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.
Seniors enrolling in Medicare in Arkansas can choose to receive benefits through Original Medicare or as a Medicare Advantage Plan. Original Medicare is a fee-for-service plan managed by the federal government in two parts. Part A covers hospital stays, skilled nursing care and some home health care. Part B covers doctors’ appointments, outpatient care, preventative care and medical supplies. Medicare Advantage Plans are sometimes called Part C, or “MA Plans.”
While Original Medicare is managed by the government, Medicare Advantage Plans are offered by private companies that have been approved and are paid by Medicare. Medicare Advantage Plans must follow the rules imposed by the Centers for Medicare & Medicaid Services (CMS). Seniors who enroll, receive all coverage through that plan, including Part A and Part B services, but most cases are limited to only using doctors who are within the plan’s network. These may also include extra benefits, such as dental care, vision, wellness programs and prescription drugs.
Using CMS data, an estimated 665,700 out of Arkansas’ 3,045,637 residents were eligible for Medicare Advantage in 2023, marking a 1.65% increase from 2022. This growth is lower than the national increase of 2.66%. Of those eligible, about 286,700 enrolled in Medicare Advantage Plans, representing 43% of the eligible population. This 18% enrollment surge from 2022 is notably higher than the 9.75% national increase. With these figures, Arkansas witnessed a 16.36% statewide growth in Medicare Advantage enrollment, significantly exceeding the national average of 6.9%. This points to more eligible Arkansas seniors opting to enroll in these plans.
This guide gives a close look at Medicare Advantage in Arkansas. It covers top providers, different plan types, how Medicare Advantage works, what it covers, who can join and how to sign up for these plans.
The Top 10 Medicare Advantage Plans in Arkansas
Medicare Advantage Plans through private insurance vary based on geographic area and the populations served. Below is a list of the top 11 Medicare Advantage providers in Arkansas based on enrollment numbers. Due to providers typically offering several plans, the table combines enrollment numbers from all plans offered by a single provider to rank them accordingly. The list also shows the average cost range and Medicare star rating for each provider. All information is current as of July 2023. Visit Medicare.gov for the most recent information on available plans.
Name
Enrollment
Medicare Star Rating
Monthly Cost Range
Plan Types
Humana
71215
3
$0 – $131
PPO, HMO, PFFS
Aetna Medicare
35986
3.5
$0 – $0
PPO, HMO
Arkansas Blue Medicare
20891
3.5
$0 – $99
PPO, HMO, PFFS
Anthem Blue Cross and Blue Shield
19749
3.5
$0 – $27
HMO
Wellcare by Allwell
18130
3.5
$0 – $35
HMO
Wellcare
10699
2.5
$0 – $20
PPO, HMO
Anthem HealthKeepers
9754
3.5
$0 – $0
PPO
Anthem Blue Cross
7341
3.5
$0 – $56
PPO
Cigna
4994
3
$0 – $0
PPO, HMO
Health Advantage
1883
3
$0 – $0
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.
