QualChoice Medicare Insurance Review & Complaints: Health Insurance (2024)

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QualChoice is an Arkansas health insurance company that offers a variety of individual and group insurance plan options. They are one of the largest insurers in the region and write major medical as well as supplemental policies.

This QualChoice Medicare insurance review will cover the available plans and how to get coverage. We’ll also look at how to get QualChoice Medicare quotes.

Before you decide to buy QualChoice Medicare insurance, make sure you have compared your options. Enter your ZIP code for fast, free quotes today.

About QualChoice

In 1994 the University of Arkansas for Medical Science established QualChoice as a third-party administrator, but soon converted to operations as a full-service health insurance provider. Policies include individual HMO and PPO plans for individuals and corporate benefits.

In 2009 QualChoice acquired Community Bank Life, and the newly merged company became QualChoice Life and Health Insurance Company, Inc. The company then formed QualChoice Holdings as a parent company the following year.

QualChoice itself was acquired in April of 2014 by Catholic Health Systems (CHI), the country’s biggest nonprofit health system. Since 2016 it has been reported that CHI is making efforts to sell the company, but as of the writing of this review, they remain QualChoice’s parent company.

Since the end of 2018, QualChoice Medicare Advantage plans have not been available. Although it is not made explicit, this may be related to the plans to sell off the company either as a whole or in parts. Medicare Supplement plans are still available, although new policies are not being written in some counties, only renewals. QualChoice Medicaid is also not offered at this time.

Read more: QualChoice Health Insurance Review & Complaints: Health Insurance

QualChoice Medicare Supplement

MediQ65 is QualChoice’s Medicare Supplement plan. Although they brand the plans with their own name, the choices are based on the letter-coded standard plans that are written in most states.

MediQ65 options are Plans A, F, F with a high deductible, G, K, and N. That is about half of the available letter-coded plans; there are a total of 11. Insurance companies can choose which of the plans they want to offer, although they are required to write Plan A which is the most basic plan.

Plan A pays for the coinsurance amounts that are not covered by Original Medicare, and also covers three pints of blood each year.

Plan F offers the most coverage available, and it pays for all of the out-of-pocket costs that Medicare does not cover. That makes it the most expensive plan in most cases, which is the reason for the high deductible option. The deductible amount allows for a lower monthly premium with a set out-of-pocket costs that can be planned for, and full coverage thereafter in the event of a major medical incident.

Of the other plans offered by QualChoice, both plans N and K are more budget-friendly due to copays and lower coverage percentages. Each also has an out of pocket maximum for catastrophic events.

QualChoice Medicare Rates

QualChoice has an easy rate chart that offers the current premiums for 2021.

Plan A has a monthly cost of $138.96 The least expensive option is the high deductible Plan F at $69.23 a month, with Plan K a close second at $77.10. Due to changes in Medicare, Plan F will no longer be offered to those eligible on or after January 1, 2020.

Since these rates are only for the state of Arkansas and only for the counties listed on the chart, we are unable to offer a real comparison to other companies. The rates compare fairly favorably to what we have seen in other states, but they can only really be useful when compared to other Arkansas insurers.

QualChoice Medicare Claims Process

Ease of Filing a Claim (Online, Over the Phone, Mobile Apps)

QualChoice Medicare Insurance provides several convenient options for filing claims. Policyholders can file claims online through their website, ensuring a hassle-free and efficient process.

Additionally, claims can be submitted over the phone, offering flexibility for those who prefer verbal communication. QualChoice also offers mobile apps that allow users to submit claims directly from their smartphones, making it even more convenient for policyholders to access their benefits.

Average Claim Processing Time

While specific claim processing times may vary depending on the nature and complexity of the claim, QualChoice Medicare Insurance strives to process claims promptly. Policyholders can expect their claims to be processed efficiently, ensuring that they receive the benefits they are entitled to in a timely manner.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback on QualChoice Medicare Insurance’s claim resolutions and payouts has been generally positive. Policyholders have expressed satisfaction with the company’s responsiveness and the smooth handling of their claims. The company’s commitment to addressing customer needs and resolving claims efficiently has contributed to a positive customer experience.

Digital and Technological Features of QualChoice Medicare

Mobile App Features and Functionality

QualChoice Medicare Insurance offers a user-friendly mobile app that provides policyholders with convenient access to their insurance information.

The app allows users to view their policy details, track claims, and even submit claims directly from their mobile devices. It also offers features for locating in-network healthcare providers, making it easier for policyholders to access care.

Online Account Management Capabilities

Policyholders can easily manage their accounts online through QualChoice Medicare Insurance’s user-friendly website. They can log in to their accounts to view policy documents, update personal information, make premium payments, and access important resources related to their coverage.

The online account management capabilities enhance the overall customer experience by providing easy access to essential information.

Digital Tools and Resources

QualChoice Medicare Insurance provides a range of digital tools and resources to assist policyholders in making informed decisions about their healthcare coverage.

These resources include educational materials, coverage guides, and online tools for comparing different insurance options. The company’s commitment to digital resources empowers policyholders to navigate their insurance plans with confidence and clarity.

QualChoice Medicare Insurance Ratings and Consumer Reviews

QualChoice has an A- rating with the Better Business Bureau (BBB), having been docked slightly for failure to respond to one complaint. Outside of that one, there have been only three complaints closed in the past three years.

Elsewhere, we found three negative reviews of the company on Yelp, for a one-star rating overall. The complaints are in regards to premium increases and coverage issues.

Overall, there is really very little in the way of customer reviews for this company out there, and none of the reviews we saw pertained directly to Medicare coverage.

QualChoice Medicare Insurance: The Bottom Line

QualChoice has a handful of Medicare Supplement plans available, but the fact that they are only writing new business in some counties and have moved out of the Advantage market may be a sign that they will not be writing this coverage in the future. We did not notice any red flags for this company, and their rates seem reasonable, but the uncertain future due to the efforts to sell off the company may be cause for hesitation.

Affordable QualChoice Medicare insurance may be available to you, but make sure you have the best deal before you buy. Enter your ZIP code to compare quotes today.