What Is Medicare Part D
Medicare Part D ensures that those living in Arkansas have access to prescription medication covered by health insurance. When you sign up for Original Medicare, you will be enrolled in Part A and Part B. Part A covers expenses related to hospital care and emergency visits. Part B covers doctor visits and other medical procedures that do not require hospitalization. Enrollment in Part D is not automatic so if you want coverage for prescription medication, you will have to manually enroll.
Medicare Part D is offered by private companies contracted by Medicare to provide insurance for prescription medications. According to KFF, over 465,000 people in Arkansas have registered for this prescription coverage. Its important to note that Part D only applies to prescription medication, and generally doesnt cover over-the-counter medications. OTC medications are typically an out-of-pocket expense for anyone who purchases them.
Best Medicare Supplement Plans In Arkansas
Medicare isnt one size fits all, the best Medigap plan for your neighbor likely isnt the most suitable plan for you. Although, most people buy either Plan N, G, or F.
Depending on your needs and budget, the best plan for you could be Plan N, G, or F. Some people save the most money by opting for a High Deductible policy.
Anyone with coverage knows these plans are full of great perks. You have the freedom to see any doctor that accepts Medicare without a referral. You can also better predict what youre out of pocket expenses, if any, will be.
Medicare Eligibility In Arkansas
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Do you have questions regarding your Medicare eligibility in Arkansas? If you are approaching 65, chances are that you do. HealthMarkets can help untangle the complexities, and help you start comparing plans.
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About Arkansass Health Insurance Marketplace
The ACAs open enrollment for its Health Insurance Marketplace runs from for coverage that starts the following January 1. You need to re-enroll during each years open enrollment to avoid a break in coverage.
Normally, if you miss the Open Enrollment Period, you will not be able to apply until the next open enrollment unless you experience a qualifying life event. Any event that leaves you uninsured or changes the size of your family triggers a Special Enrollment Period. Such an event opens a short window for you to obtain your insurance.8
Today Arkansas has a state-based Marketplace-Federal Platform. In 2019, the Arkansas Insurance Department created a division called the Arkansas Health Insurance Marketplace . This division manages and implements the state-based health insurance exchange following state and federal law.9 However, the state relies on the federal website for eligibility and enrollment functions.10
You can buy ACA-compliant coverage through the exchanges or certified agents and brokers. For families and individuals, Obamacare may be the best low-cost health insurance due to the available subsidies that lower premiums. If you are self-employed with no employees, you can access the same health insurance options as families and individuals.
Private Insurance Companies Offer Medicare Advantage Plans In Arkansas
Multiple insurance carriers may offer Medicare Advantage plans in Arkansas, depending on where you live.
Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.
When youre shopping for Medicare Advantage plans in Arkansas, you can compare plans from several different carriers by using some of the following information:
- The Medicare Star Ratings can give you an idea of a plans overall quality.
- Agencies like A.M. Best, Moodys and Standard & Poors can provide information about an insurance companys credit rating and financial standing.
- Websites such as the Better Business Bureau and Consumer Reports can teach you about a companys reputation among its customers.
- You can read through Medicare Advantage plan reviews and testimonials from customers.
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Medicare Eligibility & Enrollment
If you want to enroll in Medicare Advantage in Arkansas, you must first be enrolled in Medicare Part A and Part B, often referred to as Original Medicare.
To be eligible for Original Medicare at age 65, you must meet the following requirements:
- You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.
- You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.
- You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.
You may also be eligible for Medicare benefits under 65 if:
- You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.
- You have ALS .
- You have End-Stage Renal Disease , and you or your spouse have paid Social Security taxes for a certain length of time.
If you have ESRD, you may be able to enroll in a Medicare Advantage plan or an Arkansas Medicare Special Needs Plan that is specifically designed to help meet your health care needs.
Give Lower Premium A Look Medicare Told
WASHINGTON — The nation’s top health official Monday directed Medicare to consider lowering the premium for the part of the program that covers visits to the doctor and other care outside hospitals. It marked the first time the vast federal health insurance system for older Americans and those with disabilities has rethought the monthly amount patients pay after a change has taken effect.
Health and Human Services Secretary Xavier Becerra gave the instructions to the Centers for Medicare and Medicaid Services, the agency that oversees the program, saying a review of the Part B premium is needed because of a price drop in a controversial Alzheimer’s drug that Medicare does not yet pay for but might begin covering soon.
Becerra’s directive comes just days before the agency is due to decide preliminarily whether to include the drug, Aduhelm, among the roster of medicines that Medicare covers. The Food and Drug Administration approved the drug in June, despite considerable dispute over whether there is enough evidence that it is effective.
Medicare is currently covering Aduhelm on a case-by-case basis.
Aduhelm’s manufacturer, Biogen, set its initial price at $56,000 — sparking an outcry from both the drug’s proponents and its critics. That price tag was part of the reason that, when the Medicare agency announced the Part B premium for 2022 in November, the monthly amount consumers must pay rose from $148.50 to $170.10.
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Where Can Medicare Beneficiaries Get Help In Arkansas
State Health Insurance Assistance Program
Free volunteer Medicare counseling is available by calling Arkansas State Health Insurance Assistance Program at 800-224-6330.
SHIPs are available to help beneficiaries enroll in Medicare, compare and change Medicare Advantage and Part D plans, and answer questions about state Medigap protections. They can also make referrals to local agencies for services like home care and long-term care. This website has the locations of regional SHIP partners in Arkansas.
Elder Law Attorneys
Elder law attorneys are a helpful resources for developing plans for Medicaid long-term care benefits. You can find a local elder attorney through the National Academy of Elder Law Attorneys search feature.
Legal Aid of Arkansas
Low-income Medicare and Medicaid beneficiaries in Arkansas may be able to receive help qualifying for health care benefits or accessing care from Legal Aid of Arkansas. The phone number for Legal Aids helpline is 1-800-9 LAW AID .
Where can I apply for Medicaid in Arkansas?
The Arkansas Department of Human Services administers the states Medicaid program. You can apply for Medicaid ABD or an MSP by calling 1-800-482-8988 or visiting a local DHS county office. The DHS website also contains printable applications for Medicaid ABD or the MSP, which you can submit by mail.
Do I Need Medicare Part D Prescription Drug Coverage
Medicare Part D prescription drug coverage will ensure that you dont have to pay full price for prescription medication that you need to take on a daily basis. Without this insurance, youll be responsible for the full cost of your medications.
If you wait until after your qualifying time to get Medicare Part D prescription coverage, you could end up paying an additional late fee for the life of your policy, even though signing up is optional.
Before signing up, make sure you look through the list of medications your preferred plan covers. This list is called a formulary. If your medication is not on the formulary, youll need another plan that covers it. These lists can change, and if they do, the insurance company will alert you to changes that have occurred.
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Arkansas Began Requiring Medigap Insurers To Offer Plans To People Under The Age Of 65 Starting In 2018
- Health insurance & health reform authority
- Medicare Advantage availability ranges from 11 plans to 46 plans, depending on the county.
- 42 insurers offer Medigap plans in Arkansas the state requires Medigap insurers to offer at least one plan to people under age 65, but they can be charged much higher premiums.
- There are 31 stand-alone Part D prescription plans available in Arkansas for 2021, with premiums that range from about $7 to $140 per month. Nearly half of all Arkansas Medicare beneficiaries have stand-alone Part D plans.
- Per-enrollee Original Medicare spending in Arkansas is just slightly lower than the national average.
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How Do You Choose Medicare Advantage Plans
To choose the right plan for you, be sure to consider the costs and benefits of the plan, such as:
- Premiums: The monthly cost of your plan. You will likely need to pay the Medicare Part B premium in addition to the premium for your MA plan. Some providers in Arkansas offer zero-premium MA plans. However, your other costs may be higher on a zero-premium plan.
- Other Costs
- Deductible: Your annual out-of-pocket costs for care before your plan starts paying for services.
- Coinsurance: This is the amount youll have to cover for the cost of medical care, usually as a percentage of the total cost.
- Copay: A fixed price for a certain medical service.
- Out-of-Pocket Maximum: A yearly cap on your out-of-pocket medical expenses, usually excluding premiums.
Most Medicare Advantage plans offer vision and dental coverage.
How To Apply For Medicaid In Arkansas
The Arkansas Medicaid application process is an opportunity for residents who cannot afford health insurance to obtain medical coverage. Learning how to apply for Medicaid in AR is beneficial for families who meet the eligibility requirements to receive Medicaid benefits. It is important for prospective applicants to understand what will be on the AR Medicaid application form and where to apply for Medicaid insurance in the state. If you are wondering, Can you apply for Medicaid online? or Where do you sign up for Medicaid in Arkansas? continue reading the outlined information below.
Where do you sign up for Medicaid in Arkansas?
While many states allow applicants to apply for Medicaid online, the state of Arkansas does not have a way to sign up for Medicaid via web. However, you may print the Medicaid form from the internet and fax it to 870-534-3421 or mail the form to:
DHS Jefferson County
P.O. Box 5670
Pine Bluff, AR 71611
If you are enrolled in the program, workers at the county office will provide you with more information on what health care services Medicaid covers and which medical providers are available to you. They will also ask you to pick a primary care physician.
Find out more about the requirements to receive benefits from Medicaid in our free guide.
Information Required on the Medicaid Application Form in Alabama
- Your name, birth date and Social Security Number
- Your before-tax income
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Types Of Medicare Advantage Plans In Arkansas
There are four types of plans available in Arkansass Medicare Advantage program: Health maintenance organization , preferred provider organization , private fee-for-service , and special needs plan . Each offers a different level of flexibility in your network of care providers and varies in price. All Medicare Advantage Plans provide the same coverage as Original Medicare, but additional benefits may come with an increased premium.
Does Arkansas Help With My Medicare Premiums
Medicare Savings Programs can help Medicare beneficiaries who struggle to afford the cost of Medicare coverage MSPs pay for Medicare Part B premiums and in some cases Part A premiums and well as Medicare cost sharing.
- Qualified Medicare Beneficiary : The income limit for this category is $1,064 a month if single and $1,437 a month if married. QMB pays for Part A and B cost sharing, Part B premiums, and if a beneficiary owes them it also pays their Part A premiums.
- Specified Low-income Medicare Beneficiary : SLMB pays for Part B premiums for beneficiaries who meet income limits of up to $1,276 a month if single and $1,723 a month if married.
- Qualifying Individuals : The income limit is from SLMB levels up to $1,436 a month if single and $1,940 a month if married. QI pays for Part B premiums.
MSP asset limits:
Income and asset limits for QMB, SLMB and QI vary based on an applicants marital status. However, eligibility rules for other Medicaid programs usually vary based on the number of household members.
Income limits for MSPs and Medicaid benefits are significantly higher for applicants who still are working, because only a little less than half of employment income is counted.
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How Many Have Medicare In Arkansas
Arkansas may be known as the home of the first Walmart. Arkansas also had more than 644,372 Medicare beneficiaries in 2020, according to a Kaiser Family Foundation analysis of Centers for Medicare & Medicaid Services enrollment files.
Private insurance companies must have contracts with Medicare to offer Medicare Advantage plans and Medicare Prescription Drug Plans.
Since contracts vary, not all plans are available in every service area in the state.
Each year, the plan must renew its contract with Medicare. In some cases, the availability of a plan in a specific service area may change.
Average Costs Of Medicare Advantage In Arkansas
The average monthly premium for a Medicare Advantage plan in Arkansas in 2022 is $44.34 per month, though you may be able to find plans where you live that offer $0 premiums.
- Average in-network out-of-pocket spending limit: $5,852.87
- Average drug deductible for Medicare Advantage prescription drug plans : $322.182
Individual plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.
A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.
Find a $0 premium Arkansas Medicare Advantage plan
Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
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Local Resources For Medicare In Arkansas
- Arkansas Senior Health Insurance Information Program : The Senior Health Insurance Information Program provides one-on-one counseling to Arkansas residents regarding Medicare health coverage, Medicare Supplement plans, and Medicare Advantage plans.
- Medicare Savings Programs in Arkansas: Some beneficiaries may find it difficult to pay for all the out-of-pocket costs associated with Medicare. As such, these programs may offer financial assistance to Medicare beneficiaries with limited income.
Medicare Spending In Arkansas
Original Medicares average per-beneficiary spending in Arkansas was slightly lower than the national average in 2018, at $10,044. That figure is based on data that were standardized to eliminate regional differences in payment rates, and did not include costs for Medicare Advantage. Nationwide, average per-beneficiary Original Medicare spending stood at $10,096.
Medicare spending in Louisiana was the highest in the nation, at $11,932, which was 18 percent higher than the national average. At the other end of the spectrum, per-beneficiary Medicare spending was lowest in Hawaii, at just $6,971.
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Medicare Enrollment In Arkansas
As of September 2020, there were 646,111 residents with Medicare in Arkansas. Thats more than 21 percent of the states population, versus about 19 percent of the total US population enrolled in Medicare.
Medicare enrollment happens for most Americans when they turn 65 either automatically, if theyre already receiving Social Security or Railroad Retirement benefits, or during a seven-month enrollment window when they can complete the process of filing for Medicare benefits.
But Medicare eligibility is also triggered for younger people if theyre disabled and have been receiving disability benefits for 24 months, or if they have ALS or end-stage renal disease.
Nationwide, 15 percent of Medicare beneficiaries are under the age of 65, but 22 percent of the people with Medicare in Arkansas are eligible due to disability rather than age.
Arkansas is tied with three other states Alabama, Kentucky, and Mississippi for the highest percentage of Medicare beneficiaries under the age of 65.