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QualChoice was founded in 1994 by the University of Arkansas for Medical Sciences. Originally created to be a third-party administrator, it grew quickly into a full health insurance company providing corporate benefits as well as offering individual HMO and PPO health insurance plans.
QualChoice acquired Community Bank Life in 2009 and restructured the entire company into QualChoice Life and Health Insurance Company, Inc. The following year QualChoice Holdings was created to act as a parent company for the newly formed corporation.
In April of 2014, Catholic Health Systems (CHI), one of the largest nonprofit health systems in the country, acquired QualChoice Holdings. Only two years later, it was reported that CHI was considering the sale of QualChoice as part of a move away from health insurance, but no action has yet been taken.
QualChoice is headquartered in Little Rock and covers the entire state with a variety of products. Medicare Plans, however, have a more limited service area.
QualChoice writes both Medicare Advantage and Medicare Supplement Insurance. They do not offer Part D coverage separate from what is included with the Medicare Advantage.
QualChoice Advantage Classic Plus Rx is an HMO plan available with medical service in specific counties: Conway, Garland, Lonoke, Perry, and Polaski. Pharmacy service is statewide.
The plan has no deductible. There is a low, $5 co pay for primary care office visits, while specialist visits cost $40. Urgent care has a $50 co pay and emergency care a $75 co pay. The co pay for inpatient hospital care is $450 per day for the first four days, with no co pay thereafter. While that is a higher daily co pay than many similar plans, it is only charged for four days while most plans charge for at least the first five.
The plan also includes coverage for hearing, vision, and dental. That includes preventative exams and an allowance for hearing aids and eyeglasses or contacts. Also included is a fitness membership, as with many such plans.
The Part D coverage has no deductible and co pays for drugs start at $3 for Tier 1 drugs at a retail pharmacy. Tiers 2 and 3 have $15 and $47 co pays respectively, while Tiers 4 and 5 have 50% and 33% coinsurance respectively.
Although the wording on the company website leads the reader to believe there are several Advantage Plans, the Classic Plus HMO is the only plan listed or outlined. Because the plan is an HMO, it’s important to be aware that the provider network will be limited; if you prefer to keep your current doctor, you should check the provider list before signing up for any HMO plan.
Medicare Supplement plans are offered in most areas of the state. QualChoice offers 6 of the 11 standard plans, including the most popular selections.
Plan A is offered by all Medicare Supplement providers and is the most basic plan. It covers the coinsurance portion of hospital, medical, and hospice that isn’t paid by Medicare. It also covers the first three pints of blood annually. All of the other plans on the list include and expand upon this coverage.
QualChoice’s additional available plans are F, F with High Deductible, G, K, and N. That’s a good selection of plans that should cover the needs and budget of most consumers. F is the plan that offers the most coverage, paying for all coinsurance and deductibles as well as extras like foreign travel emergency. The high deductible option allows the choice of full coverage at a lower monthly premium in return for an overall deductible applied to benefits.
In between A and F are several plans with a variety of coverage levels, allowing the consumer to select the right amount of coverage for their needs. Plans with foreign travel emergency, for example, may not be worth paying for if you never travel outside the U.S.
QualChoice has only one Advantage plan listed, and it is a $0 premium plan. That means that you pay nothing monthly above and beyond your Original Medicare premium. While we can’t compare the plan at a national level, nor to our usual sample, the plan does appear to offer reasonable co pays and coverage for a no-added-premium choice. However, as an HMO the limited network of providers does have some impact on the value.
Rates for Medicare Supplement differed by county in 2016, but for 2017 the company consolidated the rates into a single chart. They start at $112.53 for Plan A. Plan F runs at $172.46, with the high deductible option at only $56.06, making it the cheapest choice just behind Plan K at $62.43.
Again, we can’t compare on a national level, but the Plan A rate falls something around the average price we have seen in other states, lower than many. The Plan F premium is among the highest we have seen, although with the high deductible it lands at the bottom among the cheapest. This range of high, average, and low rates makes it difficult to formulate a solid conclusion as to where QualChoice falls overall compared to other companies, but it is likely somewhere around the middle.
Ratings and Reviews
QualChoice is listed on the Better Business Bureau under its holding company, and has an A+ rating. There are only four complaints in the past three years, and only one of them was closed in the past 12 months. That’s a good record for any company, and although this isn’t a large national insurer, for its size that’s still a low complaint volume.
There are seven Google reviews of the company, totaling overall 3.6 stars. Some reviews are negative and some positive. The negative reviews seem to focus mainly on customer service and coverage.
We didn’t find the company on any of the major review sites, not surprising since it is a smaller, regional insurer. Overall, QualChoice appears to enjoy a fairly solid reputation.
The Bottom Line
QualChoice is a good choice for anyone who likes a small, local insurance company. While they don’t have a great selection of Advantage plans, the one they do outline is straightforward and has good coverage, and there is something to be said for simplicity in selection. The Supplement plan list offers several good choices. Prices for Supplement plans are mostly quite reasonable, some a bit overpriced and some below average, so the value will depend on the coverage you want. Overall, the company is worth a look when shopping for Medicare coverage in Arkansas.
For a list of companies that we recommend, visit our Best Insurance Companies page.