Arkansas Medicare Part D 2021 Updates
There are more Arkansas Medicare Part D Plans (PDPs) in 2021 than in previous years. The bad news is that the standard initial deductible is now $445 per year, an increase of $10 over last year. However, the Initial Coverage Limit increased to a new high of $4,130.
2021 Medicare Part D Standard Initial Deductible
The initial deductible is the amount that you pay before your Medicare Part D plan begins paying its share of the costs. So, if you enroll in a 2021 prescription drug plan with a standard initial deductible, you'll spend $10 more out-of-pocket in 2021 before coverage begins. Most Medicare Part D plans have an initial deductible, but many popular Medicare Part D plans exclude Tier 1 and Tier 2 drugs from the deductible, giving immediate coverage on most lower-cost medications.
2021 Medicare Part D Initial Coverage Limit (ICL)
The 2021 Initial Coverage Limit (ICL) is $4,130. The Coverage Gap (donut hole) starts when you reach the ICL and ends when you hit the out-of-pocket threshold, which is now $6,550. The Initial Coverage Limit marks the coverage gap entry point. You enter the coverage gap when the total negotiated retail value of your prescription drug purchases exceed your plan’s Initial Coverage Limit.
Will You Fall Into The 2021 Donut Hole?
An easy way to estimate if you will run out of coverage is to look at that average monthly cost of your medications. If your prescriptions have an average retail value of over $335 per month, you will enter the 2021 Donut Hole at some point in the year. This assumes that your current retail drug prices remaining stable.
The 2021 Donut Hole Discount is 75% for Generic Drugs
If you reach the 2021 Coverage Gap phase of your Part D coverage, the generic drug discount will be 75%. This means your generic drug costs in the Donut Hole will be 25% of your Part D plan's negotiated retail prices. What you pay counts towards your true out-of-pocket costs (This amount counts toward your TrOOP).
The 2021 Donut Hole Discount is 75% for Brand-Name MedicationsThe 2021 brand-name Coverage Gap discount remains the same at 75%. The pharmaceutical industry is responsible for picking up 70% of the cost of medications for beneficiaries in the Donut Hole. You get credit for 95% of the retail drug cost toward meeting your 2021 total out-of-pocket maximum or Donut Hole exit point.
Some plans offer additional gap coverage, so look for it on the plan information pages.
How Much Will You Spend To Exit The Donut Hole in 2021?
Your Total Out-of-Pocket Cost (TrOOP) threshold will increase to $6,550 in 2021. That's $200 more than the 2020 TrOOP limit of $6,350. TrOOP is the dollar amount you'll spend to get out of the Donut Hole or Coverage Gap and into your Medicare Part D plan's Catastrophic Coverage phase.
It's important to remember that TrOOP doesn't include your monthly premiums or over the counter purchases. Some plans offer additional gap coverage, so look for it on the plan information pages.
Evaluate Part D Medicare plans wisely. If you have a regular prescription or two, we suggest that you verify that the plan you want offers your medication(s) at a good price. You find this information in the formulary. We post links to the formulary and pharmacy web pages, as well as the plan's phone number, on each of the PDP pages listed above.
IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health and your finances.
Get Your Prescriptions and More with a Arkansas Medicare Advantage Plan
Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescriptions. The Medicare Prescription Drug Plans above work with Original Medicare. That's one way. But maybe you'd like even more benefits. That's where Arkansas Medicare Advantage Plans come in. Most offer Part D coverage.
Medicare Part D and Supplements Work Together
Medicare does not pay for all of your hospitalization and doctor bills. Even with the new healthcare law fully in place, your Original Medicare only pays about 80 percent of your Arkansas healthcare bills. We keep an up-to-date catalog of Arkansas Medigap Plans, also call a Medicare Supplement, with the tools you need to find the best price and coverage. The Medicare PartD plans above are fully compatible with Arkansas supplemental insurance.
Arkansas Medicaid and Your Medicare Part D
Arkansas seniors who qualify for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) may be enrolled in a Arkansas Medicare Prescription Drug Plan automatically, as well as Social Security's Extra Help program. The Extra Help program pays for most of your prescriptions, but only if you meet the strict eligibility requirements. If the dual eligible option does not meet your needs, you have the option to enroll in a Arkansas Part D plan that does. If you are already receiving Medicaid, contact your local Medicaid office for assistance in the transition to Medicare.
Frequently Asked Questions About Arkansas Medicare Part D Plans
Best plan is based on your regular prescriptions, cost, the pharmacy you use, and customer care provided by the plan. We recommend comparing these plans:
Medicare Part D plans adjust each year. For 2021 the average cost is around $32, but that varies slightly by location. To compare plans in Arkansas, which start around $20 per month, Arkansas, goto this page.
All Arkansas Medicare Part D plans, including premium, deductible, and copay information is available on this page. You will also find the 5-star rating that CMS has given each plan.
PDP Eligibility and Availability
You are eligible to enroll in a Arkansas PDP plan if:
- You are a resident of the state,
- You are enrolled in Medicare Part A and Medicare Part B, and
- You are age 65+ or have Medicare due to a qualifying disability.
All plans on this page are available to beneficiaries in Little Rock, Fort Smith, Fayetteville, Springdale, Jonesboro, Rogers, Pine Bluff, Conway, and all rural areas of Arkansas.