Medicare Options in Arkansas
In the United States, 14% of Medicare recipients are under the age of 65, while in Arkansas, 21% are eligible for Medicare due to a qualifying disability rather than old age. Arkansas, Alabama, and Kentucky all have a higher percentage of Medicare recipients under the age of 65 than any other state in the union.
As of 2018, about 22% of Arkansas Medicare beneficiaries were enrolled in Medicare Advantage plans, compared to a national average of 34%. In Arkansas, however, the percentage of Medicare patients enrolled in Medicare Advantage plans had risen to 35% by the fall of 2021.
Original Medicare
Medicare is the federal government’s long-standing health insurance program. There are two parts to the program, and you can enroll in either one or both.
Part A deals with hospital insurance. It aids in the financial burden of inpatient hospitalizations. Also included in this plan are hospice care, some in-home medical services, and short-term stays in a skilled nursing facility.
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Part B covers medical insurance. It includes a variety of preventive treatments along with medically essential services and supplies. It also covers doctors’ services, physical examinations, and health screenings.
Medicare Advantage
Private companies that have a contract with Medicare offer Medicare Advantage plans. They’re available in all of Arkansas’s counties for 2022 coverage, though service areas and availability of plans vary across the state. In Howard County, there are 16 plans for 2022, while Conway County has 53 plans.
To qualify as a Part C plan, a health insurance policy must cover all the services provided by Medicare Parts A and B. It may also include additional benefits like prescription medicine coverage; routine dental, eye, and hearing examinations; and gym memberships.
Arkansas’ Medicare Advantage program offers four types of plans:
Health Maintenance Organization (HMO)
HMOs typically require that you use only providers in their network for all your healthcare needs:
- Treatment and medicines should be approved by your primary care physician (PCP), who will also refer you to specialists.
- Most policies cover prescription medication.
- Prescription drug coverage cannot be purchased separately.
- If you stay in the network, you’ll pay less.
Preferred Provider Organization (PPO)
PPOs offer a network of recommended providers, but you can pay more if you want to visit an out-of-network doctor or hospital.
- You are not obligated to have a primary care physician (PCP) or seek referrals to specialists.
- Drug coverage is included in most policies.
- Drug coverage cannot be purchased separately.
- More expensive premiums and charges outside the network.
Private Fee-For-Service (PFFS)
PCPs and referrals are not required for PFFS plans, though they are recommended:
- Anyone who accepts the terms of the Medicare plan and agrees to help you is eligible for Medicare benefits.
- Drug coverage can be part of your overall health plan or you can purchase it separately.
- You will pay more if you choose a provider who does not agree to the terms of the plan.
Special Needs Plan (SNP)
SNPs are only available to people with specific diseases or characteristics, and they provide coordinated treatment and benefits that are tailored to your needs:
- You’ll need a primary care physician (PCP) and referrals to specialists to get treatment.
- Plans always include drug coverage.
- If you fulfill the eligibility conditions, you can enroll in this plan at any time.
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Medicare Supplement Plans or Medigap
Plan premiums for Medicare supplement insurance (Medigap) can cover all or some of the deductibles, coinsurance, and copayments under Original Medicare. The essential framework of every Medigap plan is the same. Some plans cover more cost-sharing than others, so you can have the freedom to select how much coverage you want.
Private insurers sell Medigap insurance, but the federal government standardizes them. Arkansas is one of eight states that don’t allow Medigap rates to change based on age, as long as the enrollee is 65 or older.
Medicare supplement programs are labeled from A through N. While there are ten basic Medigap plans, the most popular are Plans F, G, and N.
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Medigap Plan F
Through the years, Plan F has become a popular choice because it covers all the gaps left by Medicare Parts A and B. It covers Medicare Part A coinsurance and hospital expenses for up to a year after you’ve used your Medicare benefits. Plan F can also ease the financial burden of coinsurance for hospice or skilled nursing care.
Medigap Plan G
Plan G covers the same gaps as Plan F, except for the deductible on Part B. Once a year, you will be responsible for paying your own Part B deductible. Many new Medicare subscribers are unable to sign up for Plan F, which is why Plan G is a viable alternative. Aside from this, the plans are identical.
It always helps to compare your options to find the best one, even if the options seem identical. Aetna’s Plan G and United Healthcare’s Plan G, for instance, cover the same services. Even though Plan F covers all gaps, the Plan G premium may be less expensive if it covers the Part B deductible.
All these options can get confusing, which is where our services come in. We can offer quotations for any Medigap plan that you are considering. For instance, if you decide to go with a Medicare Supplement Plan G, we can provide you with quotes from a variety of insurers. It’s easy to compare Plan G rates since they’re all the same.
Medigap Plan N
Medicare Supplement Plan N is another popular option among Arkansas residents. Plan N includes all of Plan G’s coverage except for the Part B excess charges and may include copays. If your doctor does not accept Medicare assignment, you may face these expenses.
Under Plan N, Medicare beneficiaries will be responsible for up to $20 in-office visits and up to $50 in emergency rooms. Plan N’s rates are often lower than Plan G’s due to these copays and reduced healthcare benefits.
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Comparing Medicare Advantage Plans in Arkansas
Over 21% of the state’s residents are Medicare beneficiaries, compared to roughly 19% of the country’s population covered by Medicare. By late 2021, 651,967 Arkansas residents were enrolled in Medicare.
To make sure you enroll for the right plan, make sure you consider the following factors while weighing your options:
Provider Network
Many plans require you to see a doctor or hospital within the network to use your Medicare Advantage benefits. Otherwise, you have to cover those costs yourself. Before signing up for a health insurance plan, make sure your providers are in the network.
Amount of Coverage Required
Many Medicare Advantage plans include dental, vision, and hearing benefits that are not included in the original Medicare plans. When comparing insurance policies, keep a detailed checklist of the benefits you’re looking for.
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Check Plan Ratings
Make sure you go for a plan that has good performance ratings. The Centers for Medicare & Medicaid Services (CMS) releases annual performance data for Medicare plans. Ratings range from 1 to 5, with 5 representing the highest possible rating.
Out-of-Pocket Expenses
Your health insurance costs will be influenced by a variety of factors, including deductibles, copayments, and coinsurance. To compare the costs of various Medicare Advantage plans, you can use our plan finder tool.
Monthly Premium
This is in addition to your monthly Part B payment, so it affects your monthly budget. Regardless of whether you make use of your benefits, you are still responsible for this cost. Make sure you have at least one low-cost prescription drug plan with zero monthly premiums in your area.
Drug Coverage
Check the formula and pricing of your drug every time you get a prescription. You can talk to your doctor about getting the drug you need in a generic form or a different brand name.
Deductibles, Coinsurance & Copays
Also known as cost-sharing, these are the expenses you bear when you use your insurance benefits. Make sure you know exactly how much your health insurance will cover in terms of doctor’s visits, services, and prescriptions.
Freedom to Travel
If you frequently travel outside your plan’s coverage region, you want a policy that provides travel coverage. Medicare Advantage plans often don’t provide this option. Make sure your policy covers you while you’re away from home.
Medicare Eligibility in Arkansas
Most Arkansas residents aged 65 are eligible for Medicare. As long as you’re a US citizen or permanent resident, you’ll be able to apply once you turn 65 years old. Anyone who qualifies for or has received Social Security retirement benefits can also apply.
You can also qualify for Medicare much earlier under special conditions. Since July 1, 2018, all Arkansas Medigap insurers are required to offer at least one Medicare Supplement plan to those younger than 65 years of age.
If you have been receiving at least 24 Social Security Disability Insurance (SSDI)payments, you are eligible at any age. Patients of chronic or incurable conditions, such as end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS), can also enroll for Medicare at any point in their lives.
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Medicare Enrollment in Arkansas
Once you begin receiving Social Security or Railroad Retirement Board payments at least four months before your 65th birthday, Medicare will register you automatically. Alternatively, you can apply online or at your local Social Security office.
Enrollment in Medicare is open during the following time frames:
Initial Enrollment
Starting three months before your 65th birthday until three months after it, you can enroll for Medicare Parts A and B. For people with qualifying disabilities, this translates to the three months before or after the 25th disability compensation payment.
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General Enrollment
If you were unable to enroll during the initial enrollment period, you get another six-month window from January 1 to March 31 to sign up for Medicare. You can enroll in Medicare and Medicare Advantage plans during this period.
Open Enrollment
This enrollment runs from October 15 to December 7 each year. You can enroll in, opt out of, or adjust your Medicare Part C or D plans.
Medigap Enrollment
Medicare Supplement programs are not subject to an annual open enrollment period like other private Medicare coverage (Part C and Part D) plans. Instead, federal regulations provide a six-month window during which Medigap coverage is guaranteed to be issued.
Once a person turns 65 and is enrolled for Medicare Part B, they’re eligible for this special enrollment period. You cannot purchase Medigap coverage until both Part A and Part B are active.
Special Enrollment
For unexpected life events, like leaving your work (and health coverage) or relocating from your insurance carrier’s service region, Medicare offers special enrollment periods. You may be eligible for an 8-month special enrollment period if you meet the criteria.[/read]
Why Trust the Medicare Insurance Agents at Integrity Now Insurance?
As an independent Medicare insurance broker, we have one goal in mind: to serve your best interests. We will help you compare quotes and weigh your options so you can settle on an affordable and appropriate Medicare insurance plan.
Our company’s Medicare Insurance Agents are annually accredited by America’s Health Insurance Plan (AHIP), a national certifying authority. With this in mind, you can rest easy knowing that we can help you with all your Medicare Insurance needs.
What Makes Integrity Now Insurance Agents The Right Choice?
As an independent Medicare insurance brokerage, we have access to all Medicare insurance carriers in Alaska. Our independence enables us to give objective recommendations on the best Medicare insurance company for you.
Our insurance agents are licensed and well-versed in the local policies of Arkansas. Most clients are intimidated by hefty consultation fees and decide to do things on their own. Luckily, we offer all our assistance free of charge!
Feel free to reach us at (562) 735-3553 for a one-on-one consultation with one of our representatives.
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