Medicare in Arkansas
Key Takeaways
- If you’re 65 or older, Medicare in Arkansas provides an affordable option for your healthcare needs.
- If you’re over 65 and facing financial hardship or a disability, you may qualify for both Medicare and Medicaid.
- Medicare Advantage plans substitute for Original Medicare while 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. Most Medicare Advantage plans include prescription coverage and additional benefits such as dental, vision, and hearing.
Original Medicare
- Part A is hospital coverage, which pays toward inpatient hospital stays, hospice care, and home health services.
- Part B is medical coverage, which pays toward medically necessary services and preventive care.
Prescription Drugs and Supplemental Coverage
- Part D is drug coverage for people on Medicare. 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 usually D. These plans also offer additional benefits such as dental, vision, hearing, and more.
Let’s find your ideal Medicare Advantage plan.
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:
- Enroll online with the Social Security Administration.
- Visit a local Social Security office.
- Enroll over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
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 vary for different programs. The easiest way to determine if you qualify for Medicaid in Arkansas is to either apply or call Arkansas Medicaid (1-800-482-8988).
Can I bundle multiple benefits into one plan?
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.
What Are the Parts of Medicare?
Original Medicare includes Part A and Part B coverage. Medicare Advantage (Part C) substitutes for Original Medicare and usually 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. While you can use Original Medicare nationwide, Medicare Advantage plans usually are restricted to a specific service area and require using a network of providers to get the most out of your coverage.
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 have the opportunity to switch to a five-star plan each year.
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.
Have questions about your Medicare coverage?
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 620,150 people are enrolled in Medicare Part A and B in Arkansas. The total number of beneficiaries enrolled in Medicare Advantage increased from 180,801 to 205,563 year over year. Medicare Advantage participation in Arkansas went from 29.63% to 33.15% 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.
620,150 Beneficiaries with Part A & Part B
205,563 Medicare Advantage Beneficiaries
33.15% Medicare Advantage Participation Rate
54.95% Female
45.05% Male
86.78% Non-Hispanic White
9.66% African American
1.39% Hispanic
2.17% Other/Unknown
18.11% Eligible for Medicaid
0.98 Average HCC Score
$9,720.81 Actual Per Capita Costs
17.72% Hospital Readmission Rate
27.62% % of Beneficiaries with an Emergency Department Visit
180,801 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
29.63% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
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.
AR SHIIP - Medicare counseling
https://insurance.arkansas.gov/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
https://insurance.arkansas.gov/consumer-services/senior-medicare-patrol-smp/
What should I know about the Senior Medicare Patrol?
Helps Medicare beneficiaries protect themselves against fraud and deal with potential billing errors.
Arkansas Medicaid
Phone lines open M-F, 8 a.m. to 4:30 p.m.
https://humanservices.arkansas.gov/divisions-shared-services/medical-services/
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
https://www.arlegalservices.org
What 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 a GoHealth insurance agent that is licensed in Arkansas about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration 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
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
Apply for Benefits. SSA.gov.- Social Security Office Locator. SSA.gov.
- Division of Medical Services. Arkansas.gov.
- Special Enrollment Period. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.