Medicare in Alaska

A look at Medicare enrollment and spending on The Last Frontier

Resources for Alaska beneficiaries

State Health Insurance Assistance Programs (SHIPs) provide free, in-depth, one-on-one insurance counseling and assistance to Medicare beneficiaries, their families, friends, and caregivers. SHIPs operate in all 50 states.

In Alaska you can reach SHIP at 1-800-478-6065 or online here.

Snapshot of Medicare in Alaska

Total Medicare enrollment in Alaska

There were 97,195 Alaska residents enrolled in Medicare as of November 2018. Alaska is the only state with fewer than 100,000 Medicare beneficiaries, although Alaska also has the third-lowest population in the country. But Alaska’s Medicare beneficiaries only make up about 13 percent of the state’s total population, whereas Medicare beneficiaries account for more than 18 percent of the total US population.

The over-65 population in Alaska is growing faster than in any other state, however, so Alaska may soon catch up with the rest of the country in terms of the percentage of the population enrolled in Medicare.

Read about Medicare’s open enrollment period and other important enrollment deadlines.

Breakdown of the aged vs. disabled

Most people become eligible for Medicare when they turn 65, but Medicare coverage is also available to people who are disabled. Nationwide, 84 percent of Medicare beneficiaries are eligible due to age, while the other 16 percent are eligible due to disability. In Alaska, 86 percent of Medicare beneficiaries are eligible based on their age, while 14 percent are eligible as a result of a disability.

Medicare spending per recipient

As of 2016, per-beneficiary Original Medicare spending in Alaska was the second-lowest in the nation, at $6,846. Alaska was one of just two states — the other was Hawaii — where average per-beneficiary spending was under $7,000. Nationwide, the average was $9,533 (and on the high end, per-beneficiary spending exceeded $11,000 in Florida, Texas, and Louisiana).

That’s according to data that were standardized to account for regional differences in payment rates, and although the data did not include costs under Medicare Advantage, virtually all of Alaska’s Medicare beneficiaries have Original Medicare.

Louisiana had the highest per-capita Medicare spending, at $11,399, while Hawaii had the lowest, at $6,441.

Medigap coverage in Alaska

Medigap plans provide coverage that supplements Original Medicare, paying some or all of the out-of-pocket costs (for coinsurance and deductibles) that people would otherwise have to pay themselves if they only had Original Medicare on its own. Medigap plans are standardized under federal rules, and enrollees have a six-month guaranteed-issue enrollment window that starts when they turn 65 and enroll in Medicare Part B. But federal rules don’t guarantee access to Medigap plans if a person is under 65 years old and enrolled in Medigap as a result of a disability.

Federal rules also do not provide for any sort of annual enrollment window to change plans or sign up late; after a person’s initial enrollment window closes, they are subject to medical underwriting in most circumstances if they apply for a Medigap plan (this is in contrast to Medicare Advantage and stand-alone Part D plans — enrollees can switch from one plan to another within those products each year).

Thirty states have implemented rules to ensure at least some access to Medigap plans for enrollees under the age of 65, but Alaska is not one of them. However, Alaska has kept its high-risk pool (the Alaska Comprehensive Health Insurance Association, also known as ACHIA) operational, and the pool provides supplemental coverage for Medicare beneficiaries who are unable to qualify for Medigap coverage.

Although the ACA eliminated medical underwriting in the individual health insurance market, it did not change the rules for Medigap coverage, which is medically underwritten if people apply before they’re 65 (and their state doesn’t have a guaranteed-issue rule for that population) or if they apply after their initial enrollment window ends and they don’t have one of the qualifying events that result in a guaranteed-issue window.

Thirteen private insurers offered Medigap plans in Alaska as of 2018, in addition to ACHIA. ACHIA offers Medigap plans C and F for people 65+ and offers a Medicare “carve-out” plan with a $1,000 deductible for Medicare beneficiaries who are under 65. Alaska’s Medigap buyer’s guide clarifies that “most companies selling Medicare supplement policies in Alaska do not sell policies to Medicare beneficiaries who are younger than 65 and on Medicare due to disability.”

Medicare Advantage in Alaska

Medicare Advantage is private coverage that combines the benefits of Original Medicare with additional benefits (usually including Part D prescription coverage and sometimes additional services that Original Medicare doesn’t cover, such as dental and vision care). Beneficiaries in most areas of the country can select Original Medicare (which typically will also need supplemental coverage in the form of employer-sponsored insurance, Medigap, and/or stand-alone Part D prescription coverage) or Medicare Advantage — there are pros and cons to either option.

But in Alaska, there are no individual Medicare Advantage plans for sale. Just 1 percent of Alaska’s Medicare beneficiaries had Medicare Advantage plans as of 2017 (that amounted to just 655 of the state’s Medicare beneficiaries; as of late 2018, total enrollment in Medicare Advantage and other private coverage in Alaska stood at 1,401 people).

Although individual Medicare Advantage plans aren’t available for purchase in Alaska, employers have the option of offering employer-sponsored retiree Medicare Advantage plans (known as Medicare Advantage Employer Group Waiver Plans, or MA-EGWPs). This brief from Aetna offers some background information about MA-EGWPs, as does this AHIP brief. In a nutshell, they’re a form of Medicare Advantage plans — created as part of the Medicare Modernization Act of 2003 — that employers and unions can offer to their retirees.

The Alaska Division of Insurance confirmed that MA-EGWPs are likely the reason that more than 1,400 people in Alaska with private Medicare coverage, despite the fact that Medicare Advantage plans are not for sale to individuals in the state (Medicare Cost plans, which are another form of private Medicare coverage, are also not available in Alaska). Nationwide, about one in five Medicare Advantage enrollees have coverage under MA-EGWPs. But in Alaska, more than 40 percent (and likely all) of the state’s Medicare Advantage enrollees are covered under MA-EGWPs (there are only four states — Alaska, Michigan, Illinois, and West Virginia — where MA-EGWPs account for more than 40 percent of all Medicare Advantage enrollments).

Nationwide, 33 percent of Medicare beneficiaries are enrolled in a Medicare Advantage program, and Alaska’s percentage of Medicare Advantage enrollees is the lowest in the nation. At the other end of the spectrum, in Minnesota, 56 percent of all Medicare beneficiaries are enrolled in Medicare Advantage, which is the highest share in the country.

Stand-alone Medicare Prescription Drug plans

Original Medicare does not include coverage for outpatient prescription drugs. Many enrollees have prescription drug coverage as part of their retiree package from a former employer, or are still working and have employer-sponsored insurance that supplements Medicare and covers their prescription costs. But for those who need to obtain their own prescription coverage, stand-alone Medicare Part D prescription plans are available to new enrollees, and during the annual open enrollment period in the fall.

Alaska had 38,992 Medicare beneficiaries — about 40 percent of the state’s total — enrolled in stand-alone prescription drug plans as of late 2018. For 2019 coverage, insurers in Alaska are offering 22 stand-alone Part D plans with premiums that range from about $16 to $97 per month.

Medicare Part D prescription drug coverage was the result of legislation passed in 2003 and signed into law by President George W. Bush in 2006. By the end of its first decade, Medicare Part D was providing coverage for almost three-quarters of all eligible Medicare beneficiaries nationwide (including those who have Part D coverage as part of their Medicare Advantage plan).

Medicare coverage in Alaska for people who aren’t eligible for Medicare

Are you under 65 years of age or otherwise ineligible for Medicare? We have information on Alaska health insurance and the Alaska health insurance marketplace at our health insurance site.