Medicare 101 in Arizona: Parts A, B, C and D

Medicare is the federal health insurance program for people 65 and older, and for some younger people with a disability or permanent kidney failure. It comes in four parts. Part A covers hospital stays, Part B covers doctors and outpatient care, Part C (Medicare Advantage) is a private plan that delivers Parts A and B, and Part D covers prescriptions. Most Arizonans end up choosing between two paths: Original Medicare with a Medicare Supplement and a Part D plan, or a Medicare Advantage plan. This guide walks through each piece in plain English so the rest of your decisions make sense.

Part A: hospital insurance

Part A helps pay for inpatient care in a hospital, care in a skilled nursing facility after a qualifying hospital stay, hospice care, and some home health care. It does not pay for long-term custodial care, the kind of help with bathing, dressing and daily living that many families eventually need.

Most people pay no monthly premium for Part A because they or a spouse paid Medicare taxes for at least 10 years (40 quarters) while working. If you have fewer quarters, you can buy Part A. According to CMS, the 2026 Part A premium is $311 a month with 30 to 39 quarters and $565 a month with fewer than 30.

Premium-free does not mean cost-free. In 2026, Part A has a $1,736 deductible for each benefit period, then daily coinsurance for long stays (CMS, 2026). A benefit period starts when you are admitted and ends after you have been out of the hospital or skilled nursing facility for 60 days in a row, so you can pay the deductible more than once in a year.

Part B: medical insurance

Part B covers doctor visits, outpatient surgery, lab work, imaging, durable medical equipment like walkers and CPAP machines, outpatient therapy, many preventive services, and some home health care. If Part A is the hospital bed, Part B is almost everything else.

Nearly everyone pays a premium for Part B. The 2026 standard premium is $202.90 a month, and the annual deductible is $283 (CMS, 2026). After the deductible you usually pay 20 percent of the Medicare-approved amount, and Original Medicare has no yearly cap on that 20 percent. That open-ended 20 percent is the main reason people add a Medicare Supplement or choose a Medicare Advantage plan.

Higher earners pay more for Part B through the income-related adjustment known as IRMAA. In 2026 it starts above $109,000 of modified adjusted gross income for a single filer, or $218,000 for a married couple filing jointly, based on your 2024 tax return (CMS, 2026).

Part C: Medicare Advantage

Medicare Advantage plans are Medicare-approved plans run by private insurance companies. When you join one, the plan delivers your Part A and Part B benefits instead of Original Medicare, and most plans also include Part D drug coverage. Many add dental, vision, hearing or fitness benefits. You still pay your Part B premium.

Medicare Advantage plans use networks, copays and coinsurance, and every plan has a yearly maximum out-of-pocket for covered medical care. In the CY2027 CMS Landscape file there are 52 Medicare Advantage plans available in Maricopa County and 47 in Pinal County (not counting Special Needs Plans), with in-network out-of-pocket maximums ranging from $2,000 to $8,900 depending on the plan.

To join, you must have Parts A and B and live in the plan's service area. Plans change their benefits every January, which is why a yearly review matters.

Part D: prescription drug coverage

Part D is drug coverage sold by private companies. You can get it as a standalone prescription drug plan alongside Original Medicare, or built into a Medicare Advantage plan. Each plan has its own list of covered drugs (the formulary), its own pharmacy network and its own costs.

Since 2025 there is a yearly cap on what you pay out of pocket for covered Part D drugs. It is $2,100 in 2026. For 2027 CMS has set the cap at $2,400 and the maximum standard deductible at $700 (CMS CY2027 Rate Announcement). Once you reach the cap, you pay nothing more for covered drugs for the rest of that calendar year.

If you go without Part D or other creditable drug coverage for 63 days or more after your Initial Enrollment Period, a late enrollment penalty is added to your premium for as long as you have Part D.

The two ways to put the parts together

Everything in Medicare comes back to one choice. Here is how the two paths compare at a glance.

An example: one hospital stay on Original Medicare alone

Here is an illustration using 2026 CMS figures, not a quote. Say you are admitted to a hospital in Chandler for five days, then see a surgeon and have outpatient physical therapy afterward. On Original Medicare with no other coverage, you would pay the $1,736 Part A deductible for the stay, the $283 Part B deductible, and then 20 percent of every Medicare-approved Part B bill for the surgeon, the anesthesiologist, imaging and therapy.

If the stay ran past 60 days, you would pay $434 a day for days 61 to 90, and $868 a day for any lifetime reserve days after that. If you then needed a skilled nursing facility, days 21 to 100 cost $217 a day in 2026. None of that has an annual ceiling on Original Medicare alone.

This is exactly the exposure that a Medicare Supplement is designed to fill, and that a Medicare Advantage plan replaces with its own copays and an out-of-pocket maximum. Seeing the raw numbers first makes it much easier to judge what each option is really worth to you.

What Medicare does not cover

Knowing the gaps helps you decide what else you may need. Original Medicare generally does not cover:

• Long-term custodial care in a nursing home or at home.
• Most dental care, routine eye exams and eyeglasses, and hearing aids.
• Care outside the United States, apart from a few narrow exceptions.
• Prescription drugs you take at home, unless you add Part D.
• A cap on the 20 percent Part B coinsurance, unless you add other coverage.

Your first steps in the East Valley

If you are approaching 65 in Chandler, Gilbert, Mesa or anywhere in Maricopa or Pinal County, start by confirming when your Initial Enrollment Period opens, whether you have employer coverage that changes the timing, and which doctors and prescriptions you want to keep. Those three facts decide most of the rest.

Viola Lucero and the Rise Up Benefits team hold Medicare workshops online and in Chandler (see our Seminars page), and the official Medicare and You handbook and enrollment forms are collected on our Resources page. Our line is simple: we speak insurance, so you don't have to.

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The bottom line

Medicare is four parts and one big decision. Learn what A, B, C and D each do, then decide whether you want Original Medicare with a supplement and drug plan, or a Medicare Advantage plan, based on your doctors, your prescriptions, how you travel and how much cost uncertainty you are comfortable with. If you would like someone to walk through it with you, call us or book a time on our contact page.