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Arkansas has a state-based exchange using the federal enrollment platform at HealthCare.gov for the sale of certified individual/family dental plans.
Not all insurers who offer medical plans through the Arkansas exchange include dental coverage with their health plans, but stand-alone dental plans are available for purchase that cover both adults and children.
For adults who purchase their own or family stand-alone dental coverage through the exchange, premiums range from $36 to $93 per month.
IHC Specialty Benefits reports that the average monthly premium for a stand-alone family dental plan sold in Arkansas in 2022 was $43.57.
If a family is purchasing coverage through the health insurance exchange, the premiums associated with pediatric dental coverage may or may not be offset by premium tax credits (premium subsidies). Here’s more about how that works, depending on whether the health plan has integrated pediatric dental benefits.
The pediatric stand-alone dental plans available in Arkansas will comply with the ACA’s pediatric dental coverage rules. This means out-of-pocket costs for pediatric dental care will not exceed $375 per child in 2023 (or $750 for all the children on a family’s plan), and there is no cap on medically-necessary pediatric dental benefits.
As is the case for all essential health benefits, the specific coverage requirements for pediatric dental care are guided by the state’s essential health benefits benchmark plan.
You can see details here for Arkansas’s benchmark plan, which does include coverage for both basic and major dental services for children.
In 2023, there are three insurers that offer stand-alone individual/family dental coverage through the health insurance marketplace in Arkansas. These are dental plans that are not included with a medical plan and must be purchased separately:
These plans can be purchased through HealthCare.gov during open enrollment (November 1 to January 15) or during a special enrollment period triggered by a qualifying life event. Exchange-certified stand-alone dental plans are compliant with the ACA’s rules for pediatric dental coverage.
There are also a variety of dental insurers that sell stand-alone dental plans directly to consumers in Arkansas. These plans are not subject to the ACA’s essential health benefit rules for pediatric dental coverage, but they are regulated by the Arkansas Insurance Department. If you would like to purchase a non-ACA qualified dental plan, ask a dentist for recommendations or search online.
There are also various dental discount plans available in every state. Dental discount plans are not insurance, but can offer discounted rates at participating dentists. Here’s what you need to know about the differences between dental insurance and dental discount plans.
To find plans in your area, search online for dental discount plans and the state you are looking to buy a plan in.
Adults enrolled in Medicaid in Arkansas are eligible to receive up to $500 in annual dental services (not including extractions and dentures). Eligible children (up to age 21) can receive comprehensive dental benefits.
ARKids First (a combination CHIP program) provides dental coverage to children and some women with income above the eligibility limits for Medicaid.
Arkansas transitioned to a state-based exchange in 2017, but is continuing to use the Healthcare.gov enrollment platform. Centene/Ambetter (including QualChoice) and Arkansas Blue Cross Blue Shield (including Health Advantage) offer plans for 2023. Average rates increased about 6%, and enrollment hit a new record high for 2023.
Check short-term health insurance plan availability in Arkansas and shop for coverage. Learn about state regulations regarding short-term plan duration and renewal.
Arkansas expanded Medicaid by using Medicaid funds to purchase exchange plans for eligible enrollees. The program has been altered over time and is now called Arkansas Health and Opportunities for Me (ARHOME). The state still uses a privatized approach to Medicaid expansion, but will temporarily pause automatic enrollment of new enrollees in private plans (letting the default be traditional fee-for-service Medicaid instead) if enrollment in private plans exceeds 80% of all ARHOME enrollees (all enrollees still have the option to select a private plan).
For all information on Medicare in Arkansas, healthinsurance.org has you covered. Get all the resources you need to make an informed decision.
