Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Original Medicare is Medicare’s traditional fee-for-service health care system operated by the federal government through the Centers for Medicare and Medicaid Services. Alternately, Medicare Advantage provides another way to receive the same health care coverage as Original Medicare, but private companies authorized by CMS provide Medicare Advantage coverage offer it. Medicare Advantage plans, sometimes called MA plans or Medicare Part C, may also operate on a fee-for-service basis. However, MA plans may also have programs that include value-based or bundled payments. MA plans include the same Medicare-covered benefits, such as hospital care and doctor visits, but they also offer extra benefits that Original Medicare doesn’t.
Arkansas had about 644,000 Medicare recipients in 2020, including more than 183,500 enrollees in Medicare Advantage plans. That’s about 28.5% of the total participants and much lower than the national average of 38%. Medicare beneficiaries who opted for MA plans in Arkansas jumped to nearly 33% in 2021. However, the number of new enrollees in the Medicare system is rising more slowly in Arkansas compared to some states. The program only gained about 5,500 participants by the 2022 plan year.
The average Medicare Advantage premium dropped from $13.77 in 2021 to $11.55 in 2022, but the number of available plans also dropped from 84 to 82. This decrease differs from many states where available MA plans increased. Nationwide, many Medicare Advantage firms expanded their coverage areas, and 20 new firms joined the market for the first time in 2022, resulting in more plans in more locations.
This guide offers a detailed overview of Medicare Advantage in Arkansas, including a look at the top providers and types of plans available. It also covers how Medicare Advantage works, what MA plans cover, eligibility requirements and how to find and enroll in these plans in Arkansas.
The Top 10 Medicare Advantage Plans in Arkansas
Private insurance companies offer Medicare Advantage plans that may be unique to the geographic area and patient populations they serve. Although plan options decreased in Arkansas in 2022, Medicare beneficiaries still have access to several different types of plans in the state. Arkansas also boasts various providers serving one or more areas of the state. Below is a list of the top 10 Medicare Advantage providers in Arkansas based on total enrollment. Because providers typically offer multiple plans, the table combines enrollment numbers from all plans to create a total for ranking purposes. The list also provides average cost ranges for each provider and their Medicare star rating for comparison. This information is current as of April 2022. Visit Medicare.gov for the most up-to-date information on available plans.
Name
Total Enrollment
Star Rating
Min Cost
Max Cost
Plan Types
UnitedHealthcare
89,377
4
$0
$54
HMO, PPO
Humana
63,023
3.5
$0
$132
HMO, PPO, PFFS
Wellcare by Allwell
24,904
3.5
$0
$26
HMO
Arkansas Blue Medicare
18,261
3.5
$0
$100
HMO, PPO, PFFS
Aetna Medicare
17,574
4
$0
$0
HMO, PPO
Wellcare
17,194
3.5
$0
$23
HMO, PPO
Cigna
5,298
4.5
$0
$0
HMO
Health Advantage
2,795
3.5
$0
$0
HMO
Tribute Health Plans
1,158
0
$0
$0
HMO
Vantage Health Plan
544
0
$0
$27
HMO
How Medicare Advantage Plans Work in Arkansas
Medicare Advantage plans offered by approved private insurance companies aren’t all the same. Beneficiaries will find several different types of MA plans depending on their location and the insurance provider. Each plan type has distinct parameters, such as network rules, the ability to see specialists and coverage for out-of-network services. The most common plan types are Health Maintenance Organization plans (HMOs) and Preferred Provider Organization plans (PPOs). Some providers may also offer Private-Fee-For-Service (PFFSs) plans and Special Needs Plans (SNPs) in some parts of Arkansas. Below is an overview of Medicare Advantage plans in Arkansas and how they work.
What Medicare Advantage Plans Cover in Arkansas
Medicare designed Medicare Advantage plans to be an all-in-one solution. They combine Medicare Part A, usually referred to as hospital insurance for inpatient care and Medicare Part B, typically called medical insurance for outpatient and preventative care. Hospice care is not covered by Medicare Advantage, and remains covered under Medicare Part A. Most plans also bundle Medicare Part D to provide prescription drug coverage. Original Medicare doesn’t include prescription drug coverage, so beneficiaries must purchase Part D separately. Medicare Advantage plans usually cover various other health-related services that traditional Medicare doesn’t. More than 90% of individual MA plans nationwide provided fitness, telehealth, vision, hearing and/or dental benefits in 2022.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Arkansas
Seniors aged 65 and older and younger individuals with qualifying disabilities are eligible for Medicare; thus, they qualify for Medicare Advantage. A disability usually qualifies an applicant if the person has received Social Security Disability Insurance payments for at least 24 months. Individuals may also enroll in Medicare Advantage if they’ve been diagnosed with amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD), also called end-stage kidney disease or renal failure.
Eligible recipients wanting to enroll in an Arkansas Medicare Advantage plan must have Medicare Parts A and B. They can’t have Medigap insurance, which they can’t combine with MA plans. Beneficiaries with a preexisting condition are also eligible for Medicare Advantage in Arkansas. To receive a specific MA plan, the recipient must live in the plan’s service area. Medicare beneficiaries must be U.S. citizens or lawful U.S. residents. To join or switch Medicare Advantage plans, applicants must do so during an open enrollment period or special enrollment period, as outlined below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Arkansas
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
The Arkansas Insurance Department heads up the Senior Health Insurance Information Program (SHIIP) along with assistance from the Area Agencies on Aging offices around the state. This program is designed to help Medicare-eligible seniors with questions about their Medicare benefits, summary notices and claim denials and appeals. Certified and trained Medicare beneficiary advisors provide free, unbiased counseling on the entire Medicare program, including Medicare Advantage, Medicare Part D prescription drug plans, Medicare savings plans and Medigap policies. Advisors also answer questions about Medicaid, long-term care insurance, home health benefits and other health insurance programs available to seniors in Arkansas. SHIIP counselors are available for one-on-one, personalized counseling to individuals and group presentations on a variety of health insurance topics. Staff members also may provide referrals to other helpful programs or agencies when necessary.
Schedule a personalized counseling session with the Arkansas SHIIP Office by calling 501-371-2782 or toll free at 800-224-6330. You can also send an email to [email protected] to request more information about the program, or find and contact your local office by referring to the SHIIP Partner map. Assistance is also available at your local Area Agency on Aging.
The Arkansas Department of Human Services operates the Choices in Living Resource Center, which also acts as an Aging and Disability Resource Center to provide information about long-term services and support to Arkansas seniors. Trained program specialists help anyone who contacts the agency sort through the many options available and assist them in making informed decisions. The Arkansas DHS also oversees the Area Agencies on Aging located throughout the state, which serve multiple counties within their regions. AAAs offer counseling to seniors about Medicare, Medicare Advantage, Medicaid and Medicare Supplement Insurance. AAA counselors can provide information about and assistance applying for prescription drug and low-income senior programs. These services are provided at no cost.
Call the Choices in Living Resource Center directly at 866-801-3435 or contact them by email at [email protected] for more information about their various programs. You can also contact your local Area Agency on Aging to learn more about scheduling Medicare counseling.
Seniors can get personalized Medicare assistance through the WestArk Retired and Senior Volunteer Program. WestArkRSVP volunteers receive intensive annual training through the Arkansas Insurance Department’s SHIIP program to provide knowledgeable advice to Medicare beneficiaries through its community outreach program. Trained counselors also conduct orientations for individuals new to Medicare to help them understand their options, including coverage and gaps. Staff members assist Medicare beneficiaries wanting to apply for a federal low-income subsidy, and the Arkansas Medicare Savings program, and help them choose the most appropriate and affordable Medicare Advantage plan and Medicare Part D prescription drug plan. Staff also educates Medicare beneficiaries about free preventative health care services. WestArkRSVP offers all their services free of charge to seniors and those with disabilities in the counties of Benton, Washington, Sebastian, Crawford, Boone, Carroll, Marion and Madison.
To sign up for free Medicare counseling, Medicare beneficiaries must make an appointment. Schedule your appointment at the RSVP Center in Fort Smith by calling 479-783-4155 or the RSVP Office in Rogers by calling 479-636-0578.
El Dorado Connections
El Dorado Connections is a volunteer center sponsored by the South Arkansas Regional Health Center, a provider for the counties of Calhoun, Columbia, Dallas, Nevada, Ouachita and Union. As senior advocates, El Dorado Connections’ staff and a trained group of volunteers assist Medicare beneficiaries with problems in their Medicare coverage and help them enroll in Medicare prescription drug plans. The program also educates seniors and the public about reporting Medicare fraud and abuse.
Nonprofit CareLink is the Area Agency on Aging for central Arkansas and providesMedicare prescription drug counseling for residents in this area of the state. Staff members help seniors navigate the Medicare or Medicare Advantage application process and stay updated on their prescription drug plans. Many seniors find Medicare Part D options difficult to understand, which is compounded by their changing health needs and annual changes in their health care plans. CareLink’s trained staff attempts to alleviate confusion by helping Medicare recipients reevaluate their plans each year to ensure they always have the best coverage. Medicare-eligible seniors must schedule an appointment during the open enrollment period to receive a free evaluation, but staff may also perform reviews in the homes of older residents in central Arkansas. CareLink also schedules Medicare prescription drug counseling at various central Arkansas locations during open enrollment periods.
To schedule your free appointment, contact CareLink online or request Medicare counseling by calling 501-372-5300 or toll free at 800-482-6359. You can also send an email to [email protected] to request information and assistance.
The Medicare Health Plan Resource Center offers no-cost, professional assistance in understanding Medicare benefits and options that come with little to no premiums. Advisors help Arkansas seniors new to Medicare with their questions about Medicare and Medicare Advantage health plans, including co-payments, coinsurance, deductibles and other program elements. They also cover Medicare supplements, Medigap policies and prescription drug plans that affect Medicare costs and coverage. Seniors can also learn more about home health care, long-term care, dental plans and vision and hearing benefits. Through Medicare education, advice and consultations, trained staff help beneficiaries decide which plans best fit their lifestyles. Medicare recipients can schedule free assistance at any of the three Medicare Health Plan Resource Center offices located in Fayetteville, Mountain Home and Little Rock.
Schedule an appointment for Medicare counseling by calling 888-906-5156 toll free. You can also send your Medicare questions or request immediate assistance by contacting the Medicare Health Plan Resource Center online.
