Medicare in Arkansas
Medicare is the federal government’s health insurance program primarily for people who are 65 or older or have qualifying disabilities. This page serves as a resource for ongoing analyses, discussions, and updates on Medicare in Arkansas.
Reports and Explainers
News and Updates
Created in 1965 and expanded over time, Medicare today is the single largest payer in the U.S. healthcare system, providing coverage to about 1 in 5 people both in Arkansans and nationwide. Most Americans must actively enroll in Medicare to receive coverage when they become eligible at age 65, although people who are already receiving Social Security payments for at least four months before turning 65 are automatically enrolled in Medicare Parts A and B. Medicare is divided into four parts, each with different benefits, limitations, and costs to beneficiaries. After initial enrollment, beneficiaries can make changes each year during open enrollment.
Part A: Hospital Insurance Covers inpatient care such as hospital stays, hospice care, and short-term skilled nursing facility care.
Part B: Medical Insurance Covers outpatient care such as primary care and specialist visits, and associated costs such as ambulance rides and medical devices.
Part C: Medicare Advantage An alternative to traditional Medicare (parts A and B) where private insurers offer plans meeting Medicare coverage requirements.
Part D: Prescription Drug Coverage Standalone insurance plans sold by private insurers that cover prescription medications. May supplement Part B or certain Medicare Advantage plans that do not include prescription drug coverage.
Medicare Advantage in Arkansas
The Balanced Budget Act of 1997 established Medicare Part C, or Medicare Advantage. Offered by private insurance companies, Medicare Advantage plans consolidate Medicare Part A (hospital insurance) and Part B (medical insurance). The plans cover all medically necessary services required by traditional Medicare, but with varying out-of-pocket costs and service rules, such as prior authorization requirements — in which insurance will only pay for a service if it was approved by the insurer prior to the service being rendered — for certain services or medications.
Enrollment in Medicare Advantage plans has been increasing steadily in recent years both nationwide and in Arkansas. ACHI has published an interactive dashboard examining trends in Medicare Advantage compared to traditional Medicare, statewide and by county.
For more on Medicare Advantage, see our explainer providing an overview of the program, examining enrollment trends in Arkansas, and discussing federal oversight of the program.
