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Winter Storm Avery takes lives, puts the brakes on commutes across the Northeast. Also on our Friday rundown: A first-of-its-kind report calls for policies to ease transitions of young people living in foster care. And "got gratitude" this holiday season? It could benefit your health.

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Arkansas Seniors Have Decision to Make on Medicare Coverage

Instead of standard Medicare Parts A and B, seniors can opt for so-called Advantage Plans, which can cut the cost of co-pays and deductibles. (Medicare.com)
Instead of standard Medicare Parts A and B, seniors can opt for so-called Advantage Plans, which can cut the cost of co-pays and deductibles. (Medicare.com)
October 30, 2018

LITTLE ROCK, Ark. — If you are eligible for Medicare coverage or soon will be, choices you make in the next few weeks may determine how much you pay for health care next year.

Medicare's open-enrollment period is now open and runs through December 7. It's an opportunity for about 500,000 Arkansas seniors and others eligible for the federal health care program to decide what option will work best for them in 2019.

Gaye Humphrey, a health insurance specialist with Medicare and Medicaid Services, said there are two major choices to consider.

"This enrollment is for people to choose either a Medicare Advantage plan or a Medicare prescription-drug plan,” Humphrey said. “To participate in this open enrollment, they already need to have Medicare A and/or B in order to choose one of these plans."

Most Medicare beneficiaries are enrolled in basic plans that cover hospital care, called Part A, and doctor care, called Part B, which are managed by the federal government. However, Humphrey pointed out, folks can also opt for one of the numerous Advantage Plans, managed by private insurance companies, that may provide lower co-pays and deductibles.

Humphrey said it's up to each Medicare participant to study the various options and determine which plan is best for them. Most Advantage plans are specific to certain geographic areas such as counties or ZIP codes, and unlike Parts A and B, may limit participants to a specific set of providers.

Humphrey added that each Part D plan has a formulary for which drugs it covers and limits to which pharmacies can be used.

"The most important thing to understand about these plans is the fact that they have a network of doctors and hospitals and providers who contract with this plan to provide the service,” she said.

She said most Advantage plans will not pay for out-of-network care. If this all sounds confusing, there is a great deal of help available at the website Medicare.gov, where there is information on both advantage plans and Part D drug plans. It shows plans based on where you live and has an 800-number with agents to help.

Arkansas also maintains a Senior Health Insurance Information Program that can guide individuals in making a decision. The number is 1-800-224-6330.

Mark Richardson, Public News Service - AR