Arkansas Medicare Guide

Get your Medicare questions answered and the help you need to enroll in the best Medicare coverage for your needs. Schedule a free consultation with one of our licensed Arkansas Medicare Advisors or give us a call today at (888) 604-0055 to get started. 

Learn about the basics of Medicare in Arkansas below to understand the options available to you and when you should enroll.

Use this table of contents to jump to specific sections:

• A Snapshot of Medicare in Arkansas

• Arkansas Medicare Advantage Plans

• Arkansas Medicare Supplement Plans

• Arkansas Medicare Part D (Prescription Drug) Plans

• Get help paying for Medicare in Arkansas

• Medicare Eligibility and Enrollment Steps

A Snapshot of Medicare in Arkansas

There are 962,000 Medicare beneficiaries in Arkansas, making up 17% of Arkansas’ total population. 21% of Arkansas Medicare beneficiaries are dually eligible, meaning they’re on both Medicare and Medicaid.

Medicare Advantage vs. Original Medicare in Arkansas

When you first sign up for Medicare, you’ll enroll in Original Medicare (Parts A & B). Original Medicare offers standardized coverage and allows individuals to add supplemental plans (Medigap and a prescription drug plan) for additional coverage.

Some Medicare beneficiaries choose to transition from Original Medicare to a Medicare Advantage plan. These plans bundle together Medicare Parts A, B, and often D, and are offered by private insurance companies. 

Deciding between Original Medicare and Medicare Advantage is a personal decision based on your specific financial and health status. 66% of Arkansas Medicare beneficiaries are on Original Medicare. The other 34% have chosen to enroll in a Medicare Advantage plan (source).

Arkansas Medicare Advantage Plans

Medicare Advantage (also known as Medicare Part C) provides beneficiaries with an alternative to Original Medicare. Many of these plans have low or no premiums (but keep in mind that you’ll continue to pay your Original Medicare premiums). Medicare Advantage plans are required to provide at least the same coverage as Original Medicare, and often provide additional benefits, like dental, vision, and hearing. 

Before you enroll, consider the drawbacks that generally come with Medicare Advantage plans. These include limited provider networks, preauthorization approval requirements, and higher out-of-pocket costs when compared to Medigap plans. 

66% of Arkansas Medicare beneficiaries choose to enroll in one of the 58 Medicare Advantage plans available statewide. Premiums and out-of-pocket costs vary by plan, and plan availability varies by county. For example, Pulaski County has 51 Medicare Advantage plans available, with monthly premiums ranging from $0 to $131. Miller County only has 19 Medicare Advantage plans with the same premium range. To learn about and compare Medicare Advantage plans in your area, schedule an appointment with one of our licensed Arkansas Medicare Advisors or call us today at (888) 604-0055.

Arkansas Medicare Supplement Plans

If you’re on Original Medicare, you can also enroll in a Medicare Supplement (Medigap) plan to help cover the 20% of costs that Original Medicare doesn’t pay. Medicare Supplement plans don’t provide coverage for additional healthcare services, but they do significantly reduce your out-of-pocket costs. On a Plan G, for example, you’re only responsible for paying your Part B deductible, which is $226 in 2023. Two of the other key benefits of Medicare Supplement plans are:

• You can see any doctor that accepts Medicare (about 90% of doctors nationwide)

• You don’t need prior authorization for covered services

The best time to enroll in a Medicare Supplement plan is during the Medigap Open Enrollment period, which occurs during the first six months after your Part B effective date. During this period, you cannot be denied coverage, regardless of your age and medical history. If you decide you want to enroll in a Medicare Supplement plan later, however, insurance companies can ask you questions about your health history and you could be denied coverage. Learn more about Medicare Supplement enrollment here.

Arkansas Part D (Prescription Drug) Plans

Original Medicare doesn’t provide prescription drug coverage, which is why Part D was introduced. Medicare beneficiaries can get prescription coverage through either a stand-alone prescription drug plan (PDP) or a Medicare Advantage plan that comes with prescription coverage (MA+PD). 

There are 23 stand-alone Part D plans available in Arkansas, but the exact plans available to you will depend on your county. The average monthly premium for a Medicare Part D stand-alone drug plan in Arkansas is $34.69, which is the fifth lowest in the country.

Getting help paying for prescription drug coverage

Medicare Extra Help Program

Medicare’s Extra Help program helps those with limited incomes and resources pay for Medicare Part D premiums and out-of-pocket costs. You qualify for Extra Help automatically if you get:

• Full Medicaid coverage from Arkansas

• Help from Arkansas to pay your Part B premiums

• Supplemental Security Income (SSI) benefits

If you don’t automatically qualify for Extra Help, you can learn more about eligibility here. If you need help, you can speak with one of our Arkansas Medicare Advisors who can help you with the application process.

Other ways to save on Medicare prescription coverage in Arkansas

1. Compare pharmacy pricing - pharmacies charge different prices for prescriptions, so shop around! You may also be able to save extra by going to one of your plan’s preferred pharmacies or opting for a mail order pharmacy.

2. Change your prescription brand or type - Changing from brand name to generic or even changing the type of prescription you take (e.g., pill vs tablet) can result in big savings.

3. Compare plans during the Open Enrollment Period - Medicare plans change, and your needs may change too. You should work with a licensed Arkansas Medicare Advisor each year to be sure you’re getting the best value from your drug plan.

Get help paying for Medicare in Arkansas

In addition to Extra Help, there are two government programs that can help low-income individuals pay for healthcare expenses. 

Medicaid

Arkansas Medicaid is a joint program between the state and federal governments. The program is run by the Arkansas Department of Human Services and provides assistance with medical bills for those with low incomes and resources.

If you’re 65 or older and meet income, resource, and other requirements, you’ll be eligible for full coverage through Aged, Blind, and Disabled Medicaid (commonly ABD Medicaid). There are additional programs available for seniors, which are detailed here. Like the other states, Arkansas Medicaid provides Medicare Savings Programs specifically for low-income Medicare beneficiaries. 

Medicare Savings Programs

Arkansas has four Medicare Savings Programs. For all four of these programs, the resource limit is $9,090 for individuals and $13,630 for couples. The following information is from the Arkansas Insurance Department (AID) for 2023.

ARSeniors Program

ARSeniors provides full Medicaid. The income limit is $972 for individuals and $1,314.67 for couples.

Qualified Medicare Beneficiary (QMB) Program

The Qualified Medicare Beneficiary (QMB) Program pays Part B premiums as well as Medicare deductibles and copays. The income limit is $1,215 for individuals and $1643.33 for couples.

Specified Low-Income Medicare Beneficiary (SLMB) Program

The Specified Low-Income Medicare Beneficiary (SLMB) Program pays for the Part B premium only. The income limit is $1,458 for individuals and $1,972 for couples.

Qualified Individuals-1 (QI-1) Program

The Qualified Individuals-1 (QI-1) Program pays for Part B premiums only. The income limit is $1,640.25 for individuals and $2,218.50 for couples.

To get help determining if you qualify and applying for a Medicare Savings Program, reach out to one of our licensed Arkansas Medicare Advisors.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

• You are 65 and older, blind, or have a disability

• You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

Arkansas Medicare Eligibility and Enrollment Steps

Medicare eligibility is the same nationwide. You’re eligible for Medicare if you’re a US citizen who meets one of the following criteria:

• You’re 65 or older

• You have certain disabilities, like End-Stage Renal Disease or ALS

Three key steps for Arkansas Medicare enrollment:

1. Enroll in Original Medicare (Part A & Part B)

2. Choose your supplemental coverage

   1. Medicare Supplement (Medigap)

   2. Medicare Advantage (Part C)

   3. Part D (drug coverage)

3. Find doctors, share your plan information with your pharmacy, and set up additional benefits that come with your coverage.

You first become eligible for Medicare during your Initial Enrollment Period. Your Initial Enrollment Period starts three months before the month you turn 65 and extends until three months after. In some cases, you may choose to wait to enroll in Part B, but if you do so, be sure you qualify for a Special Enrollment Period. You can learn more about when to enroll in Medicare here. If you have any questions, schedule a free consultation with one of our licensed Arkansas Medicare Advisors or give us a call today at (888) 604-0055.