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As a Medicare beneficiary in Arkansas, you may find you need help paying for Original Medicare expenses like copayments, coinsurance, and deductibles, as well as other out-of-pocket costs. If so, a Medicare Supplement plan (or Medigap plan) may be a good option for you. Medigap plans in Arkansas are available through private insurance companies, and they’re designed to help cover expenses you may have under Original Medicare, Part A and Part B. Please note that if you’re enrolled in a Medicare Advantage plan, Medigap plans can’t be used to pay for plan costs.
As an Arkansas resident, you have a number of Medigap plan options, depending on the zip code in which you live. Here’s an overview of how Medicare Supplement insurance works in your state.
In Arkansas, as in most states, you have access to the 10 standardized Medigap plans available in most of the country (Massachusetts, Minnesota, and Wisconsin offer different standardized Medigap plans). Each Medigap plan is labeled with one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and plans of the same letter offer the same benefits.
Medicare beneficiaries in Arkansas already enrolled in Original Medicare, Part A and Part B, are eligible for Medigap plans. The best time to buy a Medicare Supplement plan is during your Medigap Open Enrollment Period, which is the six-month period that starts automatically on the first day you are both 65 or older and also enrolled in Medicare Part B. During this time, Medicare beneficiaries in Arkansas can sign up for any Medicare Supplement plan available in their service area. Insurance companies can’t reject them for coverage altogether due to pre-existing conditions or charge them more because of health. During your Medigap Open Enrollment Period, these special protections are known as guaranteed-issue rights. After your Medigap Open Enrollment Period has passed, it may be harder for you to enroll in a Medigap policy if you have health problems. The insurance company may subject you to medical underwriting and charge you more for coverage if you have health issues – or you could be denied coverage altogether. You may still have guaranteed-issue rights in certain situations (for example, if your insurance company misled you or goes bankrupt), but if you don’t, it may be much harder for you to change plans.
It’s important for you to know that Medigap plans in Arkansas, like those in other states, do not offer prescription drug coverage. If you need help to cover medication costs, you may want to get this through a stand-alone Medicare Part D Prescription Drug Plan, available through Medicare-contracted private insurance companies.
Remember that if you sign up for a Medigap plan in Arkansas, you must remain enrolled in Original Medicare, Part A and Part B for your health coverage. You’ll need to keep paying your Medicare Part B premium, in addition to any premium required by your Medigap policy. Medigap plans in Arkansas are meant to help with certain costs that Original Medicare doesn’t cover; these plans aren’t meant to be a substitute for your Original Medicare coverage.
It may be a good idea to study each Medigap plan available in your area before making your final decision. Plan benefits, costs, and availability can all vary by location, so always make sure to compare plan options in your specific zip code.
Here’s a look at the benefits that may be available under each of the 10 standardized Medigap plans in Arkansas. Keep in mind that not all 10 plans may be offered in your location; insurance companies aren’t required to sell all Medigap plan types. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Aside from covering certain out-of-pocket costs in Original Medicare, Medicare Supplement plans may also help with other costs that Medicare doesn’t cover, such as emergency foreign travel coverage or Part B excess charges. Excess charges are the 15% extra cost you may be responsible for, above the Medicare-approved amount for a service, if you use a provider that doesn’t accept Medicare assignment.
Even though Medicare Supplement plans in Arkansas with the same letter designation don’t vary in coverage or benefits, each independent insurance company offering Medicare Supplement plans is allowed to determine its own monthly premium structure, and the method that the company uses to set its plan premiums can affect how much you pay both when you enroll in the plan and later on. This also means that if you live in Little Rock, in Pulaski County, you may pay more or less than a resident of Magnolia in Columbia County for an identical Medicare Supplement plan. It can be to your advantage to compare all Medicare Supplement plans available to you in Arkansas, and then make your final choice based on your individual health and budget needs.
As you can see, you have many Medicare Supplement plan options in Arkansas, so it may be a good idea for you to understand what each plan has to offer before making your choice. Do you need help finding plan options that may meet your budget and coverage needs? Feel free to contact eHealth today to speak with a licensed insurance agent and get personalized assistance with your Medicare questions.