Medicare Advantage Plans in Arizona: What to Check Before You Switch

Medicare's open enrollment runs from October 15 to December 7 every year. Whatever you change in that window starts on January 1. The date that matters is when your plan receives the request, not the day you post it, so a decision made on December 6 is cutting it fine.

Inside that window you can do three things. You can join, drop or switch a Medicare Advantage plan. You can join, drop or switch a Medicare drug plan if you are on Original Medicare. And you can move in either direction between Original Medicare and Medicare Advantage.

You can also do nothing, and for a lot of people that is the right answer. But doing nothing is only safe if you have read what your current plan is changing.

Every Medicare Advantage and Part D plan has to get an Annual Notice of Change into your hands by September 30. It is the only document that tells you what your own plan is doing next year: the costs, the drug list, the service area, and — the part people skip — the provider network.

That last one is why staying put is not automatically the safe option. Your plan can keep its name, its card and its premium, and still drop providers on January 1. If the notice never arrived, call your plan and ask for it.

Medicare's own guidance is to check twice, not once. Ask the plan whether the providers you use are in its network — and then ask the provider directly when you book. Plan directories go out of date, and the provider is the one who knows what was signed.

Mountain View Pain Center is in network with most Medicare Advantage plans. Call us and we will confirm yours specifically — before you enroll, not after. That is a five-minute call and it is the single most useful thing you can do in this window if you are already a patient here or planning to be.

Four questions Medicare suggests asking the plan, which are worth writing down before you ring:

How do I find out if my providers are in the network? What do I pay for services in network? What do I pay out of network? And what happens if I need covered treatment that no in-network provider offers?

One more, specific to pain care: does this plan require a referral to see a specialist, and does it require prior authorization for injections or for a course of therapy? Plans built on an HMO structure usually require a referral. Plans built on a PPO structure usually do not, and will cover care outside the network at a higher cost to you. Medicare deliberately says "may" about all of this, because these rules are set plan by plan rather than by the label on the front of the card.

Two rules are worth knowing before you move.

A network can change under you at any time. Medicare states it plainly: a Medicare Advantage plan can add or remove providers from its network at any point during the year. Plans are told they should make a good faith effort to give you 30 days' notice, and should tell you if a provider you see regularly is leaving — but that is an expectation, not a guarantee, and a provider leaving does not by itself let you switch plans. If it happens to you, call 1-800-MEDICARE; there is a route for it, but it is decided case by case.

Switching plans does not restart your approvals from zero. If you are in the middle of a course of treatment when you change plans, Medicare requires the new plan to give you at least 90 days before it can make you get a fresh prior authorization. And an approval you already have has to stay valid for as long as the treatment is medically necessary.

If you are mid-course with us and thinking about changing plans, tell us before you do it rather than afterwards. We would rather sort the authorizations out in October than in January.

A Medicare Advantage plan has to cover everything Original Medicare covers. It can add more, and it can put a network, a referral or a prior authorization in front of it. So the Original Medicare rules below are the floor, not the ceiling — but they are the floor everywhere.

Pain Management. Part B covers medically necessary physician services, including outpatient procedures. There is no single national rule for individual injections: the criteria are set regionally by the Medicare contractor for the area, and they differ between states. We check yours before we schedule anything.

Physical Therapy. There is no dollar limit on medically necessary outpatient therapy in a calendar year. What exists instead is a documentation threshold — in 2026, $2,480 of combined physical and speech therapy — above which the claim has to carry an attestation that the care is still necessary. That is a paperwork step, not a cut-off. You pay 20% after the Part B deductible, which is $283 in 2026.

Chiropractic. This is the one that catches people, so here it is exactly. Original Medicare covers one Chiropractic service: manual manipulation of the spine to correct a subluxation. It does not cover anything else a chiropractor provides or orders — X-rays, massage, Acupuncture, examinations, therapies. It also stops covering treatment once your condition is stable and further adjustments are maintaining you rather than correcting something. Many Medicare Advantage plans add to that. Ask what yours includes.

Acupuncture. Original Medicare covers Acupuncture for chronic low back pain only — pain that has lasted 12 weeks or more, with no identifiable systemic cause, not related to surgery and not related to pregnancy. The allowance is up to 12 visits in 90 days, with 8 more if you are improving, and no more than 20 in a year. If it is not helping, Medicare requires it to stop. Again, some plans add cover beyond that.

All four run under one roof and on one chart here, which matters more than it sounds: when the Chiropractic benefit runs out of road, a Pain Management physician can order imaging or direct a plan that Medicare does cover, without you starting again somewhere new.

There is a second window from January 1 to March 31, and it is not a second chance at the first one. It is open only to people who are already in a Medicare Advantage plan on January 1, it allows one change, and it lets you move to a different Medicare Advantage plan or back to Original Medicare with a drug plan.

What it does not let you do is move from Original Medicare into Medicare Advantage, or shop for a standalone drug plan from Original Medicare. Those are October-to-December decisions only. A change made in this window starts on the first day of the following month.

Pain Management, Physical Therapy, Chiropractic and Acupuncture under one roof, on one chart, with no referral needed to be seen. Same-week appointments are usually available.

Phoenix metro. Deer Valley, Phoenix · Northwest Phoenix · Peoria · Westgate, Glendale · Chandler · Mesa

Injections and interventional procedures are performed on site at Westgate and Mesa, both of which have fluoroscopy. See the full Arizona list, check insurance and billing, or send an appointment request.

Here for the winter and enrolled in a plan from another state? That is a different question with a different answer, and it has its own page: pain care for Arizona winter visitors.

If you also spend part of the year in Colorado, our Colorado clinics run the same four services on the same chart.

When is Medicare open enrollment?
October 15 to December 7 each year. Changes take effect on January 1, and your plan has to have received the request by December 7.

Is Mountain View Pain Center in network with Medicare Advantage plans?
We are in network with most Medicare Advantage plans. Networks differ plan by plan and change from year to year, so call us and we will confirm yours before you enroll.

Can my plan drop my doctor in the middle of the year?
Yes. Medicare states that a Medicare Advantage plan can add or remove providers from its network at any time during the year. Plans should make a good faith effort to give 30 days' notice. A provider leaving does not automatically let you change plans — call 1-800-MEDICARE, because that is decided case by case.

Does Medicare cover Chiropractic care?
Original Medicare covers manual manipulation of the spine to correct a subluxation, and nothing else a chiropractor provides or orders. Many Medicare Advantage plans cover more. Ask what yours includes.

Does Medicare cover Acupuncture?
Original Medicare covers Acupuncture for chronic low back pain only — up to 12 visits in 90 days, 8 more if you are improving, and no more than 20 in a year.

Do I need a referral?
Not to be seen here. Whether your plan requires one before it will pay is a different question, and it depends on the plan — HMO-style plans usually do, PPO-style plans usually do not.

I am changing plans mid-treatment. Do I lose my approvals?
Not immediately. A new plan has to give you at least 90 days before it can require a fresh prior authorization for a course of treatment already under way. Tell us before you switch and we will handle the paperwork side.

Everything on this page describes how the Medicare program works in general. It is not advice about which plan to choose, and we do not recommend plans. For your own situation, the authoritative sources are your plan's own documents, medicare.gov and 1-800-MEDICARE (1-800-633-4227). Figures quoted are for 2026.