Arkansas Health Insurance Guide
Arkansas Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
As an Arkansas resident you have your choice of several health insurance programs including plans for individuals and group plans provided by private insurance carriers, as well as Arkansas State-funded affordable health insurance for eligible individuals and families, as federal programs such as Medicaid and COBRA.
Arkansas is not a guarantee issue state. That means private insurance companies are not required to sell health insurance to individuals who do not meet their underwriting criteria. You can be turned down for any number of reasons, including your current or past health, age, gender and tobacco use, but state law does not require the insurer to tell you why. If you are accepted, the insurer has the right to limit your coverage with an elimination rider exempting them from paying claims on any preexisting condition you claimed. Your Arkansas health insurance provider can also review your medical records going back 60 months to determine if any claim you make qualifies as a pre-existing condition, whether or not you declared it in your initial application. There is currently no Arkansas law limiting the exclusionary period for pre-existing medical conditions; it can be excluded indefinitely. The few exceptions to this are hernia, reproductive organ disorders, varicose veins, adenoids, appendix and tonsils, which can only be excluded for up to 6 months.
Arkansas is a guaranteed renewal state. Regardless of your health, your insurer must renew your policy as long as you’ve paid your premiums on time and haven’t defrauded the company. However, since health policy costs are not regulated by Arkansas law, your insurer can increase your premiums at renewal time.
If your Arkansas health insurance is provided through your employer’s group plan, your coverage cannot be denied or subject to higher premiums because of your health, although some limited-time restrictions are permitted for new enrollees with pre-existing conditions.
Arkansas Mandated Health Benefits
Arkansas laws require private health insurance policies to cover several state-mandated benefits. These include:
- Treatment for alcoholism and drug abuse
- Ambulatory surgery
- Breast reconstruction
- Colorectal cancer screening
- Contraceptives
- Diabetic supplies and diabetes self management
- Emergency services
- Hospice care
- In vitro fertilization
- Mammography
- Mastectomy stays
- Maternity stays
- General mental health
- Off-label drugs
- PKU/formula
- TMJ disorders
- Well child care
- Coverage for newborns under the parent's policy
- Coverage for adopted children under the parent's policy
- Coverage for continuation dependents under parents policy
- Coverage for handicapped dependents under the parent’s policy
Types of Health Insurance Plans Available in Arkansas
The following major medical health insurance plans are generally available in Arkansas. Major medical plans cover illness and injuries, hospitalization, prescription drugs and office visits, as well as the mandated services stated above.
Indemnity plans
Typically the most flexible and therefore highest priced choice, an indemnity plan lets you select your health providers and facilities. Depending on your plan, you will have to pay a deductible or co-insurance.
Preferred provider organization plans (PPOs)
You select from a network of preferred health care providers and facilities, and receive services at an agreed-upon discounted rate. You also have the option of going outside the network, but typically at a higher cost. You do not need a referral from a primary care physician to see a specialist. Premiums may be less than an indemnity plan but more than an HMO. You will have to pay a deductible or co-insurance.
Health maintenance organizations (HMOs)
HMOs plans require you to select a primary care physician from a prescribed network of providers, who must issue a referral before you can see a specialist. Services and covered costs are typically more comprehensive than those provided by a PPO. HMOs offer the advantage of affordable premiums and low out-of-pocket costs, with an emphasis on preventive care. Non-emergency services out of network are usually not reimbursed.
Point of Service plans (POS)
Similar to a PPO in that you will receive reimbursement for out-of-network care, but with an HMO’s requirement for a primary care physician who must provide referrals to specialists. Premiums, co-pays and co-insurance are typically higher than what you’d pay with an HMO.
Alternative Health Programs in Arkansas
Arkansas Comprehensive Health Insurance Pool – Arkansas CHIP provides coverage for residents who are eligible under the Health Coverage Tax Credit federal program and to HIPAA-eligible individuals who have exhausted their coverage options in the group market. One major medical plan is offered with a choice of deductibles ranging from $1,000 to $10,000, including a $1,250 HSA-qualified option. The plan typically pays 80% for most in-network covered services. The CHIP plan caps at a $1million lifetime annual benefit. Premiums are based on your deductible, age, gender and whether or not you smoke.
Arkansas ARKids First – This program offers insurance to Arkansas resident children under 19 whose parents earn too much to qualify for public health coverage but who cannot afford private insurance. Income limits are on a sliding scale. Covered services and benefits are fairly comprehensive and range from doctor’s visits, specialist care, hospitalization, lab and x-ray services and prescription drugs to pregnancy care, dental , vision and hearing care, chiropractic, speech therapy and podiatry.
Regulating Agency
The Arkansas Insurance Department is responsible is the regulatory agency for Arkansas’s insurance industry.
Get access to Arkansas health insurance quotes from http://www.einsurance.com/health-insurance/.
Arkansas Insurance Department
The primary mission of the Arkansas Insurance Department (AID) is consumer protection through insurer solvency and market conduct regulation, and fraud prosecution and deterrence. They can be reached at the following office:
1200 West Third Street
Little Rock, AR 72201
(501) 371-2600 or (800) 282-9134
(501) 371-2618 fax
http://insurance.arkansas.gov/
ARKANSAS Comprehensive Health Insurance Pool (CHIP)
P.O. Box 419
Little Rock, AR 72203
(501) 370-2659 Voice Mail
Customer Service 1 (800) 285-6477
ARKids First
1 (888) 474-8275
http://www.arkidsfirst.com/home.htm
(NAIC) National Association of Insurance Commissioners
The National Association of Insurance Commissioners (NAIC) is the organization of insurance regulators from the 50 states, the District of Columbia and the five U.S. territories. The NAIC provides a forum for the development of uniform policy when uniformity is appropriate. NAIC members are the elected or appointed state government officials who along with their departments and staff regulate the conduct of insurance companies and agents in their respective state or territory.
http://www.naic.org/
Insurance Information Institute (I.I.I)
The mission of the Insurance Information Institute (I.I.I.) is to improve public understanding of insurance -- what it does and how it works.
Contact info:
110 William Street
New York, NY 10038
212-346-5500
http://www.iii.org/