As a Medicare beneficiary in Arkansas, you may choose to receive your Medicare benefits through Medicare Advantage (Medicare Part C), which is an alternative way to receive your Original Medicare benefits. You would then receive coverage through a private insurance company contracted with Medicare rather than through Original Medicare, Part A and Part B. If you opt for Medicare Advantage in Arkansas, your choice of additional benefits would depend on the zip code in which you live and on the health insurance plan you select.
How Medicare Advantage works in Arkansas
The US government requires Medicare Advantage to offer at least the same benefits as Original Medicare, Part A and Part B (but you’ll still receive hospice care coverage through Part A). In Arkansas and the rest of the United States, Medicare Advantage plans are available through Medicare-approved private insurance companies, and they cover the same hospitalization and medical benefits offered by Original Medicare. Some plans may offer additional benefits, like vision, hearing, and dental, to name a few.
As a Medicare beneficiary in Arkansas, you are required to sign up for Original Medicare, Part A and Part B, during your Initial Enrollment Period, which begins three months before you turn 65, includes your birthday month, and ends three months after that month. If you don’t sign up for Original Medicare during this seven-month span, you may enroll at a later date, during the annual General Enrollment Period, which runs from January 1 to from March 31, but you may incur a late-enrollment penalty, for as long as you remain enrolled in Medicare.
If you’re already enrolled in a Medicare Advantage plan in Arkansas but need to switch plans to obtain different coverage, you can change plans during the fall Open Enrollment Period, also called the Annual Election Period, which runs from October 15 to December 7. Your new coverage will then go into effect on January 1 of the following year.
As an Arkansas Medicare beneficiary, you may also be able to switch Medicare plan options during Special Enrollment Periods. If you lose your current coverage, qualify for other coverage, experience changes in your current plan that affect your health benefits, move to a new address where your old plan may not be available, or go through other, specific life-changing events, you may switch Medicare Advantage plans during a Special Enrollment Period. Be aware that these periods vary according to your health plan and the reason you need to switch plans.
If for some reason you decide to leave your Medicare Advantage plan and switch back to Original Medicare, Part A and Part B, you can do so during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year in Arkansas and the rest of the United States. During this period you can also switch from one Medicare Advantage plan to another. If you disenroll from your Medicare Advantage plan, you’ll be able to join a Medicare prescription drug plan to go alongside your Original Medicare.
Types of Medicare Advantage plans in Arkansas
If you decide to enroll in a Medicare plan option provided by a Medicare-approved private health insurance company, you may have a number of health plans available to you as Medicare beneficiary in Arkansas. Here’s a look at the main types of existing Medicare Advantage plans in Arkansas.
Health Maintenance Organizations (HMOs) are among the most popular Medicare Advantage plans. HMO plans generally require Medicare Advantage beneficiaries to visit doctors, health-care providers, and hospitals included in their network, and they may also require beneficiaries to get a referral from their primary doctor to receive coverage for a number of health services. Those seeking a more flexible option can sign up for an HMO Point-of-Service (HMO-POS) plan, which sometimes lets beneficiaries in Arkansas go out of network for certain health services, but generally at a higher cost.
Medicare Advantage plan options in Arkansas also include Preferred Provider Organization (PPO)* plans, which offers even more flexibility than HMO-POS plans, letting beneficiaries choose doctors, health-care providers, and hospitals outside of the plan’s network, but again at a higher cost.
Arkansas residents also have the option to sign up for Private Fee-for-Service (PFFS) plans. These types of Medicare Advantage plans generally reserve the right to decide how much they will pay for your doctor, health-care provider, and hospital visits. PFFS plans also determine your share of each expense. Medicare Advantage beneficiaries in Arkansas may also select a Medical Savings Account (MSA) plan, which combines a high deductible with a savings account that beneficiaries use to pay for their health-care expenses.
In Arkansas, Medicare Advantage beneficiaries with specific health concerns can enroll in a Medicare Special Needs Plan (SNP). A Medicare SNP limits enrollment to people with special health needs, those living in institutions, or people who qualify for both Medicare and Medicaid. SNPs offer coverage tailored to suit those specific needs. There are Medicare SNPs for HIV/AIDS patients, for example, for patients with congestive heart failure, and for those suffering from diabetes, among other things.
Medicare Advantage plans in Arkansas also include Medicare Advantage Prescription Drug plans, which combine health and prescription drug coverage into a single insurance plan.
Remember that even if you choose to enroll in a Medicare Advantage or Medicare Advantage Prescription Drug plan in Arkansas, you need to continue paying your Medicare Part B premiums in order keep your health coverage (along with any Medicare Advantage plan premiums, and any copayments, coinsurance, and deductibles).
Comparing Medicare Advantage plans available in Arkansas
As a Medicare beneficiary, it’s important for you to compare all your available options when selecting a Medicare Advantage plan in Arkansas.
Understand that the availability and cost of Medicare Advantage plans varies depending on your state and county of residence. It’s common for premiums of a Medicare Advantage plan with the same coverage and benefits to vary between different counties within the state of Arkansas. You may find that some Medicare Advantage plans in Arkansas offer premiums as low as $0; but always keep in mind that you must continue paying your Medicare Part B premiums, no matter which Medicare Advantage plan you choose, in order to keep your Medicare insurance coverage.
Also remember that some Medicare Advantage plans may offer additional benefits beyond what is included in Original Medicare, Part A and Part B. You also need to decide whether or not you want prescription drug coverage with your Medicare Advantage policy through a Medicare Advantage Prescription Drug plan. With all these options available in Arkansas, you can see why it can be important to compare plans with the benefits and costs best suited for your individual health requirements.
For more information about Medicare insurance plans in Arkansas, access the following resources:
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.