Medicare offers healthcare coverage to Arkansas residents age 65 or older, or to those Arkansas residents that suffer from certain medical disabilities. In 2016, 580,000 people are enrolled in Medicare in Arkansas, accounting for 19.8% of the population in Arkansas. In 2009 approximately $8,949 was spent per Medicare enrollee in Arkansas, about 13.66% lower than the national average of $10,365. Between 2015 and 2030 the number of seniors living in Arkansas is expected to increase by 40.29% and therefore the number of individuals enrolled in Medicare is also estimated to rise.
Residents of Arkansas can receive free one-on-one Medicare counseling and education from the Arkansas Senior Health Insurance Information Program (SHIP). Additionally the Administration on Aging (AoA), a division of the Department of Health and Human Services (HHS) developed a program called Senior Medicare Patrol (SMP) which teaches seniors about Medicare fraud and abuse and how to report such instances. The program also educates Medicare recipients on how to protect their personal information and how to recognize services which are unnecessary and illegal healthcare marketing methods.
You can sign up for Medicare Part A (hospital services) and Part B (medical services) through the Federal government. Part A is generally paid for by paycheck deductions from your working years (or your spouse's) but most Medicare beneficiaries pay for Part B through monthly premiums unless they qualify for financial assistance. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. If you qualify for Original Medicare (Parts A & B) or if you are already enrolled in it, then you have the option to enroll in Medicare Part C (also called Medicare Advantage) or Part D (a stand alone prescription drug plan). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Many Medicare beneficiaries will elect to enroll in a Medicare Advantage plan that includes prescription drug coverage (MAPD) or purchase a stand alone prescription drug plan to go with their Original Medicare coverage. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Additional benefits of Medicare Advantage plans such as dental, vision, or hearing coverage can help reduce out-of-pocket expenses for seniors with certain medical needs.
Using CMS data HealthPocket found that:
- The average total monthly premium for a 2017 Medicare Advantage plan in Arkansas is $42.74, 31.59% less than the national average of $62.48. 22.69% of 2017 Medicare Part C insurance plans in Arkansas have a $0 monthly premium.
- The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in Arkansas the average annual drug deductible for Medicare Part C insurance plans with drug components is $179.70. 26.63% of 2017 Medicare Part C insurance plans with a drug component in Arkansas have a $0 annual drug deductible.
- The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in Arkansas is $11.84. 59.81% of 2017 Medicare Part C insurance plans without a drug component in Arkansas have a $0 monthly premium.
- The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in Arkansas is $6124.91. 17.39% of 2017 Medicare Advantage plans in Arkansas had a medical out-of-pocket limit of $4,500 or less.
To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).
- The average overall CMS star rating assigned to Medicare Part C insurance plans in Arkansas was 3.2 stars in 2017.
- Among Arkansas's 2017 Medicare Advantage plans with CMS star ratings:
- 5.03% earned a score of 4 or 4.5 stars
- 71.2% earned a score of 3 or 3.5 stars
- 21.60% earned a score of 2.5 stars
- 2.58% of plans are “Not enough data available” or “Too new to be measured”.
Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation