Compare Medicare Advantage plans and quote side-by-side to get the best rate here.
When it comes to getting Medicare in Arkansas, you may feel mystified by the sheer number of options and choices available to you. From the alphabet soup of Medicare plans to understand the difference between Medigap plans and Medicare Advantage plans, it can certainly feel confusing.
Fortunately, at Benzinga, we’ve done the work of researching a variety of top Medicare options in Arkansas to help you decide on the best choice for your health and well being.
The Best Medicare Insurance in Arkansas:
- Best Overall: Humana
- Most Affordable: UnitedHealthcare
- Best for Choosing Your Own Doctors: Humana
- Best for Low Out-of-Pocket Maximums: Humana
- Best for Healthy Individuals: BCBS
What is Medicare?
Medicare is a federal health insurance program that covers a variety of expenses related to healthcare. It is designed for individuals 65 and older.
Like Social Security, Medicare is something that most U.S. citizens pay into over time. Generally, this money comes out of their paychecks before they receive them, so their contribution is automatic. Medicare is divided into parts, commonly known as Part A, Part B, Part C and Part D.
Part A: Part A covers inpatient hospital care, as well as a limited amount of care in a specialized nursing care facility. It also covers limited home health care and hospice care. Like other forms of health insurance, Medicare doesn’t cover the full amount of your hospital bill. You’ll have to pay a percentage of the cost as well as a deductible before Medicare covers the rest.
Part B: Medicare Part B is medical insurance. It covers expenses not related to a hospital stay, including doctor visits, x-rays, blood tests and outpatient hospital care. You typically pay a monthly premium for this part. Just like with Part A, you’ll pay a deductible until your Part B benefits become active. You’ll typically pay 20% of the bill if you go to doctors who accept Medicare.
Medicare pays the full cost of a majority of lab tests ordered by your doctor.
Part C: Also known as Medicare Advantage, this is a type of insurance that includes each type of Medicare as well as additional benefits. Part C is typically offered by private insurance companies as an alternative to original Medicare.
You aren’t required to enroll in a Medicare Advantage plan, but it may be much more cost-effective while offering a number of other benefits, including things that original Medicare doesn’t cover, like eye and hearing exams, dental care, and healthcare when traveling outside the U.S.
Part D: Medicare Part D plans cover prescription drug coverage. It is a standalone program offered through private insurance companies and enrolling in Part D is optional. Depending on the plan you’re enrolled in, you may have to pay a deductible and a flat copayment amount or a percentage of the full cost of the drug, known as coinsurance.
Legalities of Medicare in Arkansas
Medicare is administered by the Centers for Medicare and Medicaid Services (CMS), which itself is a division of the U.S. Department of Health and Human Services. Medicare is funded by the Social Security Administration through the taxes that we all pay.
You pay 1.45% of your earnings into FICA, the Federal Insurance Contributions Act. Your employer pays another 1.45% which brings the total to 2.9%.
Although Medicare coverage starts the day you turn 65, you don’t have to wait until your birthday to sign up. Your initial Medicare enrollment period starts 3 months before the month you turn 65 and ends 3 months after.
Types of Medicare Advantage Plans
Medicare Advantage plans are health insurance plans offered by private insurers that contract with Medicare to provide your Part A and B benefits. Like insurance plans, the majority can be divided into HMO (Health Maintenance Organization) plans and PPO (Preferred Provider Organization) plans.
HMO: With an HMO plan, you generally must receive care from doctors and hospitals within your network. You will likely also need to get a referral from your primary doctor to see a specialist. The exceptions are emergency care, out-of-area urgent care and out-of-area kidney dialysis.
Prescription drugs are generally covered in HMO plans, and if for some reason your doctor leaves the plan, you’ll be notified and can choose another doctor. If you receive healthcare outside of the network, you may have to pay the full cost.
PPO: Like an HMO, a Medicare PPO Plan charges you less if you use doctors within their network but you can still see any doctor, healthcare provider or hospital. You’ll pay more if you go outside of the network, but you have greater flexibility than with an HMO. Unlike an HMO, you don’t need to choose a primary doctor and you generally don’t need a referral to see a specialist. Prescription drugs are usually covered in PPO plans.
PFFS: A “private fee-for-service” plan is another type of Medicare Advantage plan. Unlike HMOs and some PPOs, a PFFS plan doesn’t require a referral to see a specialist. The plan negotiates the rates that it pays to healthcare providers.
If your doctor or hospital accepts a PFFS plan’s treatment terms for one treatment, it doesn’t mean that they’ll automatically accept all future payments for other services that they provide to you. Be sure that your doctor accepts the plan’s payment terms before you move ahead with service.
How to Sign Up for Medicare in Arkansas
There are several options available for signing up for Medicare in Arkansas. Keep in mind that signing up for Medicare is not the same as signing up for a Medicare Advantage Plan or Medicare Supplemental Insurance. Medicare has very specific enrollment time frames that depend on when you turn 65 and the circumstances surrounding this milestone.
- If you’re already collecting Social Security benefits or Railroad Retirement Board benefits when you turn 65, you’ll automatically be enrolled in Medicare Part A.
- If, at the time you signed up for retirement benefits, you also enrolled in Medicare Part B, you’ll also automatically be enrolled in this part of Medicare.
- If you live outside of the U.S. or D.C. (for example, if you live in Puerto Rico or elsewhere), you’ll automatically be enrolled in Medicare Part A but will need to manually enroll yourself in Part B.
Although in most cases, enrolling in Medicare Part A is automatic, there are some instances where you may have to enroll yourself manually:
- If you aren’t receiving retirement benefits and are within your enrollment period, you can enroll in Medicare only and defer your retirement benefits to a later time.
- If you’re not eligible to receive retirement benefits, you will not be enrolled in Medicare Part A and B. However, you can still sign up for them during your enrollment period. You may have to pay a premium.
Average Cost of Medicare Advantage Plans in Arkansas
The amount you pay for a Medicare Advantage plan will depend upon whether you want to include a Part B premium, how much of a deductible you want to pay, and more.
|Plan Name||Company||Plan Type||Health & Drug Costs|
|AARP Medicare Advantage Plan 1||UnitedHealthcare||HMO||$0 Medicare Advantage with drug coverage monthly premium; does not include $135.50 Part B premium and $250 prescription drug deductible|
|Humana Honor||Humana||PPO||$0 Medicare Advantage without drug coverage monthly premium; $4,900 in-network and $10,000 out of network out of pocket maximum; no prescription drug coverage|
|HumanaChoice||Humana||PPO||$34 Medicare Advantage with drug coverage monthly premium; does not include $135.50 Standard Part B premium; includes a $1,000 annual deductible and a $195 drug deductible; $10,000 out-of-network and $6,700 in-network, out-of-pocket maximum; pay $0 for primary doctor visits and $50 per visit to a specialist|
|AARP Medicare Advantage Plan 2||UnitedHealthcare||HMO||$53 Medicare Advantage with drug coverage monthly premium; $0 health plan deductible and drug deductible plus a $0 primary doctor copay; specialist visits $25 per visit|
|AR Blue Cross Medi-Pak Advantage||Arkansas Blue Cross and Blue Shield||PFFS||$59 Medicare Advantage (without drug coverage) monthly premium with a $1,000 out-of-network health plan deductible; $6,700 in-network and out-of-network max, plus a $30 per visit fee to see a primary doctor and $50 per visit fee to see a specialist; no prescription drug coverage|
Best Medicare Insurance Providers in Arkansas
As you’ve seen, Medicare insurance providers in Arkansas can vary greatly between the types of plans they offer and the coverage options included in those plans. To get the best possible coverage, we encourage you to get a direct quote on Medicare coverage from the companies we’ve reviewed below.
1. Best Overall in Arkansas: Humana
With a variety of affordable plan types to fit nearly any budget or healthcare coverage need, Humana’s plans are flexible and accommodating.
Although the out-of-network, out-of-pocket maximum is higher than competing plans, the Humana network encompasses a wide range of doctors, specialists and hospitals across Arkansas.
2. Most Affordable in Arkansas: UnitedHealthcare
For sheer affordability, it’s hard to beat UnitedHealthcare.
If your primary care physician is part of the HMO network, you’ll save a considerable amount of money when compared to a PPO plan.
You’ll still need a referral from your doctor to see a specialist, but it’s a small price to pay when you add up all the savings you get by going to local doctors and medical providers.
3. Best for Choosing Your Own Doctor and Hospital: Humana
If you want to choose the doctor and hospital you go to, few Medicare Advantage companies can give you the level of freedom that Humana does.
Although you’ll pay more for a PPO plan than an HMO plan, the trade-off is being able to choose your preferred doctor and hospital.
If you have a practice you like and a doctor you trust, you can’t put a price on this kind of flexibility and convenience.
4. Best for Low Out-of-Pocket Maximums: Humana
Although the out-of-pocket maximum for in-network and out-of-network care from a Humana PPO is not as low as an HMO, Humana nevertheless has managed to bridge the gap in terms of affordability and flexibility.
Giving you the lower costs traditionally associated with HMOs, along with a greater degree of freedom in choosing your medical providers that PPOs typically offer.
5. Best for Healthy Individuals: Blue Cross and Blue Shield
If you simply want a plan that covers the basics, take a closer look at BCBS of Arkansas. Low copays for doctor visits and specialists, low deductibles and a low plan premium make this a solid choice for a no-frills plan.
Getting Comprehensive Medicare Coverage in the Land of Opportunity
In Arkansas, the Land of Opportunity, getting Medicare insurance coverage doesn’t have to be complicated. Get estimates from the companies profiled here to find the deal that works best for your needs. But you have to act quickly before the enrollment period ends, or else the opportunity to enroll and save will slip right through your fingers!
Frequently Asked Questions
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.