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Cover Arkansas: If You Have Experienced a Loss of Health Care Coverage
Cover Arkansas: If You Have Lost Health Care Coverage
Understanding Arkansas Marketplace
As is the case in most states, Arkansas residents also experience disruptions with their health coverage. This is often because of loss of employment, aging out of a parents’ insurance policy, divorce, or other personal situations. Luckily, the Arkansas Marketplace is here to help you navigate these changes and find new coverage.
The Arkansas Marketplace is a service that helps Arkansans shop for and enroll in affordable health insurance. The federal government operates the Health Insurance Marketplace, available at Healthcare.gov, where you can compare private plans, check for cost assistance, and enroll in a plan that meets your needs.
You may be wondering what types of coverage are available through the Marketplace. Don’t worry! We will take you through this journey to outline the various options and how to sign up or change your plan whenever necessary.
Consider Jane who recently lost her job because the company she was working for closed down. As a result, Jane lost her health insurance. She visited the Arkansas Marketplace website, checked the various plans, and found one suitable for her needs.
- *Jane could enrol in any available plan during the special enrollment period.*
- *She had the option of looking through different categories including bronze, gold, silver, and platinum.*
- *Depending upon her income and household size, she could qualify for subsidies.*
- *She looked at the medical services each plan covered before making a decision.*
- *Jane noticed that all plans included essential health benefits, preventive services, and pre-existing conditions coverage.*
- *She found it easy to compares the costs of premiums, deductibles, and copayments among different plans.*
Medicaid Expansion in Arkansas
Arkansas has expanded Medicaid under the Affordable Care Act. This means low-income adults who would have been ineligible for coverage in the past can now receive Medicaid. If you’re an Arkansan who lost your job and had your income significantly reduced, this could be a viable option for you.
Medicaid is a state-run program that provides healthcare to people with low-income, including some low-income adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid programs must follow federal guidelines, but they vary somewhat from state to state.
In Arkansas, the expanded Medicaid program covers adults aged 19-64 years old who earn up to 138% of the federal poverty level (FPL). This should include most individuals who have lost their health coverage due to income-related reasons.
Let’s look at what happened when Adam, an Arkansas resident, got laid off and his earnings dropped drastically, making him eligible for Medicaid.
- *Adam applied online for Medicaid using the access.arkansas.gov portal.*
- *He was able to qualify since his income was under the threshold set by Arkansas Medicaid.*
- *The scope of services covered under Medicaid was comprehensive, including preventive care.*
- *There were minimal out-of-pocket costs for Adam to handle.*
- *He found doctors and healthcare providers accepting Medicaid without trouble.*
- *Reevaluations were carried out annually to ascertain continued eligibility.*
Short-Term Health Insurance
If there’s a short gap between your loss of coverage and the start of new coverage—perhaps due to a waiting period at a new job—you may consider temporary health insurance or short-term health insurance as a possible solution.
This type of health insurance can help cover you for a very limited period, usually less than a year. While these plans often come with lower premiums, they do not have to meet all of the government’s requirements for comprehensive health plans. This means they might not cover certain benefits, like pre-existing conditions.
Arkansas state law limits short-term health insurance policies to six months without the possibility of renewal. Let’s explore a scenario where Mary used a short-term plan to bridge the gap between her old job and new employment.
- *Mary applied for a short-term plan soon after realizing she would have a coverage gap.*
- *She knew that this would be a temporary solution since the plan duration was only for six months.*
- *Her pre-existing condition wouldn’t be covered during this period.*
- *She compared different short-term plans, ensuring to understand their limitations.*
- *While lower premiums were advantageous, she was prepared for potentially high out-of-pocket costs in case of sickness or injury.*
- *On landing her new job, she enrolled in her employer’s health plan ending her dependence on the short-term coverage.*
Insurance Premium Tax Credit
If you’re no longer eligible for health insurance through your employer, but you’re still out of the income bracket for Medicaid, you may qualify for the premium tax credit. The premium tax credit is geared towards helping people afford health insurance purchased through the Arkansas Marketplace.
The amount of the credit is based on a sliding scale, with greater tax credits available to those with lower incomes. It can be applied in advance to your monthly premium, which could help reduce your out-of-pocket costs for your coverage.
Steven, an individual who just started his small business, found himself qualifying for the tax credit.
- *Steven applied for an insurance plan during the enrollment period through the Arkansas Marketplace.*
- *He took advantage of the tax credit to lower his monthly premiums.*
- *His eligibility depended on factors including his estimated income and members in his household.*
- *He realized that if he took more premium tax credit than eligible, it would be deducted from his tax refund or added to his federal taxes due.*
- *In case of changes in income or family size during the year, Steven learned to report it to the Marketplace immediately.*
- *At tax time, he used form 8962 to reconcile these advanced payments with the correct amount credited to him.*
Insurance Through a New Employer
Perhaps, you’ve lost your job but have quickly transitioned to a new employer. In this case, you’ll likely want to see what health insurance options are available through your new place of work.
Employer-sponsored health plans generally offer comprehensive coverage, and the employer helps share the cost. If it’s available to you, this is usually a cost-effective method of maintaining health insurance coverage after a disruption.
Nancy was swift in transitioning from her old job to a new one.
- *She reviewed the healthcare plan options provided by her new employer during the enrollment period.*
- *Since there was some waiting period before her new coverage started, she contemplated getting short-term insurance for the gap.*
- *Her contributions towards the premiums were automatically deducted from her paycheck.*
- *She went through the summary of benefits diligently understanding her copayments, deductibles, and out-of-pocket maximums.*
- *The employer’s plan included coverage for a variety of services including preventive care at no cost.*
- *She could add her spouse and dependent children under the same plan.*
Cobra Continuation Coverage
It might be possible for you to remain on your former employer’s health insurance plan for a limited time after your employment ends or after losing coverage as a dependent of the covered employee. This is through the Consolidated Omnibus Budget Reconciliation Act (COBRA).
Eligibility for COBRA continuation coverage requires certain events, like termination or reduction of employment hours. It does come at a high price because you have to pay the whole premium yourself, plus an administration fee.
Paul lost his job and elected for COBRA while he searched for a new job.
- *He preferred to stay with the same healthcare services without disruption.*
- *Despite the relatively expensive premiums compared to Marketplace plans, Paul felt COBRA was right for him.*
- *Notifications and information about his rights were sent from the plan administrator following his job loss.*
- *After evaluating his financial situation, he decided to stick with COBRA for up to 18 months.*
- *He knew that failure to pay premiums on time could lead to coverage cancellation.*
- *Upon finding a new job with health benefits, he discontinued COBRA.*
Summary – Health Care Options After Losing Coverage in Arkansas
Every individual’s situation is different, so it’s critical to consider your specific needs, budget, and preferences when seeking a new health insurance plan in Arkansas. Below is a summary table the details key features of each option discussed above.
Option | Key Features |
---|---|
Arkansas Marketplace | Affordable plans for different categories offered with potential subsidies based on income and household size. |
Medicaid | Comprehensive coverage for low-income individuals provided they meet eligibility criteria. |
Short-Term Insurance | Temporary coverage to bridge gaps but comes with limitations. |
Insurance Premium Tax Credit | Tax credit to help reduce monthly premiums, eligibility based on income and household size. |
Insurance Through New Employer | Potentially cost-effective coverage shared by employer, covers a variety of services. |
COBRA | Maintains same coverage as previous employment but is relatively expensive. |
Losing your health coverage may seem daunting, but remember that you still have multiple options in Arkansas. It’s essential to navigate through them carefully and make an informed choice about what plan is best for you in your current circumstances.