If you live in Arkansas, then you’re probably in need of some high-quality, comprehensive, affordable health insurance. You’re not alone. Lots of Arkansas residents are in need of such a health insurance policy, but unsure where to look. Luckily for you, you’ve come to the right place. We have tons of helpful information about health insurance options near you that are affordable and comprehensive. All you have to do to find them is just keep reading.
Major Medical Insurance in Arkansas
Back in 2010, then President Barack Obama signed into law the Patient Protection and Affordable Care Act. You may also know it as the Affordable Care Act, the ACA, Obamacare, and many other names. There have been a few changes to the law since it was first signed into law. Some of these changes have happened so quickly and quietly that you may not be aware of how much easier it is to find an affordable health insurance plan right now.
If you want to apply for major medical coverage through the ACA Health Insurance Marketplace, the deadline for 2019 has recently been extended to December 18th (it was originally scheduled to take place from November 1st to December 15th for the year). During Open Enrollment, most people go to HealthCare.gov, answer a few simple questions, and fill out an application for coverage. This application determines whether or not you a) qualify for a policy, and b) qualify for a federal subsidy which makes these insurance policies significantly more affordable.
Why should you try to apply for a major medical insurance policy through the ACA as opposed to the other health insurance options you may have available? The two most important reasons include guaranteed issue policies, and guaranteed benefits. A guaranteed issue major medical health insurance policy is a policy which cannot deny you coverage if you apply for it, and cannot charge you more for your monthly premiums or other costs based on your gender or any pre-existing conditions. The following short list contains the only attributes which a health insurance provider may use to determine how expensive your monthly premiums will be for a guaranteed issue policy:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
Then there are the 10 guaranteed Essential Health and Wellness Benefits as outlined in the fine print of the Affordable Care Act. All the insurance policies available for purchase in the federal Health Insurance Marketplace will include the following benefits for you (and your family if you are purchasing a family plan):
- Ambulatory/outpatient services
- Emergency services
- maternity/newborn care
- Mental health and substance abuse
- Prescription drugs
- hab/rehab services and devices
- Lab tests
- Preventive and wellness services and chronic disease management
- Pediatrics (including oral and vision)
But the most important part of the process for the vast majority of applicants is the federal subsidy. Without it, many find that the Health Insurance Marketplace isn’t affordable for them. Luckily for Arkansas residents, state leaders have accepted the federal government’s recommendation to expand Arkansas Medicaid to those who make too little money to qualify for a subsidy. The bare minimum annual income you need to make in order to qualify for a federal subsidy is 138% or more of the federal poverty level (according to household size). The chart below outlines that threshold.
So if you are applying for a 2020 health insurance plan, if you are single, and if you make $17,236 or more before taxes, you would qualify for a generous federal health insurance subsidy. If you make less than that, thanks to the Medicaid expansion, you can still apply for Arkansas Medicaid – but keep in mind that there is a legal work requirement that is still in limbo. It was implemented, then struck down by the courts, so it is not being enforced but is still in existence.
Short Term Health Insurance in Arkansas
Thanks to the Medicaid expansion, most Arkansas residents will qualify for some sort of subsidized, low-cost major medical plan through either Medicaid or HealthCare.gov and the Health Insurance Marketplace. But if you still don’t qualify for a subsidy, or if you don’t want a major medical plan, you can choose from other options such as short-term health insurance.
For the rare Arkansas resident who does not qualify for a federal subsidy, most short-term health insurance plans cost about one-third less than the price of an unsubsidized Marketplace plan. Many short-term health insurance plans offer you the chance to customize your policy to a certain degree. You can even add supplements like dental, vision, or hospital indemnity insurance. You won’t have to go through HealthCare.gov because these short-term health insurance providers are operating independently of the federal government. You will still have certain consumer protections if you ever run into a dispute about your health insurance claims. This means you will have legal recourse if your short-term health insurance company tries to deny you benefits or refuses to pay out on claims which deserve to be covered.
But these plans aren’t perfect. Two glaring disadvantages compared to ACA plans are the lack of guaranteed issue short-term health insurance policies, and the lack of short-term health insurance policies which offer you the Essential Health and Wellness Benefits you are guaranteed through the ACA. So if you have a pre-existing condition, if you are the wrong gender (according to your insurance company), or if you need less common and more expensive types of care such as mental health or substance abuse treatment, you might not be able to find what you’re looking for from a short-term health insurance plan.
It’s also worth noting that if you have to use these plans frequently, your expenses can pile up fast. There are no caps on any annual or lifetime out-of-pocket costs for you; but your insurance provider will likely impose annual and lifetime benefit caps for you to receive. Many of these plans come with extremely high deductibles – sometimes as high as $5,000 or more – before your short-term health insurance provider will pay out a single dime. Once you sign up for a short-term health insurance plan and undergo medical underwriting, you can only hold onto your initial premiums and benefits for a maximum of 36 months. After that, if you want to continue with your plan from the same provider, you will have to reapply and undergo medical underwriting all over again. Your premiums will likely go up if this happens.
Christian Health Plans/Health Share Plans in Arkansas
Christian health plans are a leftover consequence of the early years of the Affordable Care Act back when there was a mandate to either purchase a qualifying major medical insurance policy or pay an annual fee when you file your taxes. Signing up for a Christian health insurance plan instead helped save people who didn’t qualify for a subsidy and couldn’t afford a major medical plan through the Health Insurance Marketplace. Since the mandate now only exists in three states which require it (good news: Arkansas is not one of them), there are fewer financial incentives for people to look into such health sharing plans. But you should still take the time to learn more about them just in case something about them appeals to you.
You might be surprised to learn that Christian health plans actually have a lot in common with short-term health insurance. The attributes they have in common include:
- No guaranteed issue
- Unlimited out-of-pocket costs
- Lifetime and annual benefit caps
- No guaranteed Essential Health Benefits
- Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
- Not considered to be a “real” health insurance plan by major organizations and care providers
But don’t take their many commonalities to mean that these plans are identical. There are some very important differences that you need to make note of. Unlike short-term health insurance, there’s no contract between you and your Christian health plan provider. Legally, this means that you don’t have as many protections as you would with a short-term health insurance plan. If your Christian health plan provider decides not to pay out on a claim, they are free to do so and you won’t have much legal recourse. You may also be expected to adhere to “participation guidelines” based on religion and a biblical style of living. Many Christian health plans mandate that their participants declare a specific faith, give up tobacco use, stop drinking alcohol, and make other religious-oriented lifestyle changes. There’s also some specific language changes that are unique to Christian health plans: for example, your monthly premium is actually a “monthly share amount” and costs like deductibles, co-pays, and coinsurance are referred to as “personal responsibility amounts” or “unshared amounts”.
Fixed Indemnity Plans in Arkansas
For some reason, there is so much confusion around fixed indemnity plans that many people believe them to be an adequate substitute for major medical coverage through the Health Insurance Marketplace. Unfortunately, this is not the case. It’s actually much more common for fixed indemnity plans to be sold alongside an Obamacare plan as a form of supplemental coverage. These supplements make predetermined payments on a per day, per week, per month, per visit, or per event basis. This fixed amount at best covers a portion of your total medical expenses, and usually has more to do with hospital costs than doctor visits or outpatient care.
Similar to Christian health plans and short-term health insurance, a fixed indemnity plan will come with lifetime and annual benefit caps. Your premiums for these plans will be determined by medical underwriting, which means no guaranteed issue. This can make them prohibitively expensive if you have pre-existing conditions. Despite all of this, if you think you will face exorbitant hospital costs, looking into a fixed indemnity plan could save you money over the long haul.
Discount Cards in Arkansas
Whether you have major medical health insurance or not, you can try and take the edge off of your health care costs with a medical discount card. Just keep in mind that these are not any form of qualifying major medical insurance. Medical discount cards are a membership discount program similar to AARP or AAA. You pay a membership fee, you receive a discount card in the mail, and you present that card at qualifying retailers and medical providers in order to get a discount at the register. But you won’t be filing claims with anyone, you won’t get any traditional medical benefits, and you won’t be reimbursed for any of your medical expenses.
But you need to be careful when it comes to medical discount cards. If a company is offering you one of these cards and advertising ridiculously high discounts or claiming to be affiliated with medical providers that seemed too good to be true, it is likely a scam. A good thing to do would be to follow up with the entities these companies claim to be affiliated with and double-check to make sure they are, in fact, affiliated and that you will be eligible for the discounts they’re advertising. As long as the membership fee is affordable and the discounts they offer beneficial, investing in a medical discount card can help take a bite out of your out-of-pocket medical expenses.