Great Medicare comes naturally in the Natural State.
There are so many reasons to retire in Arkansas: mild winters, big-city attractions, and small-town charm (not to mention low taxes and a low cost of living). Whether you’re an Arkansas native or planning a move there, getting into the right Medicare program should be top of mind for any Arkansas resident who’s eligible.
Luckily, in Arkansas, you’ll have tons of options for Medicare. This article will help you understand and sort through your options so you can get the best out of your Medicare benefits. Let’s get started.
Ready for a Medicare plan that works for you? Use the Insurify Medicare comparison tool to find Medicare plans near you. Start with your ZIP code, and you’ll be comparing plans in less than two minutes. Try with just your ZIP!
And because we know your health plan choices can be overwhelming, we provide licensed insurance agents available to offer objective assistance, free of charge. Give us a call toll-free at 1-844-965-1378 (TTY 711) Monday-Friday 8am – 8pm ET.
In this article
- How Much Does Medicare Cost in Arkansas?
- What Is Medicare?
- Who Qualifies for Medicare in Arkansas?
- How Do I Choose Between Original Medicare and Medicare Advantage?
- How Do I Apply for Original Medicare in Arkansas?
- How Do I Apply for Medicare Advantage in Arkansas?
- What’s the Best Medicare Advantage Plan in Arkansas?
- Conclusion: Compare Arkansas Medicare Plans Before You Buy
How much does Medicare cost in Arkansas?
The cost of Medicare is not universal. Though many aspects of Medicare costs are standardized, the way you set up your Medicare coverage will likely mean you pay differently than your neighbor.
For example, an Original Medicare plan coupled with Medigap and prescription drug coverage will have different costs than a comprehensive Medicare Advantage plan. The difference in cost will be at both the premium level and the cost of care.
Be sure to consider all aspects of your healthcare plan’s cost when evaluating your options. Plans with low monthly premiums aren’t necessarily the most affordable option. Often, these plans are very expensive in the long run because they pay less for health services.
The Cost of Original Medicare in Arkansas
Original Medicare has standardized costs across the country. Wherever you go, Medicare should cost the same, even if you go out of state.
Medicare Part A is premium-free for most beneficiaries. To qualify for free premiums, you need only 40 work credits—roughly 10 years of working history. But even if you don’t qualify for premium-free, you can still get Medicare Part A. You just need to pay for it.
The Medicare Part A deductible is $1,484, and the coinsurance rates vary, depending on the facility you stay in and the level of care you receive. You should expect to pay $60 to $300 a night, depending on the care you receive.
The Medicare Part B premium is typically $148.50. However, this premium works on a sliding scale depending on income. If your income is more than $87,000 a year for singles or $174,00 as a couple, you’ll pay more. The maximum premium is $491.60 for people making more than $500,000 a year for singles or $750,000 for couples.
The Medicare Part B deductible is $203. After the deductible is met, you’ll be responsible for 20 percent of costs. This may seem high because it is.
Original Medicare alone is very expensive. That’s why many Medicare beneficiaries choose to add a Medigap plan and Medicare prescription drug coverage to their health plans.
The Cost of Medigap Plans in Arkansas
Medigap plans, also called Medicare Supplement Insurance plans, are highly regulated supplemental health plans that Medicare beneficiaries use to keep the costs of Original Medicare low. These plans can help cover the cost of deductibles, copays, and coinsurance associated with Original Medicare. Plans are regulated by the U.S. government through the CMS. Medigap plans come in 10 different types, organized by letter. For example, Medigap Plan G is one of the plans.
Each Medigap plan of the same type is virtually identical to any other Medigap plan of the same type. For example, Medigap Plan G from Company 1 is virtually the same as Medigap Plan G from Company 2.
However, these virtually identical plans can differ by monthly premium. That’s because different health insurance companies can have different pricing structures that make the cost to you different. Bear in mind that other aspects of plans can also differ, such as the company’s website, customer service, customer satisfaction, and accessibility.
The Cost of Medicare Advantage in Arkansas
Arkansas Medicare Advantage plans at a glance:
Medicare Advantage is an alternative to Original Medicare and cannot be used in conjunction with Original Medicare or a Medigap plan. People who choose a Medicare Advantage plan usually do so because these plans:
- Can have a lower cost than the public option, especially for preventive care
- Can be more comprehensive than the public option (for example, including dental coverage)
- Can be easier to use than the public option
- Can offer better accessibility, customer service, or other benefits
Additional benefits Medicare Advantage plans may offer include:
But all Medicare Advantage plans are not created equal. Often, Medicare Advantage plans can be just as expensive as or more expensive than its public counterpart. There is also the risk that the plan loses its contract with the CMS, thereby disbanding its plan to beneficiaries. (If that happens, beneficiaries are allotted a Special Enrollment Period to choose a new plan).
You should also keep in mind that a plan with a low monthly premium may not be less expensive overall than a plan with a high monthly premium. If that high-premium plan offers additional benefits and a low out-of-pocket limit, it’s likely less expensive than a plan with a $0 monthly premium but high out-of-pocket limits and additional coverage benefits.
Like other private healthcare plans, Medicare Advantage plans are often designed as a health maintenance organization (HMO). With an HMO, you work within the plans provider network. Some MA plans are in a preferred provider organization (PPO), where you can work with providers outside of your network, though it will cost you more to do so.
Rarely, MA plans are organized as private fee-for-service (PFFS). These plans tend to be quite expensive and are appropriate for only a small percentage of Medicare beneficiaries.
To learn more about choosing the right Medicare Advantage plan, please read our article The Best Medicare Advantage Plans in Arkansas.
The Cost of Prescription Drug Plans in Arkansas
Arkansas prescription drug plans at a glance:
As the name suggests, Medicare prescription drug plans cover some of the costs of your prescriptions. If you choose a Medicare Advantage plan that includes prescription coverage, you cannot purchase a stand-alone Part D plan.
Whatever way you get your prescriptions covered, you should pay close attention to the plan’s formulary. A formulary is the schedule of prices a company uses to determine how much you pay for your prescriptions. It’s broken into four tiers:
- Tier 1 covers inexpensive generic drugs.
- Tier 2 covers expensive generics or inexpensive name-brand drugs.
- Tier 3 covers expensive name-brand drugs.
- Tier 4 covers specialty drugs.
Look for a plan that covers your prescriptions in either Tier 1 or Tier 2 if possible. Those tiers are the least expensive.
Cost of Special Needs Plans in Arkansas
Arkansas Special Needs Plans at a glance:
Special Needs Plans (SNPs) work like Medicare Advantage plans but are designed for people who would not otherwise be able to afford Medicare. The most common reason is lack of income—people who are dual-eligible for Medicaid and Medicare can often find an SNP.
However, people with certain health conditions are also eligible. These health conditions include:
- Chronic heart failure
- End-stage renal disease (ESRD)
- Amyotrophic lateral sclerosis (ALS)
People living in institutions, like a nursing home, skilled nursing facility, or other long-term care facilities, may also be eligible for an SNP.
If you’re not sure if you qualify or want to learn more about your options, you should contact the Arkansas Senior Health Insurance Information Program (SHIIP). You can call them at (501) 371-2782 or toll-free at (800) 224-6330. Advocates there can help you understand your options and see if you qualify for financial assistance, such as a Medicare Savings Program. Even if you think you can’t qualify, contact them if you have financial difficulty. Chances are, there’s something available to offer your relief.
What Is Medicare?
Medicare is a federal health insurance program regulated by the Centers for Medicare & Medicaid Services (CMS). It’s meant to provide affordable healthcare to people who would otherwise be unable to afford a health plan—mainly seniors and people with certain health conditions.
Medicare is broken down into a few types of Medicare products. The first is Original Medicare, a.k.a. Medicare Parts A and B. As the name suggests, this was the first type of Medicare plan proposed in 1966. Medicare Part A, often called Hospital Insurance, takes care of some of your inpatient expenses—like a stay in the hospital or a skilled nursing facility. Medicare Part B, often called your medical insurance, is for your outpatient care, like an annual checkup.
Medicare Advantage, a.k.a. Medicare Part C, is an alternative to Original Medicare. It is meant to cover everything that Original Medicare covers. The main difference is that a Medicare Advantage plan is administered by a private insurance company. However, MA plans must comply with strict requirements from the federal government.
Medicare prescription drug coverage, or Medicare Part D, is for helping you cover prescriptions. This plan is completely optional but for most people is also necessary. It’s also relatively new—the first Medicare Part D plans hit the market in the early 2000s.
Finally, Medigap, or Medicare Supplement Insurance, is a Medicare plan meant to help you cover the costs of Original Medicare. Medigap plans cannot be used with Medicare Advantage. Their purpose is to cover some of the costs related to deductibles and coinsurance.
Who Qualifies for Medicare in Arkansas?
Eligibility for Medicare depends on a few factors. First, you need to be either a citizen or a permanent resident of at least five years to be eligible. From there, you just need to meet one of the following criteria:
- You are 65 years of age or older.
- You are drawing from disability (SSDI) and have done so for at least 24 months.
- You have been diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
If you qualify for Medicare, you may be automatically enrolled in an Original Medicare program. However, don’t leave anything to chance—always verify your enrollment. Enrolling late, even if it’s due to an administrative error, can cost you money.
The Easy Way to Compare Medicare
How do I choose between Original Medicare and Medicare Advantage?
The choice between the public and private options is a tough one—and it’s the biggest decision you’ll make in Medicare planning. We’d love for the decision to be easy, but unfortunately, plans aren’t one-size-fits-all. The key to making the right choice is to start with your needs and how you plan to use your healthcare.
To help you understand the basic pros and cons of each option, we created this side-by-side comparison:
Worried about trying Medicare Advantage but think it would be a good fit? Luckily, there is a 12-month trial period the first time you switch from Original Medicare to Medicare Advantage. If you decide during the trial period that you don’t like your Medicare Advantage plan and want to switch back, you can do so.
Keep in mind that you’ll need to wait for the fall Open Enrollment Period (OEP) to make that change (unless you qualify for a Special Enrollment Period). The great news is that you retain the right to re-enroll in your Medigap plan without medical underwriting, so long as you switch back within those 12 months.
How do I apply for Original Medicare in Arkansas?
Medicare enrollment is easy. For some, it is even automatic if:
- You’re already drawing from Social Security benefits (SSI).
- You’ve been drawing disability (SSDI) benefits for 24 months.
- You worked for the railroad and get benefits from the Railroad Retirement Board (RRB).
However, even when you should be enrolled automatically, this doesn’t guarantee everything will go off without a hitch. That’s why we recommend always, always double-checking to ensure you are properly enrolled in your Medicare program. You can do this:
- Online by logging into your account at SSA.gov or MyMedicare.gov
- Over the phone by calling 1 (800) 772-1213 (TTY users call 1 (800) 325-0778)
- In-person at your local Social Security office
We recommend avoiding in-person contact during the coronavirus pandemic until you can receive a COVID-19 vaccine.
How do I apply for Medicare Advantage in Arkansas?
Before you can apply for Medicare Advantage, you first need to apply for Original Medicare. We also recommend that you enroll in a Medigap plan to retain rights to getting Medigap without medical underwriting. This is a precaution to take in case you decide during your trial period that Medicare Advantage isn’t right for you.
To enroll in a Medicare Advantage plan, first, you need to find the right plan for you. You can do this with the Insurify Medicare comparison tool—just enter your ZIP code, and you’ll find all the ways to search for plans in your area. You can also use this tool to compare Medigap plans.
Once you find the right plan, you can submit an application. This can usually be done online or over the phone. You will need to provide your Medicare number and other information, so have that ready.
What’s the best Medicare Advantage plan in Arkansas?
The best plan really depends on the user: you. Your needs, how you use your healthcare, your lifestyle, and your budget all affect plan suitability. Before you start searching for plans, you should sit down and make a list of your needs. Be sure to also make a list of your medications—you’ll want to verify they’re covered under the plan’s formulary.
From there, you can use the Insurify Medicare plan comparison tool to help you uncover all your plan options. Be sure to consider the total cost of coverage for each plan. Some plans may have a low monthly payment but high costs for actual care, while other plans may have high monthly costs but low costs for actual care. Total costs include:
- Coinsurance rates
- Out-of-pocket cost limits
- Miscellaneous fees
FAQ: Arkansas Medicare
How much do you pay for Medicare when you turn 65?
How much you pay will depend on the type of plan you use. People who use Original Medicare typically pay less than $200 a month in premiums. However, because the cost of coinsurance is high, Original Medicare enrollees should consider adding a Medicare Supplement plan (Medigap). Additionally, they’ll want to add prescription drug coverage. These plans come with separate monthly premiums but significantly lower the cost of care. Medicare Advantage plans also come in a range of costs. Just remember that your costs aren’t limited to the monthly premium. You’ll need to cover co-pays, coinsurance, deductibles, and more. Be sure to consider all costs when evaluating your plan options.
How do I check my Medicare coverage?
You can check your Medicare coverage online at the SSA.gov website—your account with the Social Security Administration. You can also log into your account on Medicare.gov to see your information. Alternatively, you can call 1 (800) MEDICARE and speak with a Medicare representative to verify your coverage.
Conclusion: Compare Arkansas Medicare Plans Before You Buy
Whatever part of the state is called home, Arkansas residents have choices when it comes to Medicare health coverage. The key to getting the best care is to know yourself and know your options. An easy way to uncover your options is through the Insurify Medicare comparison tool. Just enter your ZIP, and you’ll be well on your way to finding the best option for you.
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