Do you have health insurance? If you don’t currently have coverage, it’s not too late to financially protect yourself with an independent plan. But with so many options, which plan is right for you? Let’s take a look at some of the best health insurance companies offering plans in Arkansas.
The Best Health Insurance in Arkansas
What is Health Insurance?
Health insurance covers a percentage of your medical care costs. Here’s how it works. Each month, you’ll pay a set premium to your health insurance company. Your premium is due every month, even if you don’t go to the doctor or need to use your benefits.
You’ll also need to meet your plan’s deductible before your insurance begins to cover you. Your deductible is a set dollar amount that you need to contribute toward your medical care costs before your insurance begins to payout. Some plans include a $0 deductible.
Once you meet your deductible, you’re only responsible for your coinsurance percentage. Your coinsurance is the percentage rate you’ll pay for services and medical treatment — anything beyond your coinsurance is covered by your health insurance provider. For example, say your plan has a 10% coinsurance rate and you receive a doctor’s bill for $100. You’d pay $10 out of this bill, while your insurance covers the remaining $90. This continues until you meet your out-of-pocket limit.
Most people get their health insurance through their employers. However, it’s also possible to buy a plan on the Affordable Care Act (ACA) Marketplace. The specific plan options you’ll have available to you will depend on where you live, how much money you earn and how many people you need to include on your plan.
Unlike car insurance or homeowner’s insurance, you won’t face a penalty if you don’t maintain health insurance coverage. However, it’s not a good idea to go too long without some form of insurance. With rising medical care costs and stagnant wages, you can quickly face medical bankruptcy if you’re hospitalized without insurance.
Average Cost of Health Insurance in Arkansas
Arkansas offers lower health insurance plans when compared to neighboring states. The average individual with an independent ACA-approved plan pays about $378 per month in Arkansas.
If you live in a low-income household, you may be able to save on your insurance with a Marketplace subsidy. To learn if you qualify, begin by filling out a profile at Healthcare.gov, the federal website for ACA-approved plans.
The ACA limits how insurance companies can calculate your insurance premium. For example, it’s now illegal to charge you more each month for having a preexisting condition. However, health insurance companies are still allowed to ask about tobacco usage when they decide how much you’ll pay for insurance. Smokers pay more for coverage because they’re more likely to develop certain medical conditions. If you need one more reason to quit smoking, this is it.
Types of Health Coverage
There are multiple types of health insurance plans. When you shop on the Marketplace, you might even see different plan types available from a single insurance provider. Let’s go over some of the differences among the most common health insurance coverage types.
- Exclusive provider organization (EPO): EPO plans are the most limited type of health insurance. With an EPO plan, you can only visit doctors and specialists within a plan’s network. EPOs aren’t available in every area and typically limit coverage to residents who live near a health insurance provider’s headquarters.
- Health maintenance organization (HMO): Like an EPO plan, HMOs require you to see doctors and specialists within your network. The HMO may operate exclusively within a single healthcare service network, or they may contract out additional healthcare providers to increase your options. HMOs are more widely available than EPOs and are the most affordable health insurance option for most people.
- Preferred provider organization (PPO): A PPO insurance plan gives you the most flexibility when it comes to using your benefits. You can see both in-network and out-of-network care providers on a PPO plan — though you can save money if you stay in your network. PPO plans are more expensive than other options but might be worth it if you have a particular out-of-network doctor you want to see.
What Does Health Insurance Cover?
The ACA established 11 essential benefits that every insurance provider on the Marketplace must offer. No matter which plan you choose, you’ll have coverage for the following services.
- Ambulatory patient services: This includes outpatient care that you receive without going to a hospital, for example, receiving treatment for a UTI at an urgent care clinic.
- Emergency services: Your insurance provider needs to cover emergency care at any emergency room in the U.S. This rule applies no matter what type of plan you have. It’s against the law for your insurance provider to require you to visit a specific hospital in a true emergency situation.
- Hospitalization: This includes overnight stays at a hospital, before and after major surgery.
- Prescription drugs: Your insurance needs to offer some form of coverage for all classes of prescription drugs; it doesn’t need to cover every prescription drug on the market. In many cases, you are to try a more affordable, generic version of a certain drug before your insurance covers the brand name version.
- Pregnancy and maternity care: Your insurance must cover pregnancy, maternity and newborn care. This coverage must apply before you give birth and care after.
- Mental health and substance abuse treatment: This covers behavioral health treatment for both mental illness and substance use disorders (like addiction).
- Laboratory services: This includes diagnostic scans and tests that you receive at a specialized facility, like an x-ray.
- Preventive and wellness services: This includes regular checkups and routine screenings. Some examples include your annual physical and bloodwork.
- Rehabilitative and habilitative services: This includes both services and devices that help you regain your mobility after an injury or accident.
- Birth control: If you’re a female, your insurance is required to provide coverage for physical, hormonal and emergency birth control methods.
- Pediatric services: Your insurance needs to cover all of these benefits for any children enrolled in your plan, plus dental and vision benefits.
These essential benefits only apply to ACA-approved, long-term insurance plans. If you buy a short term plan or a catastrophic plan outside of the Marketplace, your benefits may vary.
What Does Health Insurance not Cover?
No matter if you have the best health insurance plan or the cheapest, your plan won’t cover every medical service you might need. Let’s take a look at some of the most common exclusions.
- Adult dental and vision services: The ACA dictates that both of these services must be covered for children on your plan. However, there’s no mandate that requires adult coverage. If you want dental and vision insurance for the adults on your plan, consider adding independent dental and vision plans to your coverage.
- Cosmetic surgery: Health insurance only covers surgeries that are considered medically necessary.
- Travel vaccinations: Health insurance companies don’t typically cover vaccinations outside of the standard schedule set by the CDC. If you need one of these vaccinations before you travel abroad, plan to pay for it out of pocket.
- Male birth control: The ACA’s birth control requirement only extends to female contraceptives. Most insurance won’t cover male methods of birth control, like condoms or vasectomies.
- Abortion: There is no federal requirement that compels health insurance providers to cover any form of abortion. Insurance providers in Arkansas may only cover abortions in limited circumstances, even if they voluntarily choose to offer this coverage. The ACA’s emergency contraceptive requirement doesn’t extend to medications intended to terminate an already-viable pregnancy.
Any benefit, service or treatment outside of the ACA’s 11 essential benefits may be excluded from your coverage.
Best Health Insurance Providers in Arkansas
The insurance plans and providers you’ll have access to varies depending on where you live. Let’s take a closer look at some of the insurance providers you’ll see offering plans when you shop on the Arkansas health insurance Marketplace.
UnitedHealthcare is one of the largest health insurance providers in the U.S., offering plans in most parts of the country. UnitedHealthcare offers both individual and family plans on the ACA Marketplace that include all of the essential benefits listed above. It even offers special low-cost coverage for self-employed individuals and children of self-employed men and women who don’t have coverage.
UnitedHealthcare also offers dental and vision plans for adults as well — so you can easily add multiple coverage selections to your plan in a single afternoon.
2. Centene Insurance Company
Centene Insurance is a private insurance provider specializing in ACA-approved plans for individuals, families and the self-employed. It offers a number of plan tiers that can help you balance coverage and costs, and deductibles start at $1,250 for individuals.
Centene partnership with Ambetter also allows it to quickly and easily package dental and vision coverage with your health insurance. Its online healthcare provider directory makes it easier to find service providers within your network.
Additional Dental and Vision Coverage
After you get the coverage you need, increase your benefits with one of these additional plan options.
VSP is the largest provider of vision insurance in the U.S. About 1 in every 4 people who have vision insurance get their coverage through VSP — and the company provides plenty of options in Arkansas.
Plans are available from just $14 per month and include low copays for eye exams and lenses. VSP plans also include an allowance that you can use on glasses or contact lenses as well.
2. Physicians Mutual
Are you looking to add dental coverage for adults on your insurance plan without breaking the bank? Consider a policy from Physicians Mutual. Dental insurance plans from Physicians Mutual are available from just $18 per month for individuals, and its plans include $0 deductibles.
Even its most affordable tier includes no annual or lifetime benefits limit — a common clause in most dental insurance plans. Getting a quote is also exceptionally easy through their website. Just enter your state, the number of plan members and your age to see coverage choices and get enrolled.
Are you looking to add both dental and vision coverage to your health insurance plan? Make your first stop to Humana. Humana offers exceptionally affordable vision and dental plans throughout Arkansas — you can get dental coverage from a little over $18 per month and vision insurance from $15 per month.
Humana’s plans help you keep costs low with affordable deductibles and copays. You’ll pay just $10 for an eye exam with Humana vision coverage, while dental plans have an affordable $50 deductible for individuals. Best of all, you can add both coverages to your health insurance plan with just a few clicks.
Navigating the Insurance Marketplace
Still not sure how to get health insurance or which plan is right for you? Start by creating a profile on Healthcare.gov. Healthcare.gov is Arkansas’s official starting point for entering the federal insurance Marketplace. You’ll answer a few questions about your income, enter a bit of personal information and see all of your plan options. Getting insurance online is simple — start today to ensure that your coverage begins as soon as you need it to.