Aspects of the 2010 Patient Protection and Affordable Care Act are already changing the way insurance is written and sold in every state. For instance, it is no longer legal to exclude children from health coverage on the basis of a pre-existing condition, although adults will not enjoy this same protection until 2014. Dependent children, however, must now be carried on their parents’ health policies through age 26 regardless of marital or educational status.
Given these and other factors like the establishment of temporary high-risk insurance pools and the creation of insurance exchanges, state insurance policies are in flux. What is legal and allowed today may be different in six months. This means that being informed about the specifics of your state’s policies is now more important than ever if you want affordable and comprehensive coverage. This is especially true for low-income residents who need the assistance of federal programs like Medicare and Medicaid or the CHIP insurance coverage for children.
Basic Insurance Regulations
Currently, in Arkansas, a pre-existing condition can be any condition or ailment for which the applicant has received care in the previous five years. If, however, the insurer does agree to provide coverage, a rider can be attached to the policy so that no expenses relative to that condition will be covered. Even if the applicant has had previous coverage, a new insurer can still exclude for a pre-existing condition for up to two years.
All Arkansas health insurance plans must provide a renewability guarantee. This prevents insurance companies from denying a request to renew an insurance contract due to a medical condition. Arkansas has a high rate of premature death due to cancer and obesity. Additionally, the immunization coverage in the state is low. As you age or your health declines, insurers in Arkansas have the right to increase your rates.
There is no state regulation of insurance prices, but, if the premiums on a policy have been paid, the policy holder is guaranteed the right to renew. The state also provides temporary insurance during gaps in coverage. These “conversion” policies have fewer benefits, however, and the rates are high. Employers are not required to cover part-time employees in a group insurance plan, but pre-existing conditions are guaranteed acceptance.
Health Care Exchanges and High Risk Pools
Arkansas has decided against creating a health care exchange, but eligible residents may apply for the state’s Pre-Existing Condition Insurance Plan program run by the Arkansas Comprehensive Health Insurance Pool. For non-smokers, premiums range from $117 a month to $526, with a deductible of $1000 and no more than $1000 additional out-of-pocket expenses annually.
Although Medicaid is a federal program, states determine the income qualifications for those benefits as well as the levels for the Children’s CHIP-funded Medicaid Expansions. Infants and children up to age 5 qualify at 133% of the Federal Poverty Level for Medicaid, and 200% for CHIP benefits. Recipients age 6 to 19 qualify at 100% and 200% respectively.
Pregnant women may draw Medicaid benefits at 200% of the FPL, with parents and caretaker relatives qualifying at 15%, parents with some waivers at 200, all adults at 200, and non-elderly disabled Social Security recipients at 74%.
In addition to normal federal Medicare benefits, there are 49 approved Medicare prescription drug plans available in Arkansas.