Medicare in Alaska

The vast majority of beneficiaries enrolled in Medicare in Alaska have coverage under Original Medicare.¹⁶ There are no individual Medicare Advantage plans for sale in Alaska as of the 2024 plan year.⁵

There were two Medicare Advantage plans available in Alaska in 2022 and 2023, both of which were Medicare Savings Account plans (here’s how those work; note that this is not the same thing as a Medicare Savings Program, which is an assistance program available based on income and run by each state’s Medicaid office).¹⁷

But as of the 2024 plan year, there are no individual Medicare Advantage plans available in Alaska.⁷ There are, however, some employer-sponsored Medicare Advantage plans (EGWPs) that cover some retirees in Alaska, including retired state employees.⁶

As of June 2024, more than 2% of Alaska’s Medicare beneficiaries had Medicare Advantage plans, including EGWPs (but not counting supplemental private Medigap and Part D plans). That amounted to about 2,900 people out of more than 117,000 total Medicare beneficiaries in the state.¹

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that people would otherwise incur if they only had Original Medicare on its own.

Medigap plans are standardized under federal rules, so the benefits they provide are governed at the federal level and do not vary from one insurer to another or from one state to another (with the exception of three states that have waivers allowing them to standardize the plans differently). Under federal rules, Medicare beneficiaries have a six-month guaranteed-issue enrollment window for Medigap plans 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.

The majority of the states have adopted rules to ensure at least some access to Medigap plans for enrollees under the age of 65, but Alaska is not one of them. As of 2020, only one Medigap insurer in Alaska — United American Insurance Company — voluntarily offers a limited selection of Medigap plans to enrollees under the age of 65, with prices that are significantly higher than the prices for a person who is 65. However, Alaska has kept its high-risk pool (the Alaska Comprehensive Health Insurance Association, also known as ACHIA) operational, and the pool serves as a backstop for people who are under 65 and in need of coverage to supplement Medicare.

Prior to the Affordable Care Act (ACA), many states relied on high-risk pools for people who needed to purchase their own health insurance and couldn’t qualify for coverage due to medical underwriting. Some states, including Alaska, still have an operational high-risk pool — and Medigap access is part of the reason ACHIA and similar programs in other states are still offering coverage (other states that have maintained their high-risk pools and use them to offer supplemental coverage to Medicare beneficiaries include Iowa, New Mexico, North Dakota, South Carolina, Washington, and Wyoming).

Although the ACA eliminated medical underwriting in the individual health insurance market, it did not change anything about the rules relating to Medigap coverage. Medigap applications are medically underwritten if people apply for Medigap 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 trigger a guaranteed-issue window for eligibility.

As of 2023, only one private Medigap insurer in Alaska voluntarily offers a limited selection of Medigap plans to enrollees under the age of 65, with prices that are significantly higher than the prices for a person who is 65 or older.¹⁰

Original Medicare does not cover outpatient prescription drugs. But beneficiaries of Medicare in Alaska can get coverage for prescription drugs via an employer-sponsored plan (offered by a current or former employer) or stand-alone Medicare Part D plans. In most areas of the country, Medicare Advantage plans are another option, since most Medicare Advantage plans include integrated Part D prescription coverage. Alaska does not offer Medicare Advantage plans for individuals.

For 2024 coverage, insurers are offering 19 stand-alone Part D plans to people who reside in Alaska,¹¹ with premiums ranging from $3.50 to $110.40 per month.¹⁸

The Medicare Part D enrollment window runs from October 15 to December 7 each year, with coverage changes taking effect January 1. Medicare beneficiaries are encouraged to use Medicare’s plan finder tool (available at Medicare.gov) to compare the available options for the coming year and see how each plan would cover their own personal prescription needs.

As of July 2023, there were more than 74,000 Alaska Medicare beneficiaries covered by stand-alone Medicare Part D prescription drug plans.³

Many Medicare beneficiaries receive financial assistance through Medicaid with the cost of Medicare premiums, prescription drug expenses, and services not covered by Medicare – such as long-term care.

Our guide to financial assistance for Medicare enrollees in Alaska includes overviews of these benefits, including Medicare Savings Programs, long-term care coverage, and eligibility guidelines for assistance.

If you have questions about Medicare enrollment in Alaska or Medicare eligibility in Alaska, you can contact the Alaska State Health Insurance Assistance Program with questions related to Medicare coverage in Alaska.

The Alaska Department of Health and Social Services, Senior and Disability Services can also provide a variety of helpful information and assistance for Medicare beneficiaries in Alaska. Here is the Medicare Information Office page on their website.

The Alaska Division of Insurance oversees and regulates insurance companies that offer plans in the state (including Medigap insurers) as well as the agents and brokers who sell the policies. Their office can provide assistance and information to consumers and address complaints and inquiries about the entities they regulate.