Medicare 2026

How Medicare coverage is structured in North Little Rock

NORTH LITTLE ROCK, Ark. — Picking how you get your Medicare coverage is one of the biggest decisions you'll make as you approach 65 — or during a fall enrollment window. And while the choices can feel endless, they really come down to two paths: Original Medicare paired with a Medigap policy, or a Medicare Advantage plan. They're built differently, they pay providers differently, and they protect your wallet in different ways.

Here's a plain-language look at how the two structures compare, so you can think it through with confidence.

The two paths, side by side

Original Medicare is the traditional, federal program. It has two parts: Part A (hospital) and Part B (doctor and outpatient). You can see any doctor or hospital in the U.S. that accepts Medicare — and most do. Original Medicare pays its share, and you're responsible for the rest, which has no annual cap on its own.

That's where Medigap (also called Medicare Supplement Insurance) comes in. Medigap is a private policy that pays some or all of the out-of-pocket costs Original Medicare leaves behind — like the Part A hospital deductible or the 20% coinsurance on Part B services. Because Original Medicare doesn't include drug coverage, people on this path usually add a stand-alone Part D plan.

Medicare Advantage (Part C) is different. It's a private plan, approved by Medicare, that bundles your Part A and Part B — and almost always Part D drug coverage — into one package. Many plans also include extras like dental, vision, or hearing benefits. In exchange, you generally use a network of doctors and hospitals, and you may need referrals or prior approval for some services.

How the money works

With Original Medicare + Medigap + Part D, you're typically paying:

• Your Part B premium (everyone pays this).
• A Medigap premium.
• A Part D premium.

In return, your costs at the doctor's office or hospital are usually predictable — often very little after Medigap picks up its share.

With Medicare Advantage, you still pay your Part B premium, plus any premium the plan charges. Instead of a Medigap policy, the plan itself sets copays and coinsurance for services, and it has a yearly out-of-pocket maximum for medical care. Once you hit that cap, the plan covers 100% of covered services for the rest of the year.

Both paths have real financial protections — they just get you there differently.

What's new for 2027

A few program-level updates apply no matter which path you choose:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that number, you pay nothing for covered drugs the rest of the year.
• Part D deductible: Up to $615 in 2026 and up to $700 in 2027 (plans may charge less).
• The old "donut hole" is gone as of 2025. Part D now works in three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly payments — helpful if a big prescription hits early in the year.
• IRMAA (higher-income surcharges on Part B and Part D) kicks in above $109,000 for a single filer in 2026.

These rules apply whether your Part D coverage is stand-alone or built into a Medicare Advantage plan.

Networks, referrals, and travel

This is often the deciding factor.

• Original Medicare + Medigap: No networks. If a provider accepts Medicare, you're covered. Great for people who travel, split time between states, or want to keep seeing specialists at any hospital system.
• Medicare Advantage: Uses HMO or PPO networks. Care outside the network may cost more or not be covered at all, except for emergencies. Some plans work well for people who mostly stay close to home and like having dental and vision rolled in.

Neither is "better" — it depends on how you live and where you get your care.

What availability looks like locally

North Little Rock is in Pulaski County, and like most Arkansas counties, it has multiple Medicare Advantage plans and stand-alone Part D plans offered by several carriers each year. For 2027, Pulaski County has 60 Medicare Advantage plans from 10 carriers, including Healthy Arkansas, Inc., which is new to the county. Medigap policies are regulated at the state level and are widely available in Arkansas as well.

For a current count of plans in Pulaski County — and to compare them side by side — the official Medicare Plan Finder at medicare.gov is the most reliable source. It updates every fall before Annual Enrollment.

Dates to remember

• Annual Enrollment Period (AEP): Oct. 15 – Dec. 7. You can join, switch, or drop a Medicare Advantage or Part D plan.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you can switch to another one or return to Original Medicare (and pick up a Part D plan).
• Medigap: Your best window to buy a Medigap policy without medical underwriting is the six-month period that starts when you're 65 or older and enrolled in Part B. Outside that window, in most states, insurers can consider your health history.