Arkansas Health Insurance

Arkansas Medical Insurance Overview

Of those who enjoy health insurance coverage in the state of Arkansas, a good number of residents receive coverage from their workplace, through state-funded or individual health plans. Despite the many health insurance options available, a great deal of residents are not covered by health benefits.

For residents who are unable to afford the cost of health insurance or cannot receive coverage because of a pre-existing condition, there are various state-funded health plans offered in Arkansas. The information provided below gives a good idea of what the climate looks like in the state with regard to how healthy the state’s residents are and their options for health insurance coverage. Because of the recent healthcare reform that has taken place, we are sure the statistics listed below are likely to change.

Arkansas’ Health Care Issues

In comparison to the United States as a whole, Arkansas is ranked at 48th place with regard to the health of the state’s residents. With regard to health care issues, the state has seen a drop in place from 47th to 48th since the year 2011. The state’s ranking is particularly bad because of those residents dealing with diabetes, smoking and obesity among the population. On a better note, Arkansas’ residents do not have a problem with binge drinking and have a good track record for immunizations.

The United Health Foundation has annual data that can be viewed on their website if you are looking for more information on how Arkansas ranks overall.

Understanding Arkansas’ Uninsured Population

The Arkansas Center For Health Improvement (ACHI) gives a wide variety of details on the state of health insurance coverage in the state of Arkansas. Despite having a lower than average unemployment rate compared to the rest of the country, the percentage of residents in Arkansas covered by employer-sponsored insurance plans is 42 percent. Eighteen percent of the population in the state has no type of insurance coverage and 25 percent of working age people do not have insurance coverage. Between 2000 and 2010, insurance premiums required of families in the state have doubled, causing even more of a hardship when it comes to obtaining health insurance coverage. The lack of insurance in the state is because it is one of the poorest states in the country overall.

When thinking about the uninsured population in Arkansas, below are some statistics:

• Of those private insurance companies in the state of Arkansas, 42.5 percent of these provide insurance benefits to workers, compared to over half of those in the entire nation.
• 42 percent of low-income people over the age of 18 in Arkansas are not covered by insurance.
• Adults with dependents who are without insurance in the state of Arkansas make up 26 percent of the state’s population, which is higher than the nation as a whole.

Group Health Plans

Even though there are a low percentage of workers in Arkansas who have insurance through their workplace, residents in the state should first resort to asking their employers for health benefits. Group plans through the workplace can offer the best options in insurance coverage for individuals who work. The insurance providers offering the group plans are generally disallowed from excluding people based on if they are suffering from a pre-existing condition. If a worker in the state of Arkansas wishes to receive health insurance coverage under their employer’s plan, they are usually required to work at least 30 hours to be able to sign up for coverage. In Arkansas, the Department of Insurance is responsible for the regulation of the health insurance market.

Signing Up

If you are looking to get coverage through your employer’s health plan, you should first ask the HR Manager when the enrollment period is. If you are late signing up during the enrollment period, you may be forced to wait out another period of time before you are able to sign up for insurance coverage. There are several factors you should keep in mind when signing up for coverage:

• Research all of the details about what your plan does and does not cover. Looking into finding the best policy will have you reading many items, but do not skip over important information.
• Talk with the person in charge of Human Resources at your job. This is the person who knows the most about the benefits where you work, so he or she can give you any information you require in order to make an informed decision.
• Many employer-sponsored plans will cover your dependents until they reach the age of 26.
• Those insurance companies operating in Arkansas have to offer screenings for breast and colon cancer, reconstructive surgery following a mastectomy, care related to diabetes, vaccinations for minor children and prenatal care to pregnant women.

Pre-Existing Condition Exclusion Periods

Despite being unable to exclude you from coverage because of a pre-existing condition, your insurance company can make you wait an exclusion period before you policy will go into effect. You may have to wait a period of 12 months before your insurance benefits can be used due to a pre-existing condition. The insurance provider can also look back into your medical records for a period of six months in order to verify that you have a pre-existing condition.

Affiliation Or Waiting Periods

Affiliation or waiting periods are the time period of which you could be made to wait when you sign up for insurance coverage. If you are late enrolling into your employer’s group plan, you may have to wait a period of three months for your benefits to go into effect.

Individual Health Plans

If your employer does not offer insurance, if you are unemployed or self-employed, you may find that you need to secure your own health insurance coverage. In this case, you have the ability to choose an individual health plan in order to receive medical services. Of those living in the state of Arkansas, only 4 percent are covered under the terms of an individual health insurance plan. For those enrolling in this sort of plan, the insurance company is allowed to do a lot of underwriting and can also deny coverage to applicants with pre-existing conditions.

With regard to pre-existing conditions, there is limited exclusion and look back periods of which insurance providers have to abide. If you are looking for coverage under an individual plan in Arkansas, you can be made to wait a period of up to two years because of a pre-existing condition and the company can look back 12 months into your medical records.

The Department of Insurance has extended a brochure online for those looking for more information regarding how the HIPAA law affects the individual and group plans in the state of Arkansas.

Continuation Coverage

If you are between jobs or have recently lost your insurance coverage, a program called COBRA (Consolidated Omnibus Budget Reconciliation Act) was invented to fill in the gaps in your insurance coverage. This is a temporary insurance plan that those who have been removed from insurance plans can receive up to 18 months of coverage or when they are able to obtain coverage elsewhere.

Arkansas Health Benefit Exchange

With the passing of the Affordable Care Act, each state was given the opportunity to design and implement its own health insurance marketplace. However, the state of Arkansas opted to allow the federal government the ability to run their marketplace. The marketplace website was setup as a place where uninsured people could locate affordable insurance coverage for themselves and their family members. Despite the program being run on a federal level, there is a possibility that this can change in the times ahead.

In December 2012, Arkansas’ plans with regard to its health benefits marketplace was relayed by the governor of the state to the Department of Health and Human Services. Following that, the state created a Plan Management Advisory Committee which had the purpose of analyzing the essential health benefits (EHB) and recommended options that should be available in the marketplace on a state level. The Health Benefit Exchange in Arkansas was given final approval after the federal government provided the state with a $1 million grant to create the marketplace.

Arkansas State Insurance Programs

According to statistics, 36 percent of those living in the state of Arkansas are covered by a state-funded insurance program. There are a number of plans available to residents through the state. Among them are: the Comprehensive Health Insurance Pool (CHIP), Take Care Arkansas, Medicaid, ARKids First A, ARKids First B, Breast Care, Mother-Infant Program (MIP), Maternity Program, Medicare, Senior’s Health Insurance Information Program, the Health Coverage Tax Credit and the VA Medical Benefits Package. Of the other health resources made available to the state’s residents, there are: the Partnership For Prescription Assistance, WIC, DDS Children’s Services, Women’s Health: Family Planning, Maternity & Midwifery, and the National Association of Mental Illness Helpline (NAMI). For more detailed information on what each of these programs represent, you can check out the Arkansas Health Coverage Matrix created by the Foundation for Health Coverage Education.

Comprehensive Health Insurance Pool (CHIP) and Take Care Arkansas

CHIP provides coverage for people in the state who are suffering from pre-existing conditions and have had a hard time getting insurance coverage. It also covers those who have been offered premiums that were considered unaffordable. CHIP gives comprehensive coverage that includes medications, lab tests, x-rays, physical therapy, rehabilitation and doctor’s visits.

Take Care Arkansas also offers a wide variety of medical care services. Both of these programs require members to be residents of the state of Arkansas and to have them show proof that they have been denied for coverage elsewhere because of a pre-existing condition.

Medicaid and ARKids First A

This program aids individuals and families who are low income with acquiring health insurance coverage. Pregnant women and children in families that are earning less than 200 percent of the Federal Poverty Level are given guaranteed insurance coverage. Newborns and children up to the age of five are also guaranteed coverage if their families earn up to 133 percent of the Federal Poverty Level and those children between six and 18 whose families earn up to 100 percent of the Federal Poverty Level.

ARKids First B

This plan is for those children whose families are earning moderate wages and include immunizations, prescription medications, speech therapy, dental care, durable medical equipment, family planning services and hospice care. ARKids First B is extended to those children from families that have a yearly income of up to 200 percent of the Federal Poverty Line.

Mother-Infant Program (MIP), Breast Care, and Maternity Program

The MIP, Breast Care and Maternity Programs were created to give pregnant and low-income women coverage if they meet the income requirements. MIP gives participants nursing visits for mothers and their infant children, Breast Care gives financial help in combating the high costs of mammograms, pelvic examinations, PAP tests and breast exams. The Maternity Program administers pregnancy tests, STD testing, other labs and prenatal education.

Medicare and Senior Health Insurance Information Program (SHIP)

Through these programs, senior citizens and those who are disabled can obtain health insurance coverage that takes care of in-patient services, preventive medicines, outpatient care services and prescription medications. SHIP is a counseling service that offers the options available to those looking for coverage under Medicare. If you are 65 or older and have worked (or your spouse has worked) under a Medicare-covered job for ten years or if you have a disability, you can receive guaranteed coverage through Medicare.

Health Coverage Tax Credit

For those receiving Trade Adjustment Assistance (TAA), the Health Coverage Tax Credit offers health benefits like in and outpatient care, preventive medical services and doctor’s visits. These benefits are made available to those who are getting pension benefits through the Pension Benefit Guaranty Corporation.

VA Medical Benefits Package

If you have served in any branch of the United States military for a period of two years without receiving a dishonorable discharge, you can apply for benefits under this program that is geared toward U.S. veterans.

Partnership for Prescription Assistance

There are 475 programs available through the Partnership for Prescription Assistance and those who are without prescription insurance coverage can look to this program for help in getting covered for medications.

Women-Infants-Children (WIC)

The WIC Program offers help in the form of prenatal education, nutritious foods and by helping low-income mothers care for their infant children. It also works to aid mothers and children with getting immunizations.

DDS Children’s Services

For those children with special needs with regard to their health care because of chronic behavioral or developmental conditions, this plan goes beyond normal insurance plans and any other state-funded programs.

Women’s Health: Family Planning, Maternity & Midwifery

This programs gives education on responsible planning and reproductive education to those in the community through the use of outreach services.

National Association of Mental Illness Helpline (NAMI)

This is a resource for those looking for assistance in dealing with mental health issues. The service connects people to volunteers who have a wide variety of knowledge on these matters.

Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act of 1997 enforces rules on insurance companies with regard to any pre-existing conditions, exclusion or waiting periods and the costs associated with monthly premiums. For more information on how this affects residents living in the state of Arkansas, you can read through this document.