Looking for health care in Arkansas? According to a study by US News, AR has the second worst health care in the country. That study considers access, quality, and good public health. But it’s not all bad news – Arkansas residents still have plenty of health care options.
Health insurance options in Arkansas
There are several ways for Arkansas residents to get health care in their state.
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Arkansas residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 42% | ||
| Individual or family | 6% | ||
| Medicaid | 27% | ||
| Medicare | 16% | ||
| Military | 1% | ||
| Uninsured | 8% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
Eight percent of AR residents are uninsured, less than the national average. That’s a boon to residents. A higher percentage of uninsured people boosts costs for insured people.
Arkansas health insurance companies
Arkansas residents can choose from a few health care companies. These providers offer both individual and family plans:
- Arkansas BlueCross BlueShield
- Ambetter
- QualChoice
- QCA Health Plan
- Health Advantage
- Oscar
Coverage varies based on the county you live in. Check provider websites to see how your zip code may affect your policy.
Arkansas medical insurance costs and rate factors
AR residents spend an average of $7,408 per year on health care, about $600 less than the rest of the country. What affects rates in Arkansas? Prices vary person to person, based primarily on these factors:
Health insurance plan type
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. The higher tier of coverage you want, the more you’ll have to pay in monthly premiums.
How much should you expect to pay monthly in AR? These are the average rates for each plan type in the state for a middle-aged resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $320 | $358 | $461 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Gold plans cost about 44 percent more than bronze plans. That’s not much of a surprise, considering gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.
Some people also qualify for a catastrophic plan, the lowest level of coverage available. Catastrophic plans come with a $8,150 yearly deductible and they’re designed to save you from bankruptcy after an unexpected medical issue. Even with a higher monthly premium, you’ll save money with a bronze or silver plan if you need to use your health insurance.
Body mass index
According to the CDC, a high body mass makes you more likely to suffer from several serious health conditions. That’s why insurers analyze you BMI to determine your risk-level. A high BMI often leads to higher insurance rates.
In 2018, Arkansas had a 37 percent obesity rate, the third highest rate in the country. Out of the many state residents who used QuoteWizard to compare health insurance plans, 40 percent have a BMI in the obese range.
Tobacco use
Due to the substantial risks from smoking, tobacco users pay more for health insurance. About 23.6 percent of AR residents are smokers, the third highest rate in the country.
Age
According to HealthCare.gov, a health insurance plan costs up to three times more for an older person compared to a younger person. AR residents who used QuoteWizard to shop for health insurance are, on average, 41 years old.
Location
Your zip code plays a big role in how much you’ll pay monthly for health insurance. Every state has different health care rules, regulations, and providers.
Also, health insurance companies use community-rating to determine your costs. Rates are based in part on the combined claims that everyone files. So, your prices could be higher if your neighbor files an abnormally high number of claims.
That means living in a more health-conscious state could keep your premiums low. According to America’s Health Rankings, Arkansas is the 48th healthiest state in the country.
Arkansas health insurance laws
The Affordable Care Act limits health insurance companies from charging consumers more based on certain factors.
- Pre-existing conditions: Insurance companies used to charge you more if you had a pre-existing condition. Now, the ACA doesn’t allow providers to bump up your prices if you fall into that category.
- Gender: According to a study by Health Services Research, women historically pay more for health insurance. But now the ACA mandates that women and men can’t be charged different prices for the same policy.
- Insurance and medical history: Insurance companies also used to analyze your previous medical conditions and medical history. Any lapses in insurance or previous medical problems often meant higher health care premiums.
There’s a limit to how much you can pay out-of-pocket for a marketplace plan. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
Arkansas law requires health insurance companies to provide at least some coverage for the following services:
- Emergency room services
- Prosthetic devices
- Off-label drug use
- Nutritional counseling for diabetes
- Diabetic supplies and education
- Diagnosis and treatment of autism spectrum disorders
- Cancer screenings
There are additional services that state law requires companies to provide coverage for. Find the entire list at cms.gov.
Medicare and Medicaid in Arkansas
Medicare and Medicaid are both government-funded programs that offer affordable health care. Medicare aids seniors, whereas Medicaid helps low-income families and children.
Medicare
Medicare is for residents 65 and older. There are several options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Programs with these income requirements:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
The rate of uninsured Americans has improved dramatically since the Affordable Care Act (ACA) became law in 2010. Here’s how a key component of that legislation, Medicaid expansion, helped shrink Arkansas' uninsured rate over the last decade.
In 2008, 495,500 Arkansas residents, or 18% of the state’s population, were uninsured. Since the state expanded its Medicaid program in 2014, Arkansas’ uninsured rate has dropped to 8% (as of 2018, the most recent year data is available). Driving this reduction was a 61% increase in Medicaid enrollment — to 796,600 Arkansas residents — between 2008 and 2018.
These are the state’s Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Arkansas insurance department
- Website:
- Homepage
- Insurance Commissioner:
- Allen W. Kerr
- Insurance Hotline:
- (800) 282 - 9134
- Office Hours:
- Monday - Friday
8:00 am to 4:30 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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