Medicare Plans in Arkansas: Coverage and Costs (2026)

If you're turning 65 in Arkansas or helping a family member sort out Medicare, you're looking at four parts, dozens of plan choices, and costs that reset every January. The standard Part B premium for 2026 is $202.90 a month, the Part D out-of-pocket cap is now $2,100, and free help is available through the state's Arkansas SHIIP counseling program.

This guide walks through every piece of Medicare as it works for Arkansans in 2026, what it costs, how to find the plans offered where you live, and how to get help paying for it.1,2,3

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage Plans in Arkansas (Part C)
• Medicare Part D: Prescription Drugs
• Medicare Supplement (Medigap) Plans in Arkansas
• Help Paying for Medicare in Arkansas
• Medicare Enrollment Periods
• Free Medicare Help: Arkansas SHIIP
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs reset every January, so check the current-year figures against CMS or medicare.gov before you budget.1 To talk to a person about your own situation, call 1-800-633-4227 (1-800-MEDICARE), staffed 24 hours a day, 7 days a week except some federal holidays; TTY users call 1-877-486-2048.6 Arkansas SHIIP counselors can also sit down with you for free.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government and comes in two parts.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.7

The hospital deductible resets each benefit period.1 A benefit period starts when you're admitted and ends once you've gone 60 days in a row without inpatient hospital care or skilled care in a nursing facility. A readmission after that gap triggers a new deductible.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care.8 It does not cover routine dental, vision, or hearing.9

• Monthly premium: $202.90 (higher if your income exceeds $109,000 single or $218,000 married, under the income-related adjustment)1
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most services

Part B is optional in name only. Nearly everyone enrolls. Delay past your initial window without qualifying for a Special Enrollment Period or a Medicare Savings Program and you owe a late penalty of 10% for each full 12-month period you could have had it, added to your premium for as long as you have Part B.10

Medicare Advantage Plans in Arkansas (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They must cover all the medically necessary services Parts A and B cover, except hospice, which Original Medicare keeps covering along with some clinical-trial costs. Most bundle Part D drug coverage along with extras like dental, vision, and hearing.11

Which plans you can join depends on where you live, so start with your own ZIP code. The Medicare Plan Finder at medicare.gov compares the Medicare Advantage, Part D, and Medigap plans offered in your area side by side. It carries limited detail about extras like dental, so check those benefits with the plan itself.4

How These Plans Work

• You keep paying your Part B premium ($202.90) on top of any plan premium, though many plans charge $0 extra. Some plans go further and help pay all or part of your Part B premium.11,1
• Plans run on networks. Most, especially HMOs, generally require in-network providers except for emergency care, out-of-area urgent care, and temporary out-of-area dialysis, while PPOs let you go out of network at a higher cost. Confirm your doctors are in-network before you enroll, and note that plans may require prior authorization for some services, which Original Medicare generally does not.11
• Every plan caps your annual out-of-pocket spending. Original Medicare has no such cap on its own: there's no yearly limit on what you pay out of pocket unless you have supplemental coverage, like Medigap, Medicaid, or employer, retiree, or union coverage. The federal maximum for in-network Medicare Advantage spending is $9,250 in 2026, and many plans set lower caps.11
• Extras like dental, vision, and hearing aren't universal, so confirm what a specific plan covers before you compare premiums.9

If your plan stops serving the area where you live, you get a Special Enrollment Period to pick a new one.12

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or bundled into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap (the donut hole), so that higher-cost middle stage is gone.2 Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).13
2. Initial coverage: under the standard benefit you pay 25% coinsurance until your out-of-pocket spending reaches the cap.2
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.2

That $2,100 cap is the number that matters most. The average standalone Part D premium for 2026 is about $34.50 a month, though actual plan premiums vary by plan.1 Every plan must also offer the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket drug costs into capped monthly payments across the year instead of paying in full at the pharmacy. It doesn't lower your total drug costs; it only spreads them out.2 People who qualify for Extra Help often pay much less, sometimes nothing.

Medicare Supplement (Medigap) Plans in Arkansas

Medigap is extra insurance you buy from a private insurer to help pay your share of out-of-pocket costs in Original Medicare.14 It pairs with Original Medicare only: a Medigap policy can't pay your Medicare Advantage copayments, coinsurance, deductibles, or premiums, and while you're in an Advantage plan it's illegal for anyone to sell you one unless you're switching back to Original Medicare.14 In Arkansas, these policies are regulated by the Arkansas Insurance Department.

Medigap plans are standardized by letter. Medicare's 2026 Choosing a Medigap Policy guide charts them as Plans A, B, C, D, F, G, K, L, M, and N, and states that every insurance company that sells Medigap policies must offer at least Plan A.5 Plans C and F are no longer available to people new to Medicare, meaning people who turned 65 on or after January 1, 2020 and get Part A on or after that date; they have the right to buy Plans D and G instead.5 Plan G covers the same benefits as Plan F except the annual Part B deductible: it pays the Part A deductible, Part A and Part B coinsurance, and skilled nursing facility coinsurance, leaving the Part B deductible to you.5

When Arkansas Guarantees You a Medigap Policy

Your strongest opening is the federal Medigap Open Enrollment Period, the six months that begin the first month you're 65 and enrolled in Part B. During that window an insurer can't refuse to sell you any Medigap policy it offers and can't charge you more because you have health problems.5 Arkansas rule 23 CAR § 89-113 sets the same six-month open enrollment period in state rules.5

Arkansas also protects some people under 65. Arkansas rule 23 CAR § 89-127 requires at least one of the ten standardized Medicare supplement plans an issuer currently offers to be made available to applicants who have Medicare by reason of disability.5 For those applicants, the Arkansas rule bars an insurer from denying or conditioning a policy because of health status, claims experience, receipt of health care, or medical condition when the application is submitted during the six months beginning with the first month the person first enrolled in Part B.5 Someone who already has Part B still gets a Medigap Open Enrollment Period on turning 65.5

After those windows, Arkansas rule 23 CAR § 89-114 guarantees certain Medigap policies to eligible people in listed coverage-loss situations, including an ending employer plan, a Medicare Advantage plan that is terminated or stops serving your area, Medigap coverage that ends involuntarily, and some first-time Medicare Advantage enrollments ended within 12 months.5 In those situations the insurer can't deny the policy, price it based on your health, or impose a pre-existing condition exclusion, as long as you apply during the guaranteed issue period and submit evidence of the termination or disenrollment date with the application.5 When an employer plan ends, that period closes 63 days after the later of the termination notice or the date the coverage ends.5

Unless one of those guaranteed-issue situations applies, outside the Medigap Open Enrollment Period an insurer is allowed to deny you a policy if you don't meet its medical underwriting requirements, and you may pay more for a policy.15 The choice you make in those first six months carries real weight.

Medigap or Medicare Advantage?

Medigap works only with Original Medicare.14 Choose Medigap and you stay on Original Medicare, with the policy helping pay your share of its out-of-pocket costs. Choose Medicare Advantage and a Medigap policy can't pay that plan's copayments, coinsurance, deductibles, or premiums.14 The door back isn't sealed, though. If you join a Medicare Advantage plan for the first time and aren't happy with it, a federal trial right lets you buy a Medigap policy and a separate Medicare drug plan if you return to Original Medicare within 12 months of joining.14 Arkansas rule 23 CAR § 89-114 also lists among those guaranteed a Medigap policy people who dropped a Medigap policy to enroll for the first time in a Medicare Advantage plan and ended that enrollment within the first 12 months.5 In most cases, though, if you drop your Medigap policy to join a Medicare Advantage plan, you may not be able to get the same policy back, so weigh that trade carefully before your open enrollment window closes.14

Help Paying for Medicare in Arkansas

Two programs can significantly reduce Medicare costs for people on fixed incomes.

Medicare Savings Programs

Arkansas runs its Medicare Savings Programs through Arkansas DHS Medicare Savings Programs, administered by the state's county operations offices. They pay some or all of your Medicare premiums and cost-sharing based on your income and resources.16

QMB is the most generous program: it covers your Part B premium plus your deductibles and coinsurance, which can add up to thousands of dollars in savings over a year. Federal law also bars providers from billing a QMB enrollee for that Medicare cost-sharing. Income isn't the only gate. QMB requires you to be 65 or older, blind, or disabled and to have Part A or be able to get it, while SMB (Arkansas's name for SLMB) and QI-1 require both Part A and Part B. QMB is also not full Medicaid: QMB enrollees don't get Medicaid's prescription drug benefits, for example. Arkansas applies the standard federal MSP resource limit: $9,950 for one person and $14,910 for a couple in 2026. Ask a DHS county office which of your resources count toward that figure, and don't assume a house, a car, or a burial fund is excluded, or that it counts either. Neither the income bands nor the resource limit is a self-screening cutoff: states may effectively raise the federal limits by disregarding certain income and resources, so file at a DHS county office rather than assume you're disqualified. Income limits update annually with the federal poverty level. Arkansas's own published charts also lag the current federal number, so if you're close to the line, ask a county worker what standard they're applying today. To apply, file at your local DHS county office.16

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, helps pay Part D premiums, deductibles, and copays for people with limited income and resources. Your plan deductible drops to $0, and the premium is covered up to a regional benchmark, so if you pick a pricier plan you pay the difference. Since 2024, the partial-subsidy tier is gone, so everyone who qualifies now receives the full subsidy.17

• Income limit: about $1,995 a month for an individual, $2,705 for a couple (150% FPL) in the 48 contiguous states and DC; Alaska and Hawaii are higher. The limit rises if relatives you support live with you, and Social Security doesn't count some income, such as SNAP or housing assistance, so apply even if you're somewhat over17
• Resource limits: $18,090 for an individual and $36,100 for a married couple living together. The lower $16,590 and $33,100 limits apply only if you tell Social Security that none of your resources will go toward funeral or burial expenses. Your home, your car, and your personal possessions don't count17
• If you're enrolled in QMB, SLMB, or QI, you automatically qualify for Extra Help and don't need to apply16,17
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately16,17

If you do need to apply, Social Security handles it, online at ssa.gov or by calling 1-800-772-1213 (TTY 1-800-325-0778) to set up an appointment to apply.17,18 Arkansas SHIIP screens people for Extra Help too, and its counselors can walk you through the application.17,3

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. These dates are federal and the same in Arkansas as in every other state.19

Changes made during Annual Open Enrollment take effect January 1 of the following year. If you miss your Initial Enrollment Period, a Part B penalty applies unless you qualify for a Special Enrollment Period or a Medicare Savings Program, and a Part D penalty applies unless you had creditable drug coverage or qualify for Extra Help.19,10 Be careful about what opens a Part B Special Enrollment Period. The main one comes from job-based group health coverage through your own or a spouse's current employment (or a family member's, if you're disabled), and it ends eight months after that coverage or the employment ends, whichever happens first. COBRA and retiree coverage don't count as current-employment coverage, so the day one of those ends you get no Part B Special Enrollment Period at all.19

Free Medicare Help: Arkansas SHIIP

You don't have to sort this out alone, and you shouldn't pay a broker to help. Arkansas SHIIP (Senior Health Insurance Information Program) is the state's free Medicare counseling service, run by the Arkansas Insurance Department and staffed by certified counselors throughout Arkansas.3 The help costs you nothing, whichever way you decide to go.

A certified SHIIP counselor, by phone or in person, can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Medicare Supplement (Medigap), and Part D plans side by side
• Get screened for Extra Help with prescription drug costs, and work through SHIIP's Medicare Savings Program guide3

If you suspect a bill is wrong or fraudulent, the Senior Medicare Patrol, an ACL-managed program in every state, helps beneficiaries and families prevent, detect, and report suspected health care fraud, errors, and abuse. Find Arkansas's program with the SMP Locator.20

Find your counselor through the Arkansas Insurance Department's SHIIP page at insurance.arkansas.gov/consumer-assistance/medicare-resources/shiip/. The department's own SHIIP pages don't print a phone number; CMS's Medicare & You 2026 handbook lists Arkansas SHIIP at 1-800-224-6330.3

Learn More

Find personalized help with Medicare in Arkansas at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.