a Special Enrollment Period or a Medicare Savings Program.9 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.10

Which plans you can actually join is decided county by county, and that varies widely across Arizona. Densely populated areas (the Phoenix metro, the Sun City retirement corridor west of Phoenix, and Tucson) generally draw more competing insurers than the rural counties in the eastern and northern parts of the state, where plan choices and provider networks tend to be narrower. Treat that only as a starting expectation. The authoritative answer is whatever comes back for your own ZIP code.

How These Plans Work

• You keep paying the Part B premium ($202.90) on top of any plan premium, though CMS says some plans may help pay all or part of it. The average Medicare Advantage premium for 2026 is about $14 a month nationally; many plans charge $0 extra.10,3
• Plans run on networks (HMO or PPO). Confirm your current doctors and preferred hospitals are in-network before you enroll. Emergency care, out-of-area urgent care, and temporary out-of-area dialysis are covered whether you get them in or out of the plan's network.10
• Plans may require prior authorization (plan approval) before covering certain services or supplies. Original Medicare generally does not.10
• 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. CMS puts it this way: there is no yearly limit on what you pay out of pocket unless you have supplemental coverage like Medigap, Medicaid, employer, retiree, or union coverage. With none of those, your exposure is open-ended.10

You cannot hold a Medigap policy and a Medicare Advantage plan at the same time, but that isn't a permanent lock-out. If this is your first Medicare Advantage plan and you aren't happy with it, federal law gives you a trial right to buy a Medigap policy and a separate drug plan as long as you return to Original Medicare within 12 months of joining; if you dropped a Medigap policy to join, you may be able to get that same policy back if the company still sells it, or another policy sold by an Arizona insurer if it doesn't. Wait past that window and in most cases you can't get the old policy back, and you may not be able to get any Medigap policy.10

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.4 Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).11
2. Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
3. Catastrophic: once your out-of-pocket spending hits $2,100, you pay $0 for covered drugs the rest of the year.4

The $2,100 cap (up from $2,000 in 2025) is the most significant change for high-cost drug users. Standalone Part D premiums vary widely by plan; the 2026 projected average runs roughly $34.50 a month.3 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.4 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 with Original Medicare, and a Medigap policy can't pay a Medicare Advantage plan's copays, coinsurance, deductibles, or premiums.10

Arizona is not one of the three states (Massachusetts, Minnesota, and Wisconsin) that standardize Medigap their own way,12 so the plans sold here are the federal lettered set: A-D, F, G, and K-N.13 Benefit packages are uniform across carriers within each plan letter, so a Plan G is a Plan G whichever Arizona insurer sells it; what differs is the premium. A number of states have added an annual "birthday rule" or anniversary switching window on top of the federal rules, and Arizona is not among the states confirmed to have one, so plan around the federal window below and ask an Arizona SHIP counselor before assuming you have a second chance to switch.6

Plans C and F, which covered the Part B deductible, are closed to anyone new to Medicare on or after January 1, 2020, meaning anyone who turned 65 on or after that date and anyone who first became eligible through age, disability, or ESRD on or after it. If you already hold one, you don't have to switch, and if you were eligible for Medicare before January 1, 2020 but haven't enrolled yet, you may still be able to buy Plan C or Plan F.12,13 Plan G covers the same benefits as Plan F except that annual Part B deductible: it pays the Part A deductible, the Part A coinsurance and hospital costs for up to an additional 365 days, the Part B coinsurance, Part B excess charges, the first three pints of blood, the Part A hospice coinsurance, and skilled nursing facility coinsurance, and it covers foreign travel emergency care at 80% up to plan limits.5 The $283 Part B deductible stays yours to pay.3

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 can't refuse to sell you any Medigap policy it offers, can't use medical underwriting to accept or deny your application because of pre-existing health problems, and can't charge you more because you have health problems.5

One limit applies even inside that window: an insurer may still refuse to cover your out-of-pocket costs for a pre-existing condition for up to six months. That waiting period can't be imposed if you had at least six months of continuous prior creditable coverage before the policy started.5 Outside the Open Enrollment Period, insurers may use medical underwriting, which means they can review your health, charge more, or decline you. No second Arizona-specific protected window has been confirmed, so treat those six months as your one guaranteed shot.

Medigap or Medicare Advantage?

While you're in a Medicare Advantage plan it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. 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.10

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.2 These programs pay some or all of your Medicare premiums and cost-sharing, and because Arizona applies no resource test to them, the financial test is income alone.

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.2 Arizona applies no asset or resource test to these programs. On the AHCCCS eligibility chart the resource limit for QMB, SLMB, and QI-1 is shown as "N/A," so only your income counts toward eligibility.2 AHCCCS measures monthly household income after deductions, and its own eligibility chart prints each figure $20 lower, $1,330 for QMB against the $1,350 above: that gap is the federal $20 income disregard, not a stricter Arizona rule. The figures above come from the AHCCCS eligibility chart revised effective February 2026 and Social Security's tables effective February 26, 2026, so confirm the current ones with AHCCCS. They are the federal standard rather than a hard cutoff to screen yourself against, so apply if you are anywhere close. QI-1 also has to be reapplied for every year; being approved one year does not carry you into the next.2

Arizona residents apply online at healthearizonaplus.gov or through an AHCCCS office. Enrolling in QMB, SLMB, or QI-1 automatically qualifies you for Extra Help with Part D.2

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.14 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, the figures for the 48 contiguous states and DC (Alaska and Hawaii are higher)14
• Resource limits: $16,590 for an individual, $33,100 for a married couple, or $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses14
• QMB, SLMB, or QI-1 enrollment triggers automatic Extra Help qualification2
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately2,14

Apply through Social Security at ssa.gov.14 Extra Help isn't available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, where residents apply through their local Medicaid office instead.14 Social Security's national line is 1-800-772-1213 (TTY 1-800-325-0778).15

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.16

Changes made during Annual Open Enrollment take effect the following January 1. If you start receiving Social Security or Railroad Retirement Board benefits at least four months before you turn 65, Parts A and B enroll automatically and a welcome package with your Medicare card arrives about three months before coverage starts; claim benefits later than that, and you have to sign up through Social Security yourself.16 If you missed your Initial Enrollment Period, you can sign up during the General Enrollment Period (January 1 to March 31); certain life events, such as losing group health coverage based on your own or a spouse's current employment, open a Special Enrollment Period outside the regular windows. COBRA and retiree coverage are not coverage based on current employment and do not open one. That window runs eight months, counted from the month the job or the coverage ends, whichever comes first, and if you're self-employed or your plan isn't available to everyone at the company, ask your insurer whether it counts as employer group health plan coverage before you delay Part B; if it doesn't, sign up at 65.17

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 Division of Aging and Adult Services at the Arizona Department of Economic Security (DES). SHIP is a free health benefits counseling service for Medicare beneficiaries, their families, and caregivers; its counselors are trained to offer unbiased advice and to help with plan comparisons, and the program is federally funded by the Administration for Community Living and is not affiliated with the insurance industry.1

Nationally, SHIP teams help people:

• Get coverage through Original Medicare (Parts A and B), Medicare Advantage (Part C), Part D drug coverage, and Medigap
• Compare Medicare Advantage and Part D plans side by side
• Apply, when income is limited, for programs such as Medicaid, the Medicare Savings Program, and Extra Help1

DES lists a confidential SHIP assistance helpline for Arizona: call 1-800-432-4040.1

Learn More

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.