I IQChoice

Apply Online

Use the button at right or download a printable application.

Before You Start

Make sure you have these for each person to be covered:
Date of Birth
Social Security Number
Driver's License Number (if applicable)

Who Can Apply?

Arkansas residents age 64 or younger.

The applicant and spouse on any family policy must both be age 19 or older.

Dependents are covered until age 26. There is no age limit for disabled children but some restrictions apply and proof of disability is required. Disabled Dependent form must be completed for every disabled dependent in your household applying for coverage.

Individuals who are on Medicaid or Medicare-eligible are not eligible to apply for this product. If you're Medicare-eligible, review our MediQ65 Medicare supplement plans.

Important Information

Make sure you have enough time to complete the application. It could take from 10 to 20 minutes and you will not be able to save your work and come back to it. If there is no activity after 20 minutes, your information could be lost.

Open Enrollment for all Affordable Care Act qualified plans is November 1, 2018 through December 15, 2018 for coverage beginning on or after January 1, 2020. If you need coverage after open enrollment ends, you must have a qualifying event such as birth, marriage, divorce or other. You must request coverage and provide proof of the qualifying event within 60 days of the event

Effective Date: The date your policy goes into effect is based on when we receive your application and payment. If we receive your completed application and payment on or before the 15th of the month, your policy will be effective the first of the following month. If it is after the 15th of the month, your policy will be effective the first of the second following month.