Arizona is one of the most active Medicare Advantage states in the country. Roughly 52% of the state's 1.5 million Medicare-eligible residents chose a Medicare Advantage plan in 2026, driven by strong $0-premium competition in metro Phoenix and Tucson and a retiree population that is growing faster than the national average. The statewide average premium dropped to $4.82 per month in 2026, down from $7.23 in 2025, with 46 of Maricopa County's 52 plans charging $0.
The Arizona market concentrates heavily in the Phoenix metro (Maricopa County, 52 plans) and Tucson (Pima County, 50 plans). Rural counties tell a different story: Yavapai has 15 plans, Cochise has 9, and remote counties like Navajo have 6. Star Ratings also vary: urban plans average 3.3 to 3.5 stars in Maricopa, while Blue Cross Blue Shield of Arizona stands out statewide with a 4.5-star rating, the only non-SNP plan in Arizona at that level for 2026. For a full comparison of the MA vs Original Medicare tracks, see Medigap vs Medicare Advantage.
This guide covers the 2026 Arizona Medicare Advantage market: plan count, top carriers, how to compare HMO vs PPO options, what AHCCCS (Arizona's Medicaid program) means for dual-eligible residents, and the key enrollment dates. Annual Election Period is October 15 to December 7, 2026, with coverage starting January 1, 2027.
2026 Medicare Advantage Market Overview in Arizona
In 2026, Arizona has 133 Medicare Advantage plans available, with 796,500 beneficiaries enrolled (52% MA penetration). The average monthly premium is $5 and the statewide average Star Rating is 3.7.
Top Medicare Advantage carriers in Arizona (2026)| Carrier | Plans | Avg Star Rating | Avg Premium |
|---|
| UnitedHealthcare | 14 | 4.0 | $0/mo |
| Humana | 16 | 3.5 | $0/mo |
| Blue Cross Blue Shield of Arizona | 4 | 4.5 | $0/mo |
| Aetna | 8 | 3.8 | $3/mo |
| SCAN Health Plan | 2 | 4.5 | $0/mo |
| HealthSpring (Cigna) | 5 | 3.5 | $0/mo |
| Devoted Health | 11 | 3.3 | $0/mo |
| Wellcare (Centene) | 3 | 3.5 | $0/mo |
Source: CMS Medicare Plan Finder Q4 2025, KFF Medicare Advantage 2026 Spotlight, medicare.org county data, azblue.com press release Oct 2025
Plan Types in Arizona: HMO vs PPO vs SNP
Medicare Advantage plan-type breakdown in Arizona| Plan Type | Plans Available | Avg Premium | Best For |
|---|
| HMO | 35 | $1.50/mo | Lower premiums, willing to stay in network |
| PPO | 20 | $11/mo | Flexibility to see out-of-network providers |
| HMO-POS | 6 | $4/mo | HMO with limited out-of-network option; popular in metro Phoenix |
| Special Needs Plan (SNP) | 39 | $0/mo | Dual-eligible (AHCCCS + Medicare), chronic conditions, or institutional |
| PFFS / MSA | 33 | $0/mo | Remaining plan types including regional PPO and other structures |
HMO plans dominate Arizona, especially in Maricopa and Pima counties. SNPs are a large share of AZ plans (39 of 133) due to Arizona's substantial dual-eligible population covered by AHCCCS.
Source: CMS Medicare Plan Finder Q4 2025, medicare.org Arizona county data 2026
County-Level Variance in Arizona
Plan availability varies significantly by Arizona county. Phoenix metro and Tucson offer 50+ plans with $0 premiums widely available; rural and tribal counties may have only 6-15 plans and higher average premiums due to lower carrier competition.
Plan count and average premium by county in Arizona| County | Plans Available | Avg Premium |
|---|
| Maricopa County (Phoenix metro) | 52 | $5/mo |
| Pima County (Tucson) | 50 | $5/mo |
| Yavapai County (Prescott area) | 15 | $13/mo |
| Cochise County (Sierra Vista area) | 9 | $7/mo |
| Navajo County | 6 | $8/mo |
Plan counts and premiums are from CMS Medicare Plan Finder and medicare.org Q4 2025. Run a ZIP-code search at medicare.gov to see exact plans for your location.
Source: CMS Medicare Plan Finder Q4 2025, medicare.org county-level data, medicareadvantage.com county pages
What to Look For in a Medicare Advantage Plan in Arizona
Picking a Medicare Advantage plan in Arizona is not just about premium. Here's what matters most when shopping in 2026:
- Provider network. Confirm your primary care physician, specialists, and preferred hospital are all in-network. In Arizona, most MA plans are HMO models with closed networks, meaning out-of-network care (except emergencies) is not covered. This matters more in rural counties where network depth is thinner.
- Prescription drug coverage (formulary). Most Arizona MA plans include Part D. Check that your specific medications are on the plan's formulary at a tier you can afford. The 2026 Part D out-of-pocket cap is $2,100 across all plans, established by the Inflation Reduction Act.
- Star Ratings. CMS rates plans 1-5 stars annually on quality of care, member experience, and customer service. 4-star and 5-star plans receive bonus payments from CMS that fund richer benefits. In Arizona, Blue Cross Blue Shield of AZ and SCAN Health Plan both hold 4.5-star ratings for 2026.
- Extras (dental, vision, hearing, fitness, transportation). MA plans differ widely on supplemental benefits. Many $0-premium Arizona plans still include dental cleanings, annual eye exams, and gym memberships. Review the Evidence of Coverage to compare what each plan actually covers and any annual dollar limits.
- Maximum out-of-pocket (MOOP). MA plans cap your annual in-network out-of-pocket spending. The 2026 federal MOOP ceiling for in-network MA is $9,250 (down $100 from $9,350 in 2025). In Arizona, many plans set MOOP lower: Maricopa County PPO plans average around $5,874. Original Medicare has no MOOP.
- Prior authorization burden. Arizona MA plans, like plans nationwide, can require prior authorization for surgeries, advanced imaging, and specialist referrals. Check CMS-published prior authorization denial rates if you have a chronic condition or anticipate significant care needs.
Key Medicare Dates in Arizona
Medicare and Medicare Advantage have several enrollment windows. Missing them can mean waiting months for the next opportunity or facing late penalties.
- Annual Election Period (AEP): October 15 - December 7, 2026 — Switch between Original Medicare and MA, change MA plans, or change Part D plans. Coverage starts January 1, 2027.
- Medicare Advantage Open Enrollment Period (MA OEP): January 1 - March 31, 2026 — If you are already in an MA plan, you can switch to a different MA plan or return to Original Medicare. One switch only.
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday — Starts 3 months before your 65th birthday month, includes the birth month, and runs 3 months after. Enroll in Medicare Parts A and B first, then choose MA or Original Medicare plus Part D.
- Special Enrollment Periods (SEPs): Varies by qualifying event — Triggered by moving out of your plan's service area, losing employer coverage, qualifying for AHCCCS (dual eligible), or other life events. Typically a 2-3 month window.
Notable Extras in Arizona Plans
Arizona has several market features worth understanding before you shop:
- AHCCCS and dual-eligible D-SNPs: Arizona's Medicaid program is called AHCCCS (Arizona Health Care Cost Containment System). If you qualify for both AHCCCS and Medicare, you are dual-eligible and can enroll in a Dual Special Needs Plan (D-SNP). Arizona has 39 SNP plans in 2026, many of them D-SNPs, typically offering $0 premiums, $0 copays for most services, and integrated care coordination between Medicare and AHCCCS. Important: AHCCCS is the state Medicaid program; Medicare Advantage is a separate federal program. Do not confuse the two.
- Retiree hotspot competition: Arizona's retirement communities (Scottsdale, Sun City, Tucson, Prescott) drive intense carrier competition in Maricopa and Pima counties, pushing premiums down and supplemental benefits up. Sun City alone has one of the highest per-capita Medicare enrollment rates in the US. This benefits plan members with more plan choices and more $0 premium options than most states.
- Rural and tribal coverage gaps: In northeastern Arizona, particularly Navajo and Apache counties covering parts of the Navajo Nation, plan availability drops to 5-7 plans, Star Ratings average below 3.5, and premiums are higher relative to urban markets. Arizona beneficiaries in these areas should compare available plans carefully at medicare.gov and consider contacting the Arizona State Health Insurance Assistance Program (SHIP) at 800-432-4040 for free counseling.
Medicare Advantage vs Original Medicare in Arizona
Original Medicare (Parts A and B) plus a Medigap supplement and a standalone Part D drug plan gives you nationwide provider freedom and no prior authorization for most services. In Arizona, a Medigap plan plus Part D typically costs $180-$350 per month in combined premiums. Medicare Advantage bundles all of this into one plan, with an average premium of $4.82 per month statewide in 2026, but it comes with a defined provider network and prior authorization requirements.
If you winter in Arizona but spend summers in another state, or you travel frequently, Original Medicare plus Medigap works better because MA plans generally restrict non-emergency coverage to their service area. If you live in Arizona year-round and want to minimize monthly costs while gaining dental, vision, and hearing benefits, Medicare Advantage wins on total cost for most beneficiaries.
One practical note: if you leave a Medicare Advantage plan and return to Original Medicare, Medigap insurers in Arizona are not required to sell you a policy without medical underwriting unless you have a guaranteed issue right. Arizona does not have a state-level Medigap birthday rule (unlike California). Plan ahead before switching out of MA.
Medicare Advantage vs Original Medicare in Arizona detail| Factor | Medicare Advantage (AZ) | Original Medicare + Medigap |
|---|
| Avg monthly premium | $4.82 (many plans $0) | $180-$350 combined |
| Provider access | In-network only (HMO) or broader (PPO) | Any Medicare-accepting provider nationwide |
| Annual out-of-pocket cap | Yes, max $9,250 in-network (2026) | None (without Medigap) |
| Dental / vision / hearing | Often included | Not covered (buy separately) |
| Prior authorization | Often required | Rarely required |
| Travel / out-of-state use | Emergency only (HMO) | Nationwide any time |
Medigap premium estimate for Arizona based on 65-year-old non-smoker. Part B standard premium is $202.90/month in 2026.
Source: CMS 2026 Part B premium announcement, KFF Medicare Advantage 2026 Spotlight
How Star Ratings work and why they matter in Arizona
CMS publishes Medicare Advantage Star Ratings every October, rating plans 1 to 5 stars on roughly 40 quality measures: how well plans manage chronic conditions, customer service scores, member complaints, and Part D drug safety. Plans rated 4 stars or higher receive quality bonus payments from CMS, which plans often pass through as richer benefits the following year.
Arizona's statewide average Star Rating is approximately 3.7 for 2026, slightly below the national average of around 3.8. The best-rated plans in AZ are Blue Cross Blue Shield of Arizona (4.5 stars, the only non-SNP plan at that level) and SCAN Health Plan (4.5 stars). UnitedHealthcare plans in AZ average around 4.0 stars. Devoted Health, HealthSpring, and Wellcare average closer to 3.0-3.5 stars. No Arizona plan holds a 5-star rating for 2026.
A special enrollment note: plans with a 5-star CMS rating trigger a Special Enrollment Period, meaning you can switch into them any time of year. Since no AZ plan has 5 stars in 2026, this SEP does not apply statewide this year. Check medicare.gov each October when new ratings are released.
How to enroll in Medicare Advantage in Arizona
To enroll in a Medicare Advantage plan in Arizona, you must first be enrolled in both Medicare Part A (hospital) and Part B (medical). Always check whether your doctor is in-network before committing to a plan. Most people enroll in Parts A and B at age 65 during their Initial Enrollment Period. Once you have Part A and Part B, you can choose a Medicare Advantage plan during AEP (October 15 to December 7), the MA OEP (January 1 to March 31), or a qualifying Special Enrollment Period.
Ways to enroll in Arizona: online at medicare.gov/plan-compare, by calling the plan's member services directly, through a licensed Medicare insurance broker (brokers are compensated by carriers and cannot charge you a fee), or by calling 1-800-MEDICARE (1-800-633-4227). For free, unbiased counseling, contact the Arizona SHIP program at 800-432-4040. SHIP counselors are trained volunteers who do not sell plans.
When comparing plans in Arizona, always enter your exact ZIP code at medicare.gov. Plan availability varies by ZIP code within a county. Two neighbors in different ZIP codes can have meaningfully different plan options and premiums even within the same carrier.
Frequently Asked Questions
How many Medicare Advantage plans are available in Arizona in 2026?
Arizona has 133 Medicare Advantage plans available statewide in 2026, down from 149 in 2025. The exact number varies by county and ZIP code. Maricopa County (Phoenix) has 52 plans, Pima County (Tucson) has 50, Yavapai has 15, Cochise has 9, and Navajo County has 6. Run a ZIP-code search at medicare.gov to see exact options for your address.
What is the average Medicare Advantage premium in Arizona for 2026?
The statewide average Medicare Advantage premium in Arizona is $4.82 per month for 2026, down from $7.23 in 2025. The vast majority of Arizona plans charge $0 monthly premium: 46 of Maricopa County's 52 plans and 44 of Pima County's 50 plans are $0. PPO plans tend to run higher, averaging around $11-$26 per month for broader network access.
Who are the top Medicare Advantage carriers in Arizona for 2026?
The top carriers by enrollment in Arizona are UnitedHealthcare, Humana, Blue Cross Blue Shield of Arizona, and HealthSpring (Cigna). SCAN Health Plan and BCBS Arizona are the top-rated carriers by CMS Star Rating (both at 4.5 stars). Devoted Health has the second-largest plan count at 11 plans. No Arizona carrier holds a 5-star rating for 2026.
When can I sign up for Medicare Advantage in Arizona?
The main window is the Annual Election Period (AEP), October 15 to December 7, 2026, for coverage starting January 1, 2027. You can also enroll during your 7-month Initial Enrollment Period around your 65th birthday, or during a Special Enrollment Period triggered by a qualifying life event such as moving, losing employer coverage, or qualifying for AHCCCS. Existing MA enrollees can make one switch during the MA Open Enrollment Period, January 1 to March 31, 2026.
What is AHCCCS and how does it relate to Medicare Advantage in Arizona?
AHCCCS (Arizona Health Care Cost Containment System) is Arizona's Medicaid program. If you qualify for both AHCCCS and Medicare, you are dual-eligible. Dual-eligible Arizonans can enroll in a Dual Special Needs Plan (D-SNP), which coordinates both programs and typically offers $0 premiums, $0 copays, and very low prescription costs. Arizona has 39 SNP plans in 2026, many of them D-SNPs. Note: AHCCCS handles Medicaid; Medicare Advantage is a separate federal program. Eligibility and benefits are determined independently.
What is the maximum out-of-pocket on Arizona Medicare Advantage plans in 2026?
The federal MOOP ceiling for in-network Medicare Advantage spending in 2026 is $9,250 (down $100 from $9,350 in 2025). Arizona plans frequently set lower MOOP limits: Maricopa County PPO plans average around $5,874, and many HMO plans cap at $4,900 to $7,000. PPO plans have a separate, higher out-of-pocket limit for combined in-network and out-of-network spending. Always compare MOOP when shopping, especially if you expect significant medical expenses.
Does Medicare Advantage cover prescriptions in Arizona?
Most Arizona Medicare Advantage plans include Part D prescription drug coverage. These are called MA-PD plans. The 2026 Part D annual out-of-pocket maximum is $2,100, established by the Inflation Reduction Act. Insulin is capped at $35 per month. Always check the plan's specific formulary to confirm your medications are covered and at what cost tier, since formularies vary by carrier and plan.
Are dental, vision, and hearing included in Arizona Medicare Advantage plans?
Most Arizona Medicare Advantage plans include some supplemental dental, vision, and hearing benefits that Original Medicare does not cover. Coverage varies widely: some plans include basic dental cleanings and eye exams only, while others cover crowns, hearing aids, and prescription eyewear. Higher-Star-Rated plans (BCBS AZ, SCAN) tend to have more generous packages. Always check the Evidence of Coverage document for the annual dollar cap and what procedures are actually covered.
