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How Do Medicare Advantage Plans Work in Arkansas?



Arkansas Children's Hospital
Arkansas Children's Hospital
1 Children's Way
Little Rock, AR 72202
Phone: (501) 364-1100
Plus Code: PPR5+95 Little Rock, Big Rock Township, AR
Map: Map


Until recently, there was only one way to go when it came to Medicare coverage.  First you would acquire Medicare coverage.  You would then supplement your coverage by purchasing a Medicare Supplement plan.  A stand-alone Medicare plan contains "gaps" in coverage that can lead to significant out-of-pocket costs for several possible medical circumstances.  There are a variety of Medicare supplement health plan options that provide different levels of supplement protection.  The various plan types are designated by letters of the alphabet (A-N).  Generally, the more comprehensive the coverage, the higher the cost of the supplement plan.

Good to know:  Talk to an independent agent.  An independent insurance agent is an essential resource when purchasing insurance.  An independent agent works with multiple different carriers, which is different from captive agents who can only sell insurance from the carrier they work for.  Working with an independent agent can help make sure that you are getting the best coverage, for the best price.

In Arkansas, Medicare Advantage Plans are an "all in one" alternative to the Original Medicare / Supplement plan arrangement.  These plans are offered by private companies approved by Medicare.  If you join a Medicare Advantage Plan, you still have Medicare.  These "all in one" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Medicare Advantage Plans cover all services covered by original Medicare.  In addition, Advantage plans are required to offer at least the same level of coverage as the Original Medicare Part A and Part B coverage.  In almost every case, Advantage plans feature several attractive additional benefits that are not covered by original Medicare.  Dependent upon which Arkansas advantage plan you choose, these benefits may include coverage for vision care, hearing aids, dental care, prescription drug coverage, transportation to and from medical facilities, and even fitness center membership.  The end result is a very comprehensive medical insurance plan.

If you enroll in a Medicare Advantage plan, you continue to pay your Medicare Part B premium.  The private insurer determines what the Medicare Advantage plan premium will be.  This premium amount will vary from one plan style to another.

Medicare Advantage plans tend to be significantly less expensive than Medicare Supplement coverage.  Some Medicare Advantage plans may have premiums as low as $0.

Copay costs may also be less with a Medicare Advantage plan.  For, example, if you visit a primary care physician under a Medicare Advantage plan, you may pay a copayment of $10.  However, if you visit a primary care physician under Original Medicare, you may have a coinsurance of 20%, which could be significantly more than $10.

A Medicare Advantage plan will limit your maximum out-of-pocket expense.  Once you have spent that maximum, you pay nothing for covered medical services for the remainder of the year.

Interesting Fact:  The per capita price of healthcare per year is higher in the United States than in any other nation in the world.  In the U.S., healthcare spending accounts for 17.9 percent of the Gross Domestic Product (GDP), or the total value of goods and services produced by the entire nation for the entire year, according to the Centers for Medicare & Medicaid Services.
Medicare Advantage Rules and Guidelines

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans.  In turn, these companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different Out-of-pocket costs.  They can also have different rules for how you get services – for example:

  • Whether you need a referral to see a specialist.
  • What shared medical costs you are responsible for.


Which Medicare Avantage Plan Carriers Are Available in Arkansas?

Following is a list of some of the insurance companies that offer Medicare Advantage plans in Arkansas:

  • Allwell - Arkansas. (Several plan variations)
  • Aetna - Arkansas . (Several plan variations)
  • Cigna - Arkansas.
  • Humana. (Several plan variations)
  • Blue Advantage. (Several plan variations)
  • UnitedHealthcare. (Several plan variations)
  • AARP. (Several plan variations)

Good to know:  You shouldn't promptly pay medical bills.  Yes, you read that right.  The reason is, healthcare providers tend to send bills well before the insurance company has decided what part of the claim they are obligated to pay.  The average person sees a bill and thinks they are obligated to pay it.  This couldn't be further from the truth.  Health care companies routinely shoots out bills to everyone one involved - regardless of who is actually responsible for paying it.  You need to know what the insurer is going to pay before you do anything.  Our advice? Don't pay a dime until you get an EOB (Explanation of Benefits) from your insurer that explains your claim and how much they are paying.
For more information concerning Medicare Advantage, Medicare Supplement or Medicare Prescription Drug Plans, please give us a call.


Other articles:
Medicare Supplement Insurance Rates in Arkansas.
Medicare Supplement Vs Medicare Advantage Plans.
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