Complete with a range from big city (Little Rock) to the quaint, Folk Capital of America (Mountain View), Arkansas is an authentic American place to call home. Arkansas also holds an emphasis on nature, with six national parks, fifty state parks and 2.5 million acres of national forests. Residents of Arkansas have several health insurance companies to choose from, including Arkansas Blue Cross Blue Shield, Celtic, Humana, UnitedHealthcare and QualChoice – a native Arkansas company. To compare prices and available plans in your area, you can enter your zip code below, or for extra guidance, call one of our agents at 888 803 5917.
In the state of Arkansas, the population has become slightly healthier than two years ago, but still earned 47th place out of all 50 states by UnitedHealth Foundation’s health rankings. As with all other states in the country, the amount of obese adults has increased over the past ten years, which in Arkansas is now 681,000 individuals over age 19. There is also a sizable smoking population in the state, with nearly 23% of adults being smokers. Diabetes has also increased among adults, now affecting 212,000 people. Another issue is the lack of health insurance: the percentage of uninsured Arkansas residents has increased from 13.7% to 18.9% over the past ten years.
There are a few less negative points of Arkansas health, including a low frequency of excessive drinking, and a moderate level of public health funding. Those who live in Arkansas can continue the climb upwards on the health ranking scale by using the great number of parks in throughout the state and finding an effective regular physical activity to do. It is also essential to get health insurance if you have not already. Since the amount of uninsured individuals in Arkansas is getting steep, it is very important – especially due to the new health care legislation – to find a plan that fits your budget and needs. If health insurance is not something you can afford, see our resources for public health options below.
Health Insurance Plans
Arkansas Blue Cross Blue Shield
- Comprehensive PPO plans come in a large selection of deductibles, ranging from $1,000 to $25,000, and in two plan types. When you choose a plan with a higher deductible, you get 100% coverage after deductible on most medical services, while deductibles from $1,000 – $5,000 cover 80%. Both types of plan have a $30 copay for primary care physician office visits and no limit on maximum lifetime benefits. Emergency room services are available for a $200 copay, and prescription drugs start at $10 for generics and $35 for brand names. Using the Arkansas Blue Cross network, you can receive preventive care services for no cost as soon as your plan starts.
- HSA PPO plans have deductible options of $1,50o, $2,500 and $5,000 for individuals and $3,000, $5,000 or $10,000 for families. These plans are compatible with health savings accounts (HSAs) for increased flexibility with your health care and how you pay for medical expenses. Offering a simple, comprehensive type of coverage, HSA Blue PPO II plans cover 100% of your major medical expenses when you meet the deductible. When you use in-network doctors for preventive care, such as vaccinations and check-ups, it will be no cost from the day your plan begins.
- CeltiCare Preferred Select PPO plans have 80/20 coinsurance coverage after deductible, and a range of deductibles to choose from. Physician office visits are available for a $30 copay for both specialists and non-specialists, and prescription coverage is included as well, starting at a $15 copay for generic drugs. Once you have met the deductible, you can receive hospital services such as emergency care, outpatient lab and X-ray, surgery and inpatient hospitalization for 20% coinsurance. Before the deductible, you can receive such services for a copay.
- Celtic Basic PPO plans come in either 70/30 or 80/20 coinsurance options, both of which offer doctor’s office visits for primary care and specialists at a $30 copay. From the start date of your plan, preventive care including periodic health exams, OB-GYN exams immunizations and screenings for various cancers are available for no cost with a network provider. Prescription medications are covered at 35% coinsurance for brand names on the formulary and $15 for generics. Once your deductible is met, you can receive many major medical services for either 20 or 30% coinsurance, though some services have an additional deductible.
- CelticSaver HSA PPO plans cover a wide variety of medical services before and after you meet your deductible. They also have the capability of being connected to a health savings account (HSA) to optimize your control over health care spending. HSA funds can be used to pay for certain medical expenses, outlined by your insurer, without any tax withdrawn. Preventive care is available immediately when your plan starts for no cost when you use an in-network provider for care. After you meet the deductible, you can receive outpatient surgery, lab work, inpatient hospital care, emergency room services and more for 20% coinsurance.
- Short Term Medical plans are available though HumanaOne for Arkansas residents. These plans are not going to last for more than a short period of time, as indicated by the name, usually six to twelve months depending on the area. There are two types of short term plan available in Arkansas: Short Term 100/75 and Short Term 80/60. Short Term 100/75 covers 100% of medical expenses once you meet the deductible, and Short Term 80/60 plans cover 80% after deductible. Both have deductible options of $1,000, $2,500 or $5,000 to choose from. Once your plan has reached its end, you cannot renew, due to the short term nature.
- IQ Choice Select Premier plans are available in a range of deductibles, from $500 to $5,000 for individuals when using in-network providers. Primary care office visits are a $30 copay, and specialist visits are $50 in-network (except with the $5,000 plan, there is no copayment). After you have met the deductible, your plan pays for 80% of covered medical expenses, such as inpatient hospital stays, outpatient surgery, diagnostic labs and more. There is also prescription drug coverage, and 100% coverage on preventive services such as physical exams and vaccinations for disease.
- IQ Choice Select Complete/Complete Plus plans have lower monthly premiums and six deductible options, from $500 to $5,000 for individuals. These plans are designed for a single individual with no dependents needing coverage. For primary care doctor’s office visits, you pay $30, and specialist office visits will cost a $50 copayment. Emergency room services are available for a $250 copay, with the exception of the $5,000 deductible plan where the copay is $200. These plans also have a $3,000 out-of-pocket maximum, and offer discounts on prescription drugs. Once you have met the deductible, your plan covers 70% of qualified medical services.
- IQ Choice Select Basic plans are simple offer a great deal of convenience due to the high deductible allowing for low premiums each month, and 100% coverage on the majority of physician and hospital services. As with the other plans, doctor’s office visits are $30 for primary care in-network, and there is a $250 copay for emergency care. When the deductible has been reached, you can seek care from specialists, and receive in-network surgery, inpatient hospital stays, lab and X-rays, allergy testing and more at no cost.
- IQ ChoiceSelect Saver plans are available in either a $2,500 or $5,000 deductible, and have a broad selection of benefits covered after deductible for no cost. Once the deductible has been met, primary care visits, inpatient hospital services, routine visits to a specialist, emergency care, surgery and more in-network care is covered in full. Without having to wait to meet the deductible, you can use a network doctor for preventive services at no cost. There are also prescription drug benefits included with Select Saver plans.
- Copay plans are available in two types in Arkansas: Copay Select Value and Copay Select. Value plans have 70/30 coinsurance, while the Copay Select plans have 80/20 coverage. Both plans have a number of deductibles to choose from, spanning between $1,000 and $10,000 for Value plans. A more simple prescription drug option is available for discounts, featuring $15 generics only, saving you money compared to the generic and brand name option. Copay Select plans have a four-tier prescription coverage, and low out-of pocket costs due to higher deductibles. Preventive care is available as soon as your plan starts (both types), with coverage in full when using in-network providers.
- High Deductible plans from UnitedHealthOne have three different types to choose from, including Plan 100, Plan 80 and Saver 80. Plan 100 is very simple, with 100% coverage on major medical costs when you use a network doctor or facility. Out-of-network care is also an option, though it will be covered by your plan at a lesser degree. Once you have met your deductible, Plan 80 and Saver 80 plans require you pay 20% coinsurance for covered health care services. All plans have preventive care for no cost with in-network providers from the start date of your plan.
- Health Savings Account plans come in two types, HSA 100 and HSA 70, which indicates the amount your plan will cover after you meet the deductible. As the name suggests, these plans are qualified to be linked to a health savings account (HSA) for increased control over medical expenses. The funds from your HSA can be used to pay for deductibles, coinsurance or services that your plan does not cover. Preventive care is available at any time before meeting the deductible for no cost with in-network providers from UnitedHealthOne. Health Savings Account plans cover outpatient surgery, consultations, emergency room care, specialist visits, inpatient room and board and more when you have met the deductible.
Public Health Options
The Arkansas Department of Health is responsible for administering many programs for residents of the state at no cost. The state funds a variety of health care services, which are open to individuals of any income level or background. Arkansas residents who are uninsured have health care options through state funding as well when it comes to routine care. Medicaid is offered in Arkansas for low income families with children, pregnant women, disabled or aged individuals, or persons with other medical needs. For a full list of services offered by the state, visit the Arkansas Department of Health site. The following is a brief summary of health programs that residents of Arkansas may use if eligible.
- Medicaid: state-funded medical coverage for residents who are blind, disabled, pregnant, under age 19, elderly, or meet certain income guidelines. For more about qualifying for Medicaid, visit our Medicaid Eligibility by State page.
- ARKids First: Medicaid programs for uninsured children in Arkansas to receive health care coverage.
- Maternity Program: the Arkansas Department of Health administers care to pregnant women of any income level for prenatal and postpartum care, as well as birth control and STD testing.
- Immunization Section: prevention of infectious diseases by use of vaccines for Arkansas residents of all ages.
Health Insurance Laws
Regulations in the state of Arkansas for health insurance include various rules for judging the eligibility of certain individuals for a health plan, based on their medical history. If a health insurance underwriter reaches the conclusion that you have a pre-existing condition, they judge by the prudent person standard. This method of evaluating leaves the possibility of having a condition open to any medical issue for which you have or even could have received care or medical advice. For those who have pre-existing conditions, according to an Arkansas health insurer, there is the chance you may be denied a plan or receive an increase in premiums based on your risk.
Health insurance companies can also give elimination riders and exclusion periods to individuals with pre-existing conditions, which exempts the insurer from paying for treatment of that condition. Elimination riders make it so the insurance company never has to pay, and exclusion periods are issued up until a certain time frame. While in other states the limit for exclusion periods is 12 or 24 months, Arkansas has no limit. If you have been decided as having a pre-existing condition, there are changes to the law happening soon, and an alternative in the meantime.
The Pre-Existing Condition Insurance Plan (PCIP) is available to residents of Arkansas who have been determined as having a pre-existing condition and want to have equal health care coverage. These plans are state-run, and require a monthly premium payment like a private health insurance plan. PCIPs will be accessible until the Affordable Care Act makes it illegal for adults with health problems to be treated unequally by insurers in 2014. All health insurance companies will then be required to accept all persons, regardless of health status, for a plan without charging more for premiums. State health exchanges will operate in the same way. The use of elimination riders and exclusion periods will also be ended at this point.
Those who do get a health insurance plan have rights, according to HIPAA, to keep their plan even if they come down with an illness during the term. The guaranteed renewability provision allows for individuals to renew the same plan when their current one ends, so long as they have been paying their premiums and other necessary fees. If the policy-holder has committed fraud or misrepresentation, or violated their plan in any other way, they are not eligible for guaranteed renewal.