Medicare in Arkansas
Before acting, get all the facts about Medicare in Arkansas
Reviewed by: Selah Lee, Licensed Insurance Agent. Written by: Bryan Strickland.
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Key Takeaways
If you’re 65 or older, Medicare in Arkansas provides an affordable option for your healthcare needs.
If you’re 65 and facing financial hardship or a disability, you may qualify for both Medicare and Medicaid in Arkansas.
While Original Medicare is the starting point, Medicare Advantage plans in Arkansas replace Part A and B benefits while also offering additional services like dental, vision and more.
The capital of Arkansas is Little Rock, but the state also is known for some big rocks.
According to National Geographic, Arkansas is the only state that actively mines diamonds. Crater of Diamonds State Park is the only place in the world where visitors can search for diamonds within their original volcanic source.
While the prospect of finding a diamond in the rough is appealing, your chances are slim if you’re digging in the dark. The same concept applies to your healthcare journey, but GoHealth is here to shed some light on Medicare options in Arkansas.
What Does Medicare Cover in Arkansas?
Medicare in Arkansas looks a lot like Medicare in other states because it’s a federal health insurance program that provides affordable coverage options to U.S. citizens age 65 and older and some individuals with disabilities. Original Medicare includes Parts A (“hospital insurance”) and B (“medical insurance”).
Medicare beneficiaries also have an opportunity to add Part D (prescription) and/or supplement plans (Medigap). Medicare Advantage in Arkansas is sometimes referred to as Part C because it replaces Medicare Parts A and B. Some Medicare Advantage plans include prescription coverage and/or additional benefits such as dental, vision and hearing.
Original Medicare
- Part A is hospital coverage, which pays towards inpatient hospital stays, hospice care, and home health care services.
- Part B is medical coverage, which pays towards medically necessary services and preventive care services.
Prescription Drugs and Supplemental Coverage
- Part D is drug coverage for people with Parts A and/or B. Private insurance companies administer these plans.
- Medigap is supplemental insurance for people with Parts A and B that helps control out-of-pocket costs associated with premiums, copays, and coinsurance.
Medicare Advantage
Part C is private insurance approved by Medicare, and it combines Parts A, B and sometimes D. These plans also offer additional benefits such as dental, vision, hearing and more.
How do I apply for Medicare in Arkansas?
If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply. Your first chance to sign up is during your Initial Enrollment Period, a seven-month window that begins three months before the month of your 65th birthday and ends three months after you turn 65.
Your choices for applying for Medicare in AR include:
What is the Income Limit for Arkansas Medicaid?
While Medicaid supports some people regardless of age because of a qualifying disability, an “income limit” can come into play for those seeking assistance via Medicaid because of financial hardship.
Because each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965, the income limits are different for different programs offered by the state. The easiest way to determine if you qualify for Medicaid in Arkansas is to either apply or call Arkansas Medicaid (1-800-482-8988) to find out if you should apply.
Who is Eligible for Medicaid in Arkansas?
If you’re 65 or older, it is possible to be eligible for both Medicare and Medicaid in Arkansas. This is called dual eligibility.
Medicaid takes many forms in Arkansas, including the one-of-a-kind Arkansas Works program that partners with private insurance. The state also offers what it calls a “Medicaid Spend-Down” that provides temporary assistance to Arkansans who don’t qualify for Medicaid but are going through a period when a large portion of their income is devoted to medical expenses. [3]
What are the Different Plans of Medicare?
There are several Medicare plans, and they include Part A, Part B, Medicare Advantage (Part C), Part D and Medicare Supplement plans. Original Medicare includes Part A and Part B coverage. Medicare Advantage (Part C) replaces Original Medicare but offers the same Part A and B benefits as Original Medicare.
Along with receiving Part A and B benefits, Medicare Part C often bundles your benefits with additional ones like dental, hearing, vision and prescription drug coverage. When you have Medicare Part C, your Part C benefits ID card replaces your Medicare red, white and blue card at every visit.
- Medicare Advantage combines the benefits of Original Medicare, but you still get the same Part A and B coverage.
- Medicare Advantage plans sometimes cover prescription drugs. These are called Medicare Advantage Prescription Drug plans.
- While you can use Original Medicare nationwide, Medicare Advantage plans usually are restricted to a specific service area and may require the use of a network of providers.
Which Company Has the Best Medicare Advantage Plan?
The Centers for Medicare & Medicaid Services has a Medicare Star Rating system that assigns a rating of one to five stars (five being the highest-rated) to individual Medicare Advantage plans.
If you’re already on a Medicare Advantage plan and it’s not five-star rated, you are offered the opportunity to switch to a five-star plan each year. [4]
While the rating system can shed light on a Medicare Advantage plan’s performance, the enrollment process is not as simple as just picking the highest-rated plan. A GoHealth licensed insurance agent can help you compare plans and find the one that’s the right fit for you.
Medicare in Arkansas by the Numbers
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 602,253 people are enrolled in Medicare in Arkansas. The total number of beneficiaries enrolled in Medicare Advantage in Arkansas is 163,501. The previous year, 147,024 enrolled in Medicare Advantage. Medicare Advantage participation in Arkansas went from 24.77% to 27.15% year over year. If you’d like to dive deeper into how Medicare in Arkansas breaks down across the state, we provide a glance at who is using Medicare, and how.
Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Arkansas Medicare Resources & Contacts
Beneficiaries spend an average of $9,382.97 each year on Medicare in Arkansas. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Arkansas-based resources, like these, may be able to help:
AR SHIIP - Medicare counseling
1-800-224-6330 or 501-371-2782
https://insurance.arkansas.gov/pages/consumer-services/senior-health/What should I know about AR SHIIP?
The Arkansas Senior Health Insurance Information Program provides free, unbiased Medicare advice to residents.
Senior Medicare Patrol
1-866-726-2916
https://humanservices.arkansas.gov/divisions-shared-services/aging-adult-behavioral-health-services/senior-medicare-fraud-patrol/What should I know about the Senior Medicare Patrol?
Helps Medicare beneficiaries protect themselves against fraud and deal with potential billing errors.
Arkansas Medicaid
1-800-482-8988 (eligibility) or 1-800-482-5431 (coverage)
Phone lines open M-F, 8 a.m. to 4:30 p.m.
What should I know about Arkansas Medicaid?
This state organization administers the federal Medicaid program and other cost-savings programs geared toward residents in need.
Legal services for seniors
1-800-952-9243 or 501-376-3423 (depending on your county)
http://www.arlegalservices.org/sites/default/files/Help%20Line%20Final%20Draft.pdfWhat should I know about legal services for seniors?
The state sponsors a pair of nonprofit organizations offering free legal services to qualifying Arkansas seniors in need.
Nationwide Resources
Speak with an insurance agent that is licensed in Arkansas about your Medicare questions.
1-855-792-0088 TTY: 711Monday - Friday, 8 AM - 9 PM CT
Medicare & Medicaid
If you have general questions about Medicare in AR, or need help with current Medicare benefits.
1-800-MEDICARE (1-800-633-4227)Social Security Administration
You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET