Medicare in Arkansas: Everything You Need to Know
More than 10,000 baby boomers become eligible for Medicare each day, and many would agree that Medicare can be overwhelming. Should you enroll in Medicare Advantage for extra benefits, or would you rather get financial benefits through Medicare Supplements? What about a Part D plan for prescription drug coverage? The options can be overwhelming, but we’re available to help Arkansas Medicare beneficiaries navigate it all.
Click below to learn more about Arkansas Medicare:
- Arkansas Medicare Eligibility & Enrollment
- The Parts of Medicare
- What Does Arkansas Medicare Cost?
- Can I Have Medicare and Medicaid in Arkansas?
- Resources in Arkansas
Arkansas Medicare Eligibility & Enrollment
There are four ways to become eligible for Medicare:
- Turning 65
- Being diagnosed with ESRD
- Being diagnosed with ALS
- Receiving SSDI for at least 25 months.
You can only enroll in Medicare during certain times of the year.
When you first become eligible, you’ll enter an Initial Enrollment Period. If you age into the program, this will begin three months before your 65th birthday and end three months after. If you are eligible due to SSDI, you’ll automatically be enrolled in your 25th month of benefits. If you qualify due to ESRD or ALS, you can enroll when you receive your diagnosis.
To add additional coverage after your Initial Enrollment Period, you’ll have to wait for the following enrollment periods:
- General Enrollment Period: January 1 – March 31, only for those who missed their Initial Enrollment Period
- Open Enrollment Period: January 1 – March 31, only for those who enrolled in a Medicare Advantage plan and decided they don’t like it
- Annual Enrollment Period: October 15 – December 7, for anyone eligible for Medicare
- Special Enrollment Period: Time period depends on your situation; for eligible people with low-income, disabilities, or a special circumstance such as moving to a new coverage area
The Parts of Medicare
Original Medicare includes Part A and Part B. Part A covers services like hospital stays, nursing homes, hospice, and home health services. Part B covers outpatient services such as ambulance travel, medical equipment, mental health, partial hospitalization, lab tests, and x-rays. Once you are enrolled in Original Medicare, you can start to explore other plan options that are specific to your zip code.
Private Arkansas Medicare plans include Medicare Advantage, Medicare Supplements, and Part D. Each plan offers a different type of benefits (health, financial, or coverage).
Medicare Advantage plans are offered from privately-owned carriers, not the government. This means that even though they are still federally regulated, they are able to offer benefits that the Original Medicare program does not. To have Medicare Advantage, you’ll have to keep your Part A and Part B, so you’ll still have all of those benefits.
Plans vary by zip code, but can include benefits like dental, vision, hearing, fitness programs, and prescription drugs.
Medicare Supplements add financial benefits that work alongside Original Medicare. There are ten different types of plans, (A, B, C, D, F, G, K, L, M, and N), and each letter represents a different combination of coverage. Depending on which plan you select, you can have the following financial benefits:
- Part A coinsurance and hospital costs
- Part B coinsurance and copayments
- Blood work copays (up to three pints)
- Hospice coinsurance and copayments
- Skilled nursing facility coinsurance
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign emergency travel
Medigap plans are the same regardless of which carrier you enroll with, but plan prices will still vary. One of our licensed agents can show you plans in your area and help you enroll at the best price. Click here to give us a call at 833-438-3676.
Part D plans work alongside Original Medicare to provide prescription drug coverage. Your coverage will consist of a deductible, initial coverage phase, coverage gap, and catastrophic coverage phase.
The annual deductible for 2020 is $435. Some plans may waive, reduce, or change your deductible up front. Once you reach the set deductible, you’ll be covered according to the plan you chose. Your plan will have given you a “formulary,” which explains which drugs are covered. Formularies are typically organized in tiers which represent how much you can expect to pay per drug.
What Does Arkansas Medicare Cost?
Private plan costs can vary greatly based on the benefits you are looking for and where you live. Medicare Advantage plans in 2020 may cost an average of $23/month.
Most people will not have to pay a premium for Part A so long as they have worked and paid Medicare taxes for at least 40 quarters. If you have worked for 30-39 quarters, you will have to pay $252/month in 2020. For any time worked less than 30 quarters, you will have to pay $458/month in 2020.
The Part B premium is $144.60/month in 2020, but this can change based on your income. Pricing for Medicare Advantage, Medicare Supplements, and Part D plans will vary based on the plan, location, and benefits. Click here or give us a call at 844-431-1832 to get in contact with a licensed agent.
Arkansas Medicare Savings Program and Extra Help
The Extra Help program, also known as LIS (Low Income Subsidies) can help you save more than $4,000/year on prescription drugs, and Medicare Savings Programs can help cover other Medicare-related costs like premiums, deductibles, copayments, and coinsurance.
If you have low income, it may be worth applying for LIS and Medicare Savings Programs to see if you qualify. There is no fee to apply, and your insurance agent can help you complete your application. Don’t have an agent? Call 844-431-1832 to chat with one of ours! It is free to speak with an agent and there is never any obligation to enroll.
Can I Have Medicare and Medicaid in Arkansas?
Medicare is designed for older adults over the age of 65 and people with certain disabilities (regardless of age). Medicaid is designed for low-income individuals and families regardless of age. It is possible to be enrolled in both programs. In fact, more than 16,000 beneficiaries are enrolled in both Medicare and Medicaid throughout Arkansas.
If you qualify for both programs, you may also qualify for a Dual Special Needs Plan (DSNP). A DSNP allows you to get additional benefits at lower costs and grants you a Special Enrollment Period (SEP), which may allow you to change plans outside of the traditional enrollment periods.
Resources in Arkansas
No matter what health insurance you have, the state of Arkansas has a series of additional programs that you may qualify for.
Arkansas Area Agencies on Aging
Area agencies on aging provide human resources for elderly Arkansas residents. Contact your local agency for help applying for programs and navigating your concerns.
- Northwest Arkansas (Baxter, Benton, Boone, Carroll, Madison, Marion, Newton, Searcy, & Washington)
- Northeast Arkansas (Clay, Craighead, Crittenden, Cross, Greene, Lawrence, Lee, Mississippi, Phillips, Poinsett, Randolph, St. Francis)
- Western Arkansas (Franklin, Logan, Polk, Sebastian, Crowford)
- West Central Arkansas (Hot Springs, Arkadelphia, Malvern, Russellville, Morrilton, Clarksville)
- Southeast Arkansas (Arkansas, Ashley, Bradley, Chicot, Cleveland, Dallas, Desha, Drew, Grant, Jefferson, Lincoln)
- Southwest Arkansas (Magnolia)
- White River Area
Senior Farmers’ Market Nutrition Program
If you are at least 60 years old and have an income at or below 185% of the Federal Poverty Level, you may qualify for the Arkansas Senior Farmers’ Market Nutrition Program. The program provides “access to locally grown fruits, vegetables, honey and herbs.” Your Area Agency on Aging can help you apply.