Call or text Greg: 623-523-1557 Email: [email protected]
Greg Slaughter, Loving Phoenix Team Real Broker West Valley 55+ Communities
Menu
Home › Medicare guide
Medicare guide · West Valley 55+ · Updated October 2026

Medicare guide for West Valley retirees

Original Medicare vs. Medicare Advantage, Medigap and Part D in plain English, the dates for Open Enrollment (October 15 to December 7, 2026), and where to get free, unbiased help close to home.

See 55+ homes for sale Get free Medicare help

Key dates for 2027 coverage

Open Enrollment runs October 15 to December 7, 2026. You can join, switch or drop a Medicare Advantage Plan or a Medicare drug plan, or switch between Medicare Advantage and Original Medicare. Changes start January 1, 2027, and the plan must get your request by December 7 (Medicare.gov).

If you're happy with your coverage, you don't have to do anything. But plans can change their costs, covered drugs and doctor networks every year, so it pays to check.

DateWhat happens
By September 30, 2026Medicare Advantage plans send their “Annual Notice of Change,” listing changes to costs, coverage, networks and service area for 2027 (Medicare & You 2027). If you didn't get yours, call your plan.
October 15 to December 7, 2026Open Enrollment for 2027 coverage.
January 1, 2027Any changes you made take effect.
January 1 to March 31, 2027Only if you're in a Medicare Advantage Plan: you can switch to another Medicare Advantage Plan, or go back to Original Medicare and join a separate drug plan (Medicare & You 2027).

Turning 65? Your Initial Enrollment Period lasts 7 months: it starts 3 months before the month you turn 65 and ends 3 months after it (Medicare.gov).

The parts of Medicare in plain English

Part A: hospital

Helps cover inpatient hospital care, skilled nursing facility care, hospice and home health care. Most people pay no Part A premium (Medicare.gov).

Part B: medical

Helps cover doctors, outpatient care, home health care, medical equipment such as walkers and wheelchairs, and many preventive services (Medicare.gov).

Part D: prescription drugs

Sold by private companies that follow Medicare's rules. You add it to Original Medicare, or get it inside most Medicare Advantage plans (Medicare.gov).

Medigap: supplement

Extra insurance from a private company that helps pay your share of costs in Original Medicare, like the 20% coinsurance (Medicare.gov).

Medicare Advantage (Part C)

A Medicare-approved private plan that replaces Original Medicare for your health coverage. It bundles Parts A and B, and usually Part D (Medicare.gov).

2026 Original Medicare costs, from Medicare.gov

  • Part B premium: $202.90 a month in 2026 for most people (higher at higher incomes).
  • Part B deductible: $283 a year in 2026. After that, you usually pay 20% of the Medicare-approved amount.
  • Part A hospital deductible: $1,736 for each benefit period in 2026.

The 2027 amounts hadn't been published when we checked in October 2026. The Medicare & You 2027 handbook says to check Medicare.gov for them.

Original Medicare vs. Medicare Advantage

These are the two main ways to get your Medicare. Neither is right for everyone. It depends on your doctors, your prescriptions, your budget and how much you travel. This side-by-side comes from Medicare.gov.

Original Medicare (Parts A and B)

  • Doctors and hospitals: Any doctor or hospital that takes Medicare, anywhere in the U.S.
  • Specialists: In most cases, no referral needed.
  • What you pay: Usually 20% of the Medicare-approved amount for Part B services after the deductible, plus the Part B premium and a separate Part D premium if you add drug coverage.
  • Yearly out-of-pocket limit: None, unless you have supplemental coverage such as Medigap.
  • Medigap: You can buy a Medigap policy to help pay your share.
  • Prior approval: In most cases, not needed.
  • Extras: Doesn't cover routine physicals, eye exams or most dental care.
  • Travel outside the U.S.: Generally not covered. Some Medigap policies cover emergency care abroad.

Medicare Advantage (Part C)

  • Doctors and hospitals: You may need to use doctors and other providers in the plan's network and service area (for non-emergency care). Some plans cover out-of-network care at a higher cost.
  • Specialists: You may need a referral.
  • What you pay: The Part B premium, and possibly a plan premium. Out-of-pocket costs vary by plan. Most plans include drug coverage.
  • Yearly out-of-pocket limit: Yes. Every plan has a yearly limit on covered services.
  • Medigap: You can't buy Medigap to cover a Medicare Advantage plan's costs.
  • Prior approval: You may need approval (prior authorization) for some services.
  • Extras: Must cover everything Original Medicare does. Many plans add some vision, hearing and dental.
  • Travel outside the U.S.: Generally not covered. Some plans offer emergency coverage abroad as an extra.

Arizona DES lists five types of Medicare Advantage plans offered in Arizona (HMO, PPO, Private Fee-for-Service, Medical Savings Account and Special Needs Plans) and notes that not every type is available in every county.

Medigap (Medicare Supplement Insurance)

  • It only works with Original Medicare. You generally need both Part A and Part B to buy a policy (Medicare.gov).
  • Plans are standardized by letter, such as Plan G or Plan K. A Plan G has the same benefits from every company, so price is the only difference between policies with the same letter (Medicare.gov).
  • Timing matters. Your one-time Medigap Open Enrollment Period lasts 6 months, starting the first month you have Part B and are 65 or older. During it, companies can't turn you down or charge more for health problems. After it, they may (Medicare.gov).
  • It doesn't cover prescriptions. Medigap generally doesn't cover drugs, long-term care, dental, vision or hearing aids, so most people pair it with a Part D plan (Medicare.gov).
  • Fall Open Enrollment isn't a Medigap window. Medigap's 6-month window doesn't repeat every year (Medicare.gov).

Part D prescription drug coverage

  • Each plan has its own drug list (called a formulary), sorted into price tiers. Enter every drug you take in the Medicare Plan Finder to compare total costs (Medicare.gov).
  • Out-of-pocket cap: your Part D drug costs are capped at $2,100 in 2026 and $2,400 in 2027. In 2027, a plan's drug deductible can be no more than $700 (Medicare & You 2027; CMS).
  • Avoid the late penalty. If you go 63 days or more without Part D or other creditable drug coverage after you first get Medicare, you may pay a penalty for as long as you have Part D (Medicare.gov).
  • Help with costs: people with limited income may qualify for Extra Help with drug costs, or a Medicare Savings Program for Part B premiums. Free SHIP counselors can screen you (Area Agency on Aging, Region One).

Free, unbiased Medicare help in the West Valley

Insurance agents and brokers can be helpful, but they're paid by insurance companies. These counselors aren't selling anything.

SHIP counseling (Maricopa County)

Arizona's State Health Insurance Assistance Program gives free one-on-one Medicare counseling and isn't affiliated with the insurance industry (Arizona DES). In Maricopa County it's run by the Area Agency on Aging, Region One: 602-280-1059. Statewide SHIP helpline: 1-800-432-4040.

Benefits Assistance Program

Certified Medicare counselors and volunteers at the Area Agency on Aging, Region One explain Original Medicare, Medicare Advantage, Medigap and drug plans, help with appeals, and screen you for low-income savings programs. Start with the 24-Hour Senior HELP LINE: 602-264-HELP (4357), toll-free 888-783-7500.

Senior Medicare Patrol (SMP)

Helps you spot and report Medicare fraud, errors and scams, such as charges for things you never got. Arizona SMP helpline: 1-800-432-4040 (Arizona DES). Medicare won't call or visit you to ask for your Medicare number.

Medicare itself

Call 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048), or compare plans yourself at Medicare.gov/plan-compare.

How to check that your hospital and doctors are in network

This matters most with Medicare Advantage, where you may need to use the plan's network. Medicare says plans can add or remove doctors and hospitals at any time during the year, and doctors can leave a network too.

  1. Make a list of your doctors, specialists, the hospital you'd want, and your pharmacy. To see which hospitals and 24/7 ERs are closest to each 55+ community, see our hospitals & healthcare guide.
  2. Search the plan's provider directory on its website, or call the plan and ask. Then use the Medicare Plan Finder to compare plans in your ZIP code.
  3. Call each doctor's office and ask, “Are you in this exact plan's network for 2027?” Plan names can be very similar.
  4. Ask about hospitals. In some Medicare Advantage plans, choosing a primary care doctor also picks the hospitals and specialists you can use (Medicare.gov).
  5. On Original Medicare? Ask whether your doctors “accept assignment.” Most do, and it keeps your costs lowest (Medicare.gov).
  6. Read your Annual Notice of Change every fall, and check again before each Open Enrollment.

If you think a network change will interrupt your care and put your health at risk, Medicare says to call 1-800-MEDICARE.

Moving to Arizona from another state

  • Original Medicare moves with you. You can use any doctor or hospital in the U.S. that takes Medicare (Medicare.gov).
  • Medicare Advantage and Part D plans are tied to a service area. When you move out of yours, you get a Special Enrollment Period to switch. It starts the month you move and lasts 2 full months after. If you tell your plan before you move, it starts the month before (Medicare.gov).
  • Don't miss that window. If you move out of your Medicare Advantage plan's area and don't pick a new plan, you'll be put in Original Medicare when your old plan drops you (Medicare.gov). That can leave you without drug coverage, so plan ahead.
  • Medigap usually comes with you. In general, you can keep your Medigap policy wherever you live as long as you have Original Medicare. Switching to a different policy may mean answering health questions (Choosing a Medigap Policy, Medicare.gov).
  • Update your address with Social Security at SSA.gov so your Medicare mail follows you (Medicare & You 2027).
  • Snowbirds: if you split the year between Arizona and another state, ask any Medicare Advantage plan how it covers non-emergency care in your other state before you enroll. A SHIP counselor can walk you through it.

Buying in the West Valley? Greg can help you time your move. See Moving to Arizona at 55+ and the snowbird & seasonal living guide.

Your Open Enrollment checklist

  • Read your plan's Annual Notice of Change and note any changes for 2027.
  • List every prescription, with dose, and compare total yearly drug costs in the Medicare Plan Finder.
  • Confirm your doctors, hospital and pharmacy are in network for 2027.
  • Compare the full cost: premiums, deductibles, copays and the yearly out-of-pocket limit.
  • Book a free SHIP appointment early. October and November are busy.
  • Never give your Medicare number to someone who calls you out of the blue. Report it to the SMP helpline.
  • Make your choice by December 7, 2026.

Frequently asked questions

When is Medicare Open Enrollment for 2027 coverage?

October 15 to December 7, 2026. Changes take effect January 1, 2027, and the plan must get your request by December 7 (Medicare.gov).

Where can I get free, unbiased Medicare help in the West Valley?

Call Arizona's SHIP program. In Maricopa County it's the Area Agency on Aging, Region One, at 602-280-1059, and the statewide SHIP helpline is 1-800-432-4040 (Arizona DES). SHIP counselors aren't affiliated with any insurance company.

Can I have both Medigap and Medicare Advantage?

No. Medigap only works with Original Medicare. You can't buy Medigap to cover a Medicare Advantage plan's out-of-pocket costs (Medicare.gov).

I'm moving to Arizona. What happens to my Medicare?

Original Medicare works anywhere in the U.S. If you have a Medicare Advantage or Part D plan, moving out of its service area gives you a Special Enrollment Period to switch, lasting 2 full months after the month you move. Medigap policies can generally be kept as long as you have Original Medicare (Medicare.gov).

What is the Part D out-of-pocket cap in 2027?

$2,400, up from $2,100 in 2026. Once you reach it, you pay $0 for covered Part D drugs for the rest of the year (Medicare & You 2027).

How do I check if my doctor is in a Medicare Advantage plan's network?

Search the plan's provider directory or call the plan, use the Medicare Plan Finder, and call your doctor's office to confirm they're in that exact plan for 2027. Networks can change during the year (Medicare.gov).

Can I join Medicare Advantage between January and March?

Only if you're already in a Medicare Advantage Plan. From January 1 to March 31, 2027, you can switch to another Medicare Advantage Plan or go back to Original Medicare. You can't use that window to move from Original Medicare into Medicare Advantage (Medicare & You 2027).

Related guides

Planning a move to a West Valley 55+ community?

Greg can show you homes near the hospitals and doctors you want to keep, and walk you through each community's fees and rules. No pressure.

See homes for sale Get a Free Home Value Contact Greg Free Buyer's Guide (PDF)

Prefer the phone? Call or text 623-523-1557

Get answers from Greg

Tell Greg what you're looking for. He'll reply personally, usually the same day. No pressure, and no spam.

Prefer to call? Call or text 623-523-1557 · Email Greg · See 55+ homes for sale

Sources (checked October 2026)

Every fact on this page comes from Medicare.gov, CMS, Arizona DES or the Area Agency on Aging, Region One, checked October 6–8, 2026. We don't recommend plans or agents, and plan premiums aren't listed because they vary by plan and ZIP code. Programs, phone numbers, hours and dollar amounts change, so confirm with the agency or company before you rely on them. This page is general information, not legal, tax, insurance or medical advice.

  1. Medicare.gov: Open Enrollment (Oct 15 – Dec 7)
  2. Medicare.gov: Medicare & You 2027 handbook (key dates, Annual Notice of Change, 2027 Part D cap)
  3. Medicare.gov: Parts of Medicare
  4. Medicare.gov: Your coverage options
  5. Medicare.gov: Compare Original Medicare & Medicare Advantage
  6. Medicare.gov: Joining a plan (enrollment periods)
  7. Medicare.gov: Special Enrollment Periods (moving)
  8. Medicare.gov: Medicare costs (2026 amounts)
  9. Medicare.gov: What's Medicare Supplement Insurance (Medigap)?
  10. Medicare.gov: Medigap – Get ready to buy (Medigap Open Enrollment Period)
  11. Medicare.gov: Choosing a Medigap Policy (moving out of state)
  12. Medicare.gov: What's Medicare drug coverage (Part D)?
  13. Medicare.gov: Understanding your Medicare Advantage Plan's provider network (fact sheet)
  14. Medicare.gov: Does your provider accept Medicare as full payment?
  15. Medicare.gov: Medicare Savings Programs
  16. CMS: CY 2027 Medicare Advantage and Part D Rate Announcement (April 6, 2026)
  17. Arizona DES: Medicare Assistance (SHIP, SMP and local offices)
  18. Area Agency on Aging, Region One: Benefits Assistance Program
  19. Area Agency on Aging, Region One: 24-Hour Senior HELP LINE

Greg Slaughter, AZ License #SA665093000, Loving Phoenix Team, brokered by Real Broker AZ, LLC (AZ License #LC696641000). Equal Housing Opportunity.