Arkansas health plan · 2026

HA Bronze National · 13262AR0230006

HMO Partners, Inc. d/b/a Health Advantage offers this marketplace health insurance plan (Plan ID 13262AR0230006) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Expanded Bronze Plan type: POS CSR: Limited Cost Sharing Plan Variation Issuer: HMO Partners, Inc. d/b/a Health Advantage
Telehealth Data pending HSA eligible Yes Dental Not listed Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 64.57% (35.43% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$285 – $1118

Before subsidies

Estimate after subsidies

Deductible

$9,975

$19950 per group

See deductible details

Max out-of-pocket

$9,975

$19950 per group

Review MOOP rules

Office visits

Primary care $50.00
Specialist $100.00
HSA Eligible

Drug tiers

Generic $30.00
Preferred brand $210.00

View formulary tiers

$390 / mo before subsidies

≈ $4685 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1237 / mo before subsidies

≈ $14847 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1498 / mo before subsidies

≈ $17981 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$952 / mo before subsidies

≈ $11427 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge, No Charge

Emergency Room Services

No Charge after deductible

Durable Medical Equipment

No Charge after deductible

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Arkansas). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge, No Charge

Emergency Room Services

No Charge after deductible

Durable Medical Equipment

No Charge after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 13262AR0230006
Coverage year 2026
State Arkansas
Issuer HMO Partners, Inc. d/b/a Health Advantage
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 13262AR0230006-03
Available variants

Standard Off Exchange Plan · 13262AR0230006-00

Standard On Exchange Plan · 13262AR0230006-01

Open to Indians below 300% FPL · 13262AR0230006-02

Open to Indians above 300% FPL · 13262AR0230006-03
Last plan update Wed, 15 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Arkansas 22669
PCPs in Arkansas 2302
Telehealth support Data pending
Nationwide providers 36079
22,669 doctors statewide 2,302 PCPs 81 OB/GYN

Provider network(s)

Providers Arkansas All US states
All 22669 36079
PCP 2302 2935
Allergy 4 6
OB/GYN 81 111
Dentists 646 736

Drug coverage overview

3,724 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
GENERIC 2,661
PREFERRED-SPECIALTY 454
PREFERRED-BRAND 304
NONPREFERRED-BRAND 223
NONPREFERRED-SPECIALTY 82
Prior authorization Drugs
Required 872
Not Required 2,852
Step therapy Drugs
Required 226
Not Required 3,498
Quantity limits Drugs
Has Limit 1,087
No Limit 2,637

Customer highlights

What stands out for members

  • Issuer: HMO Partners, Inc. d/b/a Health Advantage · Plan ID 13262AR0230006 · 2026 filing.
  • Disease management programs available: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 13262AR0230006-03 (Open to Indians above 300% FPL) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Limit is explicitly a combined 30-visit limit for PT, OT, ST and chiro.

Diabetes Care Management

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Diabetes Education

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network No Charge after deductible

Home Health Care Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Limit: 50.0 Visit(s) per Year

Coverage is provided for Home Health Services when Coverage Policy supports the need for in-home service and such care is prescribed or ordered by a Physician. Covered Services must be provided through and billed by a licensed home health agency. Covered Services provided in the home include services of a Registered Professional Nurse (R.N.), a Licensed Practical Nurse (L.P.N.) or a Licensed Psychiatric Technical Nurse (L.P.T.N.).

Laboratory Outpatient and Professional Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Other Practitioner Office Visit (Nurse, Physician Assistant)

$50.00
Tier 1 in-network $50.00
Out-of-network No Charge after deductible

Preventive Care/Screening/Immunization

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

Preventive Drugs

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network 100.00%

Primary Care Visit to Treat an Injury or Illness

$50.00
Tier 1 in-network $50.00
Out-of-network No Charge after deductible

Coverage includes 3 free visits before copay for consultation and evaluation in-network services if the services are from one of the following categories:Primary Care Physician visits, Outpatient Rehabilitation Services, Outpatient Habilitation Services, or Outpatient Mental Health Services. This benefit applies to the first 3 claims submitted in the calendar year which meet this description.

Rehabilitative Occupational and Rehabilitative Physical Therapy

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Limit is explicitly a combined 30-visit limit for PT, OT, ST and chiro.

Rehabilitative Speech Therapy

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Limit is explicitly a combined 30-visit limit for PT, OT, ST and chiro.

Specialist Visit

$100.00
Tier 1 in-network $100.00
Out-of-network No Charge after deductible

Urgent Care Centers or Facilities

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

X-rays and Diagnostic Imaging

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Delivery and All Inpatient Services for Maternity Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

For childbirth and delivery professional services, the plan's coinsurance after deductible may apply for in network and out of network services. See the plan's Summary of Benefits and Coverage for more cost details on childbirth and delivery professional services. Coverage for Out of Network newborn services is limited to $2000 per Member for all services first 90 days after birth.

Dialysis

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Durable Medical Equipment

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Emergency Room Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Emergency Transportation/Ambulance

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Hospice Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

If the Member has been diagnosed and certified by the attending Physician as having a terminal illness with a life expectancy of six months or less, Health Advantage will pay the Allowance or Allowable Charge for Hospice Care. The services must be rendered by an entity licensed by the Arkansas Department of Health or other appropriate state licensing agency and accepted by Health Advantage as a Provider. This benefit is subject to the Deductible, Copayment and Coinsurance specified in the Schedule of Benefits.

Inpatient Hospital Services (e.g., Hospital Stay)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Inpatient Physician and Surgical Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Mental/Behavioral Health Inpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Mental/Behavioral Health Outpatient Services

$50.00
Tier 1 in-network $50.00
Out-of-network No Charge after deductible

Cost Sharing does NOT apply to screenings.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Outpatient Rehabilitation Services

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Limit is explicitly a combined 30-visit limit for PT, OT, ST and chiro.

Outpatient Surgery Physician/Surgical Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Radiation

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Skilled Nursing Facility

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Limit: 60.0 Days per Year

1. The admission must be within seven days of release from an inpatient Hospital stay; 2. The Skilled Nursing Facility services are of a temporary nature and increase ability to function.

Substance Abuse Disorder Inpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Substance Abuse Disorder Outpatient Services

$50.00
Tier 1 in-network $50.00
Out-of-network No Charge after deductible

Transplant

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network No Charge, No Charge

Coverage is limited to $1400/hearing aid

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage for routine ultrasound is limited to 1. Member is encouraged to notify Health Advantage as specified in the Evidence of Coverage.

Routine Eye Exam for Children

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Year

Well Baby Visits and Care

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network 100.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$30.00
Tier 1 in-network $30.00
Out-of-network 100.00%

Mail Order cost: 13262AR0230006-01-$90 Copay in-network; 13262AR0230006-03-$90 Copay in-network.

Non-Preferred Brand Drugs

$1,600.00
Tier 1 in-network $1,600.00
Out-of-network 100.00%

Mail Order cost: 13262AR0230006-01-$4800 Copay in-network; 13262AR0230006-03-$4800 Copay in-network.

Off Label Prescription Drugs

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Subject to Coverage Policy

Preferred Brand Drugs

$210.00
Tier 1 in-network $210.00
Out-of-network 100.00%

Mail Order cost: 13262AR0230006-01-$630 Copay in-network; 13262AR0230006-03-$630 Copay in-network.

Specialty Drugs

$5,000.00
Tier 1 in-network $5,000.00
Out-of-network 100.00%

Requires Prior Authorization from Health Advantage.

Specialty Drugs Tier 2

$5,000.00
Tier 1 in-network $5,000.00
Out-of-network 100.00%

Requires Prior Authorization from Health Advantage.

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Anesthesia

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage is provided for Hospital services including anesthesia in connection with performance of the covered treatment for a complex dental condition provided to: (i) a Covered Person who is determined by two (2) dentists (in separate practices) to require the dental treatment in the hospital setting; (ii) a Covered Person with a diagnosis of serious mental or physical condition that precludes or inhibits the performance of the covered dental treatment in an office or outpatient setting; or (iii) a Covered Person, certified by his or her Primary Care Physician to have a significant behavioral problem that precludes or inhibits the performance of the covered dental treatment in an office or outpatient setting.

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Home infusion therapy.

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage is provided for dietary and nutritional counseling services when provided in conjunction with diabetic self-management training, for services needed by covered persons in connection with cleft palate management and for nutritional assessment programs provided in and by a hospital.

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prosthetic Devices

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Replaced no more frequently than once per 3-yr period except when necessary for growth or end of device's useful life.

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Treatment

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage subject to $25,000 Non-EHB Deductible and not applicable to IN or Out of Network MOOP. Non-EHB Deductible must be met before coinsurance applies. Coverage includes bariatric surgery, revision bariatric surgery, preoperative care (including psychological screening and counseling; behavior modification counseling; nutritional and dietary counseling; and exercise or physical therapy and counseling); and post-operative care (including without limitation: post-operative follow-up; behavior modification counseling; nutritional and dietary counseling; exercise or physical therapy and counseling; and psychological screening and counseling. Requires Prior Authorization from Health Advantage.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acquired Brain Injury

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage subject to $25,000 Non-EHB Deductible and not applicable to IN or Out of Network MOOP. Non-EHB Deductible must be met before coinsurance applies. Coverage is subject to Prior Authorization as outlined in the plan's Evidence of Coverage.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

SOB includes 'allergy services.'

Applied Behavior Analysis Based Therapies

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Bariatric Surgery

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage subject to $25,000 Non-Essential Health Benefit (EHB) Deductible and not applicable to IN or Out of Network MOOP. Non-EHB Deductible must be met before coinsurance applies. Coverage includes bariatric surgery, revision bariatric surgery, preoperative care (including psychological screening and counseling; behavior modification counseling; nutritional and dietary counseling; and exercise or physical therapy and counseling); and post-operative care (including without limitation: post-operative follow-up; behavior modification counseling; nutritional and dietary counseling; exercise or physical therapy and counseling; and psychological screening and counseling. Requires Prior Authorization from Health Advantage.

Biomarke

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Cochlear Implants

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

One cochlear implant per ear per Member per lifetime

Community Health Worke

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Craniofacial Surgery

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage subject to $25,000 Non-EHB Deductible and not applicable to IN or Out of Network MOOP. Non-EHB Deductible must be met before coinsurance applies. Requires Prior Authorization from Health Advantage.

Doulas

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Eye Glasses for Children

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Limit: 1.0 Item(s) per Year

Gastric Electrical Stimulation

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Genetic Testing for Cance

No Charge
Tier 1 in-network No Charge
Out-of-network No Charge

Habilitation Services

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Limit is explicitly a combined 30-visit limit for PT, OT, ST and chiro; Limited to a maximum of 180 units for developmental services visits per Member per calendar year, except where the services are rendered in connection with Autism Spectrum Disorder benefits as set forth in the Evidence of Coverage.

Imaging (CT/PET Scans, MRIs)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Inherited Metabolic Disorder - PKU

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Lung Cancer Screening

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network 100.00%

Coverage is provided for lung cancer screenings that meet the American Cancer Society screening guidelines.

PANS/PANDA

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Coverage subject to $25,000 Non-EHB Deductible and not applicable to IN or Out of Network MOOP. Non-EHB Deductible must be met before coinsurance applies. Requires Prior Authorization from Health Advantage.

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

1. Treatment provided for the correction of defects incurred in an Accidental Injury sustained by the Member; 2. Surgery performed for the removal of a port-wine stain or hemangioma (only on the face) 3. Treatment provided for reconstructive surgery following neoplastic (cancer) surgery; 4. In connection with a mastectomy resulting from surgery, services for (a) reconstruction of the breast on which the cancer-related surgery was performed; (b) surgery to reconstruct the other breast to produce a symmetrical appearance; and (c) prostheses and services to correct physical complications for all stages of the mastectomy, including lymphedemas; (d) artificial or biological mesh used to support the tissue; and (e) a nerve graft to preserve or restore nerve function. Breast reconstruction surgery for all stages of surgery to repair physical defects caused by the removal or medical treatment of diseased breast tissue and all stages of surgery to reconstruct a breast mound or to create a new breast mound to reestablish symmetry between two breasts is covered subject to the Coverage Policy. Prior Authorization is required for this service. 5. Reduction mammoplasty, if such reduction mammoplasty meets Coverage Criteria as specified in Coverage Policy.

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Treatment for Temporomandibular Joint Disorders

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Well Child Care

No Charge, No Charge
Tier 1 in-network No Charge, No Charge
Out-of-network 100.00%

Variant attributes

HA Bronze National · Variant 13262AR0230006-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

13262AR023

Metal Level

Expanded Bronze

Plan ID (Standard Component ID with Variant)

13262AR0230006-03

Plan Marketing Name

HA Bronze National

Plan Variant Marketing Name

HA Bronze National

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

13262

Issuer Marketplace Marketing Name

Health Advantage

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

Yes

Network ID

ARN001

Out of Country Coverage

Yes

Out of Country Coverage Description

Emergency Care

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Benefit Reduction

Service Area ID

ARS001

State Code

AR

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.645674046

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$9,975

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$0

SBC Scenario, Having Diabetes, Deductible

$7,300

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$1,900

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$19950 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$9975 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$9,975

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

$59850 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

$29925 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

$29,925

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

ARF004

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$40

SBC Scenario, Having Diabetes, Limit

$60

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

3

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs

EHB Percent of Total Premium

0.9999

First Tier Utilization

100%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

Yes

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Level Exclusions

No

Plan Type

POS

QHP/Non QHP

Both

Source Name

SERFF

Plan ID

13262AR0230006

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$19950 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$9975 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$9,975

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

$59850 per group

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

$29925 per person

Combined Medical and Drug EHB Deductible, Out of Network, Individual

$29,925

Unique Plan Design

No

Wellness Program Offered

Yes

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Arkansas?

HA Bronze National (13262AR0230006) is a Expanded Bronze POS from HMO Partners, Inc. d/b/a Health Advantage in Arkansas for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does HA Bronze National support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is HA Bronze National HSA-eligible and does it include dental or vision coverage?

It is HSA-eligible, so you can pair it with a Health Savings Account to lower taxes.

Dental coverage is not listed for this plan.

Vision add-ons: Child.

Does HA Bronze National support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with HA Bronze National?

The issuer lists disease management resources for: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs.

Is there out-of-country coverage for HA Bronze National?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency Care

Does HA Bronze National cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Benefit Reduction

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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