Arizona Health Insurance: Find Affordable Plans
See how you can get cheap health insurance in AZ, including marketplace plans, Medicare, and Medicaid.
Arizonans have numerous ways to obtain affordable health insurance. Many people receive health benefits through an employer. However, depending on your income, employment, and other qualifications, you may opt to enroll in Medicaid, Medicare, choose an Affordable Care Act plan, or purchase a plan directly from a health insurance company.
This guide explains your Arizona health insurance options in detail.
Do I Have To Use The Health Insurance Marketplace In Arizona
There are many pathways to insurance the marketplace is just one of them. The main benefit of purchasing a policy through the marketplace is the potential to qualify for the Advanced Premium Tax Credit. If youre unable to qualify for the credit or dont want to receive it, youre free to purchase insurance from any insurance company you choose.
Frequency Of Using Medical Services Other Than A Doctor Or Hospital
Non-doctor health care visits is a measure of how often people receive medical care without seeing a doctor. This type of care excludes patients that have been admitted to hospitals or other institutions. Examples of non-physician health care includes appointments or walk-in clinics to see a nurse, physical therapist, counselor for mental health appointments or other non-physician medical personnel.
Residents insured with group insurance receive this type of medical care with a similar frequency as the average for the U.S. Medicaid managed care patients in Arizona use this type of health care with a much higher frequency than the U.S. average. By comparison, Medicaid managed care patients use this type of health care more than three times as frequently as people covered with group insurance. People enrolled in individual and Medicare Advantage plans use this type of health care well below the national average.
Non-physician care tends to be an expensive form of treatment. The reason non-physician visits are expensive is that many times these are visits to outpatient facilities. Many outpatient facilities are owned and operated by hospitals. While hospital owned and operated medical facilities are less expensive than a hospital, oftentimes they are more expensive than a doctor visit.
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How Do I Avoid The Individual Mandate Tax
To avoid this penalty and protect yourself from the potential financial burden of unexpected medical expenses, you can enroll in a health insurance plan during the open enrollment period. For 2021 coverage, the national open enrollment period will take place from November 1st 2020 through December 15th 2020. Some states have extended this period. To learn about your states open enrollment period, read our article, 2021 Obamacare Open Enrollment Dates by State.
If you lose your insurance in the middle of the year, you may qualify for a special enrollment period to purchase an ACA-compliant plan on the public exchange. You may buy an ACA-compliant plan outside the public exchange anytime. Depending on which state you live in, you may be able to enroll in short-term health insurance to help fill any coverage gaps you may experience throughout the year.
Your health and financial well-being are important to us. As the largest online health insurance broker, eHealth offers a variety of health insurance plans to fulfill your coverage needs, wherever you live in the United States. These include on and off exchange ACA-compliant plans, major medical insurance, and short-term health insurance. Let us help you explore your coverage options now. Simply click Individual & Family Health Insurance to find affordable insurance. Our licensed insurance agents are here to help you and share their expertise as you consider your choices.
Keep Your Information Up To Date
The federal Public Health Emergency will be ending soon. If you have an AHCCCS Medical Assistance/MA case, keep your information up to date so you can receive the latest information. Learn more about how AHCCCS is planning for the end of the Public Health Emergency.
To update your information, you may go online to . If you have any questions, you may call 1-855-432-7587, Monday through Friday 7:00 a.m. – 6:00 p.m.
The Arizona Health Care Cost Containment System is Arizona’s Medicaid agency that offers health care programs to serve Arizona residents. AHCCCS provides medical insurance coverage to thousands of Arizonans each year, for which DES provides eligibility services.
Health insurance through AHCCCS helps individuals cover the cost of doctors office visits, physical exams, immunizations, prenatal care, hospital care and prescriptions they need.
Health Insurance Plans In Arizona
Shopping for coverage on your own? Open Enrollment for 2022 plans has ended. If you’ve had a qualifying life event you could still be eligible to get a plan during Special Enrollment, which runs until Oct. 31, 2022.
To shop for a plan during the Special Enrollment Period, visit HealthCare.gov.
Health Care Reform Measure Was Blocked From Appearing On The 2020 Ballot In Arizona
Arizona health care reform activists were working to get a measure on the 2020 ballot that would have enshrined various ACA consumer protections into Arizona law. The ballot initiative would have also prevented surprise balance billing on state-regulated health plans , and would have increased wages for most hospital employees.
Volunteers in Arizona had until July 2, 2020 to gather 237,645 signatures. A reported 425,000 signatures were submitted, but a Maricopa County judge ruled in August that the measure could not appear on the ballot because some of the signatures were invalid for a variety of reasons and because the way the measure was described to people during the signature-gathering process was potentially misleading. Backers of the ballot initiative have appealed to the Arizona Supreme Court, but the Court ruled in August 2020 that the measure would not appear on the 2020 ballot.
The ballot initiative was controversial from the start the Arizona Hospital and Health Care Association had expressed opposition, as the measure would have caused hospital expenses to increase in the state due to the higher wages that would have to be paid to hospital staff. And a significant amount of the financial backing for the measure came from a California-based union for health care workers.
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Arizona And The Patient Protection And Affordable Care Act Of 2010
The Patient Protection and Affordable Care Act became law in 2010. Provisions of the law have continued to be phased in following passage. As of January 1, 2014, most U.S. citizens and legal residents are required by law to have qualifying health care coverage or pay an annual tax penalty for every month they go without insurance. This is called the individual mandate. There is a grace period through March 31, 2014. Beginning in 2014, the penalty for not having qualifying coverage is $95 per adult and $47.50 per child or 1% of your taxable income, whichever is higher . The penalty increases annually through 2017 and beyond.
After Getting Your Arizona Insurance License
Once youve passed your exams and completed the licensing application, you are now a licensed insurance agent in Arizona. A common question we hear is, I have my insurance license, now what? Here are a few things you can do or need to know:
- Get a job in the insurance field. Check out StateRequirements Insurance Jobs board.
- If youre going to sell advanced life insurance products, youll need to have the proper securities licenses. Series 6, Series 7, and Series 63 are the most common among insurance agents, but youll need to begin with the SIE exam. Find out which licenses you need with our Securities Licensing Guide.
- Every four years, youll need to renew your insurance license. Check out our guides on Arizona Insurance License Renewal and Arizona Insurance Continuing Education for more details.
Is It Illegal To Go Without Health Insurance
The federal government no longer requires individuals to have health insurance. However, a handful of states and the District of Columbia have instituted a health insurance coverage mandate, and most carry a penalty for not doing so. If you live in California, Massachusetts, New Jersey, Rhode Island, or Washington, D.C., you must have insurance or pay a penalty. Vermonts mandate does not include a penalty for noncompliance.
Arizona Health Insurance Costs
For 2021 premiums, the state approved a 1.82% rate increase for Blue Cross and Blue Shield of Arizona, a 9.33% increase for Bright Health Company of Arizona, a 1.87% increase for Cigna Healthcare of Arizona, a 0.8% decrease for Health Net of Arizona and a 6.75% decrease for Oscar Health Plan.5
In the previous year, Arizona residents werent likely to experience any increase in costs for 2020 individual and family plans compared to the previous year.
The average monthly premium in Arizona for a 2021 Marketplace silver plan was $436, down from $442 for 2020. You could pay much less if you qualify for government subsidies.
For example, a 30 year old in Mesa, AZ earning $30,000 a year could pay $85 after subsidies for an Obamacare silver plan.6
Arizona Department Of Insurance And Financial Institutions Contact Information
Mailing Address:100 North 15th Avenue, Suite 261Phoenix, Arizona 85007-2630
How long is the insurance license period in Arizona?
Learn how to get an insurance license renewal here: Arizona Insurance License Renewal
How long does it take to get an insurance license in Arizona?
2-8 weeks. The bulk of the time is spent studying for your Arizona insurance exam. Some people study for as little as one week and feel comfortable taking the exam. We recommend you take whatever amount of time you need to feel comfortable with the material. Check out our guide: How to Pass the Insurance Exam
How much does the Arizona insurance license cost?
The total cost for your insurance course, application, and exam will be about $375. If you dont pass the exam the first time, add $56 for each subsequent attempt.
How do I get a life insurance license in Arizona?
Follow the steps above. The licensing process is the same for all insurance agent and producer licenses.
How do I get a property and casualty license in Arizona?
Follow the steps above. The licensing process is the same for all insurance agent and producer licenses.
Arizona State Health System Ranking
Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Arizona Health System are listed below:
- Arizona: Overall Ranking: 33 of 51
- Arizona: Overall Performance: Above U.S. Average
- Arizona: Access and Affordability: 43
- Arizona: Prevention and Treatment: 36
- Arizona: Avoidable Hospital Use and Cost: 9
- Arizona: Healthy Lives: 32
- Arizona: Health Care Disparities: 16
Find Affordable Health Insurance in Arizona
The Future Of Individual Health Insurance Mandates
Over the past year, a few additional states have considered or are considering individual mandates, including:
However, so far, none of these states havemanaged to ultimately pass state individual mandates.
Lawmakers who push for individual mandate laws argue that its needed to incentivize people to get health insurance. The argument is that if not enough healthy people sign up for coverage, the pool of insured individuals will be made up mostly of sick people, and health premiums will rise for everyone. However, many states have attempted and failed to pass individual mandate legislation, and these laws remain politically controversial.
According to Forbes.com, the new Biden administration is expected to bring back the federal tax penalty for going without ACA-compliant health coverage. Its unclear yet whether he would do this through an executive order or legislative reform. Find out more on if it is okay to be uninsured.
Hmo Health Insurance Plans
HMO stands for Health Maintenance Organization. HMO plans offer a wide range of health care services through a network of providers that contract exclusively with the HMO, or who agree to provide services to members. Employees participating in HMO plans will typically need to select a primary care physician to provide most of their health care and refer them on to HMO specialists as needed.
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How Much Do These Plans Cost
The amount you pay monthly for your coverage will vary depending on where you live, the size of your household, your income, and other factors.
Nine out of ten people get financial help when enrolling in a plan through the Affordable Care Act4, and 43% pay less than $10/month after federal assistance.*
Learn more about health care subsidieshealth care subsidies
Small Business Health Insurance Tax Credits
Small businesses with up to 25 full-time equivalent employees may qualify for a tax credit for offering employee health benefits. The credit is broken in to two phases. Phase 1 includes a tax credit worth up to 35% of a small businesss health insurance costs. Phase 2 includes a tax credit up to 50% of a small businesss health insurance costs.
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Medical Coverage And Ancillary Benefits
NON ACA Term Medical
- Hospital, Office Calls, Labs, Surgeries
- Usually at least half the price as ACA plans
- Coverage lasts for a specific term but can be re written automatically
- Must answer a few simple medical questions
- NOT available on government healthcare website
- NO Tax penalty ***
- Several carriers to choose from
NON ACA Fixed Indemnity
- Protect your assets against catastrophic loss
- NOT available on government healthcare website
- NO Tax Penalty ***
- Premium subsidies available if income is low
- No medical questions
Insurance For Individuals In Arizona
If you have a chronic health condition, however, you need to weigh the low premium against other out-of-pocket costs. A plan that costs $350 per month and has a $500 deductible may be a better fit for your financial needs than a plan that costs $250 per month and has a $5,000 deductible if you require regular medical care. A more expensive plan may also give you access to more specialists or better coverage for your prescriptions.
Before you select a plan, you should understand the differences between each type of plan:
- Health Maintenance Organization plans: HMO plans offer lower premiums while putting more restrictions on your care. Youll need to get a referral to see a specialist and only see local doctors in the network to receive coverage.
- Preferred Provider Organizations : PPO plans dont require approval to see the specialist of your choice. PPOs also offer nationwide coverage and out-of-network benefits. Youll likely pay more in premiums for a PPO than an HMO, though.
- Point-of-Service plans: POS plans compromise the advantages and disadvantages of HMOs and PPOs. You still need a referral to see a specialist, but if youre willing to pay a little more, you can still see out-of-network providers.
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Small Business Health Insurance Reform
Are you ready for health care reform in 2014?
Today, employers are more stressed than ever. Heres why:
The business environment is uncertain,
Employer-sponsored health insurance costs increase annually, and
New fees and penalties take effect next year, and most employers dont fully understand how this will affect their financials.
It is time for employers to examine the specifics of healthcare reform, and start thinking strategically vs. emotionally. Change is hard. However, employers that educate themselves and plan ahead can avoid severe financial impacts.
The more change and disruption your business can embrace, the more cost savings you will be able to realize over the long term. In order to embrace this change, you must be familiar with the key aspects of ACA. For many small businesses, the solution to healthcare reform is simple: Offer a Business Expense Account for Healthcare. A new vehicle, called a Healthcare Reimbursement Plan , allows employers to get out of the health insurance business, and simply give select employees monthly allowances to spend on their own health insurance policy in a state health insurance exchange.
Listed below are key ACA components to consider when choosing small business health insurance.
How Many Hours Do You Have To Work To Get Benefits In Arizona
To qualify for benefits in Arizona, you must have worked for an employer who paid unemployment tax and you must have earned: At least 390 times the Arizona minimum wage in your highest earning quarter and the total of the other three quarters must equal at least one half of the amount in your high quarter.
Do you get health insurance working full-time?
The Affordable Care Act requires employers to offer health insurance to employees working at least 30 hours per week to avoid paying penalties. See Identifying Full-time Employees. This requirement applies to both full-time and part-time employees.
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Arizona Small Business Resources*
Arizona Health Insurance Coverage:
Group Plans: There is a maximum 6-month look-back/12-month exclusionary period for pre-existing conditions on enrollees that do not have prior coverage. Benefits will vary depending on the chosen plan. Pre-existing health conditions covered.
Individual Plans: Assorted plans depending on medical needs. There is a maximum look-back period of 60 months and a maximum exclusion period of 24 months for pre-existing conditions on enrollees that do not have prior coverage. Elimination riders are permitted. Limits on pre-existing health conditions may apply.
COBRA: Coverage available for 18-36 months depending on qualifying events. Benefits are what you had with your previous employer. Pre-existing health conditions covered.
HIPAA: Benefits are based on program
health conditions covered.
Arizona Health Insurance Eligibility:
Group Plans: Guaranteed coverage for companies with 2-50 employees. Eligible employees must work at least 30 hours a week. Owner can count as an employee. Owner name on business license must draw wages from the company.
Individual Plans: Eligibility is subject to medical underwriting. If you are denied coverage for a medical condition, you may be eligible for AHIP, or PCIP.
COBRA: Guaranteed coverage available for employees who work for businesses with 20 or more employees. Employees have 60 days from date of termination to sign-up.
HIPAA: Must qualify for Medicaid and have access to Employer-Sponsored Insurance or Cobra.