Availability of short-term health insurance in Arkansas

Yes. As of 2024, there are at least six insurers offering short-term health insurance in Arkansas.

The average monthly premium for a short-term health insurance plan sold in Arkansas was $253.13 in 2023, according to data from IHC Specialty Benefits.

Because Arkansas doesn’t impose its own limits on short-term health plan duration, the federal regulations apply in Arkansas. Those rules limit these policies to initial terms of no more than three months. Total duration, including renewals, is limited to no more than four months.

Insurers can offer short-term plans with maximum durations that are below the limits allowed under federal regulations.

Short-term health insurance in Arkansas can be purchased by residents who can meet the insurers’ underwriting requirements.

In most cases, this means being under 65 years old and not having a medical condition that will result in a declined application.¹ But the specific requirements vary from one insurance company to another.

Short-term health insurance plans typically include blanket exclusions for pre-existing conditions, and they often use post-claims underwriting (meaning that they will go back through a person’s medical records after a claim is filed, to make sure it isn’t related to a pre-existing medical condition).²

Short-term health plans also generally exclude coverage for some of the ACA’s essential health benefits — most commonly, maternity care, prescription drugs, and mental health care.¹ They also generally impose dollar limits on any coverage they provide. It’s important to double-check all of the plan information before purchasing a short-term policy, to make sure that you understand the limitations of the plan.

If you need health insurance coverage in Arkansas and it’s outside of the annual open enrollment period for ACA-compliant plans (November 1 to January 15 in Arkansas), start by checking your eligibility for a special enrollment period that you can use to enroll in an ACA-compliant major medical plan. A variety of qualifying life events can trigger a special enrollment period and allow you to buy a plan through the health insurance exchange/Marketplace in Arkansas (HealthCare.gov).

The plans available through the exchange are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months. So if you’ll soon have coverage under another plan — maybe Medicare or a new employer’s plan — you’ll be able to cancel your Marketplace plan when the new coverage takes effect. And if you’re eligible for a premium subsidy through the exchange, you can receive that even if you only need the coverage for a short time.

(Note that the premium subsidy is a tax credit that gets reconciled on your federal tax return based on your household income for the whole year; if your income is going to end up above the subsidy-eligible range due to a new job later in the year, you wouldn’t be eligible for the premium subsidy for the months prior to starting the new job, and would have to repay it on your tax return. But through at least the end of 2025, the American Rescue Plan and Inflation Reduction Act have made subsidies available to people with incomes well above the limits that applied in previous years.)

Be it in Fayetteville or Pine Bluff, there are times when a short-term health insurance plan might be the only realistic option, such as:

• If you missed open enrollment for ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
• You’ll soon be enrolled in Medicare, it’s outside of the annual open enrollment period for ACA-compliant coverage and you’re not eligible for a special enrollment period, and you don’t have access to any other coverage in the meantime.
• You’re newly employed and will soon be covered by your new employer’s health plan, but have a waiting period before you’re eligible for the coverage (this can be up to three months).
• If you’re not eligible for Medicaid or a premium subsidy in the exchange, an ACA-compliant plan might be unaffordable, and the less costly monthly premiums for short-term plans might be a more realistic option.

Folks not eligible for premium subsidies include:

• Those earning too much money to qualify for a subsidy. Prior to the American Rescue Plan, this cap was set at 400% of the poverty level, but the American Rescue Plan made subsidies available at higher incomes, and the Inflation Reduction Act extended that through 2025.
• People who were previously caught by the ACA’s family glitch, and still aren’t eligible for a subsidy even with the family glitch fix in place.
• People whose immigration status prevents them from enrolling in a plan through the marketplace (premium subsidies are only available through the marketplace, and enrollees must have a valid lawfully present status in the US in order to enroll through the marketplace).

Arkansas defaults to the federal regulations in terms of the allowable duration of short-term health insurance policies, so insurers can offer plans with initial terms of up to a year, and total duration, including renewals, of up to three years. As noted above, the allowable durations will be much shorter for policies issued starting in September 2024.

The state conducts rate review for short-term plans to ensure that the rates are actuarially justified, and also requires short-term plans to include coverage for some state-mandated benefits.

The Arkansas Insurance Department allows short-term insurers to submit their initial rate filings and implement them without review, but rate changes after that are required to go through the state’s rate review process (short-term rate filings in SERFF indicate that Bulletin 14-2016 and Arkansas statute 23-79-109 are applicable to short-term plan rate filings).

Arkansas also requires short-term plans to cover some state-mandated benefits, but these are not the same as the ACA’s essential health benefits. Some examples of state-mandated medical benefits applicable to short-term health insurance plans are preventive healthcare for children, medical foods, gastric pacemakers, and treatment for loss or impairment of speech or hearing.

Arkansas insurance statute also indicates that sections 23-85-105 through 23-85-117 apply to all plans sold in the state (including short-term health plans), but those regulations largely pertain to things like billing, grace periods, and the processing of claims, rather than coverage of medical conditions.

In November 2018, after the allowable duration for short-term coverage had been extended, the Arkansas Insurance Department issued a warning to consumers, noting that short-term plans are not compliant with the ACA, do not cover some of the ACA’s essential health benefits, do not cover pre-existing conditions, use medical underwriting to determine eligibility for coverage, and are limited to initial terms of under 12 months.