Medicare Advantage plans are offered by private insurance companies to replace Parts A and B coverage provided by Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). as well as additional coverage.
All Arkansas residents had access to at least one $0 premium Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plan in 2022.
Many Medicare Advantage plans in Arkansas offer Part DMedicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. prescription drug coverage.
In 2022, 82 Medicare Advantage plans were available in Arkansas. With Medicare Advantage, the availability of plans varies by geographic location.
If you enroll in Parts A and B of Original Medicare, you have the option of switching to a Medicare Advantage plan offered by a private insurance company. Medicare Advantage plans in Arkansas must offer the same coverages as Parts A and B and often offer prescription coverage and may offer other benefits not available from Original Medicare.
Every Arkansas resident eligible for Medicare had access to at least one Medicare Advantage plan with a $0 monthly premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. in 2022. Some plans offer innovative additional benefits like wellness planning, cost sharing and incentive programs for healthcare participation.
Different plan types exist within Medicare Advantage. The most popular Medicare Advantage plan types in Arkansas are:
- HMO: Also known as a Health Maintenance Organization, HMOs were the most popular type of Medicare Advantage plan in Arkansas. This plan type requires you to choose an in-network doctor to be your primary care provider. Your primary care provider can refer you to an in-network specialist if need be.
- PPO: Also known as a Preferred Provider Organization, PPOs are similar to HMOs, except PPOs will usually pay a portion of fees for out-of-network providers while HMOs do not.
- PFFS: Also known as a private-fee-for-service plan, PFFS is a plan option where an enrollee can see any medical providers who accept their plan’s terms.
Each available plan should outline its coverage so you can determine the plan that is right for you. Remember that Medicare Advantage plans may offer coverage that exceeds Original Medicare benefits. Examples may include vision, hearing and dental benefits as well as delivered meals after surgery or a hospital stay.
Find a local Medicare plan that fits your needs
Medicare Advantage plans have premiums starting at $0. However, the average monthly Medicare Advantage premium in Arkansas was $11.55 in 2022.
When you choose Medicare Advantage, you may have a monthly Medicare Advantage premium as well as your monthly Part B premium. For 2022, the Part B premium was $170.10. However, if you have an income level higher than $91,000 on your individual tax return or $182,000 on your married filing jointly return, you will have to pay a higher Part B premium.
There are key considerations regarding costs for your Medicare Advantage plan that extend beyond the monthly premium. These include a deductible you must meet before insurance pays, as well as copaymentsA copayment is the fixed amount you pay directly to your provider for medical services or prescription drugs covered in your plan. For example: If your plan includes a copayment of $20 for office visits, you'll pay $20 to your doctor whenever you have an appointment. and coinsuranceCoinsurance is the percentage of your medical costs that you pay after you meet your deductible. Your insurance company pays the remaining amount. For example: If you have a $1,000 medical bill and your coinsurance is 20%, you'll pay $200. Your insurance company will cover the final $800.. When you take these factors into account, a $0 premium plan could actually be the more expensive option long-term should you require significant healthcare services. GoHealth can help you find the right plan for your circumstances.
Under Original Medicare, you usually pay a 20-percent copayment for Part B benefits. Medicare Advantage companies do not usually set their cost structure like this. Instead, they usually set a per-visit copayment for services that may include a flat fee per physician visit.
Medicare outlines several key times you can enroll in Medicare Advantage. The first is your Initial Enrollment Period. This is the time when you first qualify for Medicare. Most people in Arkansas will qualify for Medicare based on their age. The three months before, the month of, and the three months after you turn age 65, you can sign up for Part A and B of Original Medicare. If you sign up for both parts, you are eligible to switch to Medicare Advantage.
When you have Medicare Advantage, you will receive a new card detailing your policy. While you should keep your Original Medicare card in a safe place, you will primarily use your Medicare Advantage card when providing billing information for healthcare services.
If you already have a Medicare Advantage plan, you can enroll in a new one if you wish at key times during the year. The Medicare Open Enrollment Period, also known as the Annual Enrollment Period, is from October 15 through December 7. Even if you are happy with your current Medicare Advantage plan in Arkansas, it may be worth taking a look at available options to see if you could find a plan that could save you money or offer enhanced services.
Are you eligible for cost-saving Medicare subsidies?
Medicare enrollees can benefit from a Part D prescription drug plan. Private insurance companies offer standalone plans if you are on Original Medicare, or Medicare Advantage plans that incorporate Part D coverage.
The Part D Senior Savings Model, new in 2021, assures that people on participating plans are offered insulin at a cost that does not exceed $35 a month. For those who rely on insulin to manage their diabetes, choosing a Part D plan that participates in the Part D Senior Savings Model has the potential to significantly reduce their monthly costs. Not all plans participate in this model, so it’s important to perform careful research. A GoHealth licensed insurance agent can help.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement