Health insurance in Arizona and the United States is worth knowing since the citizens understand the importance of health insurance coverage.
As many Arizona residents know, November is when the ACA (Affordable Care Act aka Obamacare) open enrollment period begins.
The time is coming when folks looking for health insurance for themselves and their families need to evaluate, choose, and enroll in individual insurance plans.
For Arizonans who do not have group health insurance through their employer, the “open enrollment” period that comes with the end of each year is a critical moment.
This window may be the only opportunity to obtain or modify health insurance coverage for the coming year.
If open enrollment comes and goes this year without your taking any action to sign up for a plan, you may be out, facing the prospect of living without health coverage during the year.
That can be scary – and it should be. In this time of uncertainty amid a global pandemic, a lack of health insurance is a potential catastrophe waiting to happen. Without coverage, an illness or injury to you or a member of your family could cost you dearly.
Here is what Arizonans like you need to know about open enrollment and obtaining individual health insurance this year:
What Does “Open Enrollment” Mean? Under the Affordable Care Act (ACA), individuals cannot apply for health insurance coverage any time they want to.
Individuals must either enroll in a plan during a designated open enrollment period or during what is called a special enrollment period.
What is Group Health Insurance? How does it differ From Individual Health Insurance?
Individuals who do not obtain coverage during the open enrollment period can only get or modify coverage outside of that timeframe if and when a “qualifying life event” occurs. Such events include:
- Loss of existing coverage due to job loss, disqualification from Medicare or Medicaid, or aging out of coverage under a parent’s plan
- Birth, adoption, death of a named insured, marriage, or divorce
- Moving to an area outside of your existing insurer’s coverage
- Becoming a U.S. citizen or release from incarceration[lwptoc]
Where Do I Go To Apply For Individual Health?
Private health insurance companies offer individual insurance plans through online portals called exchanges.
While several states operate their own exchanges, many others, including Arizona, use the federally established exchange: healthcare.gov. This means Arizona residents must go through this site to obtain coverage offered through the exchange.
What Can I Do At Healthcare.gov to Get Individual Health Insurance Coverage?
When you visit healthcare.gov, you can review and evaluate the individual insurance plans available in Arizona. By providing some basic information about yourself and your family, you can also see prices for different plans based on your age, household, and income. You can then enroll in the plan of your choice before the close of the open enrollment period.
Who Offers Individual Health Insurance Coverage For 2022?
Arizona has 5 health insurers offering a variety of plans for Arizonans for the calendar year 2022. Those insurance companies are:
- Blue Cross and Blue Shield of Arizona
- Bright Health Company of Arizona
- Cigna HealthCare of Arizona
- Health Net of Arizona
- Oscar Health Insurance
The Health Insurance Market Place in Arizona
Cheap health insurance in Arizona is also available through private companies, and there are individual and family plans that can be suitable for you.
In the guide below, we will evaluate the different options as well as crucial factors that impact your health insurance choice.
If you are looking for providers outside of Arizona – make sure to take a look at our list of best health insurance providers.
Let’s explore the health insurance marketplace in Arizona in more detail!
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List of Providers and Plans
Health insurance providers in Arizona offer private plans to individuals and families. Some have contracts with the ACA that give you access to government-subsidized plans too.
BlueCross BlueShield of Arizona
BlueCross BlueShield of Arizona provides consumers with three main plans. It’s important to note that your location, age, gender, medical history, and other factors do influence your payment options. Here are the 3 plans you can choose from:
Everyday Health; this is great for patients who expect frequent visits to the doctor and take generic drugs. There are different deductibles that you can choose from as well as predictable costs. You will receive primary care, doctor visit co-payments, prescription drug copayments, and low deductibles.
True Health Plan; this fits people with health conditions to manage healthcare costs in an effective way. There are fixed copayment amounts for specialist visits, free visits for PCP, as well as payments for specific brand-name drugs. Deductibles are higher, but there are also more benefits that you can take advantage of.
Advance Health – incorporates online doctors and low-cost drugs, making sure that you are healthy even in case of emergencies. BlueCross BlueShield also provides lowered costs for those who are eligible for financial assistance.
Cigna has 3 metal-tier levels for their Arizona health insurance plans: Gold, Silver, and Bronze. Their Bronze plan is better for people who want low premiums and don’t go to the doctor that often. While out-of-pocket costs can be high, the low premiums make up for it.
The Silver plan is right for families or individuals who frequently go to the doctor for accidents or illnesses. The premium costs are medium level, and so are out-of-pocket costs.
Lastly, the Gold plan is perfect for people who visit the doctor regularly and have multiple prescriptions for drugs. While premiums are high under this plan, there are low out-of-pocket costs to deal with.
Health Net of Arizona
Health Net of Arizona has different health insurance plans that are designed for specific groups of people. Here is an overview of their plans:
Medicare offers no-cost or low-cost dental and medical services for individuals and families. You have to qualify for the plan based on your income, but it can be a great plan for people who can’t afford to pay high premiums.
Medicare has partnered with Health Net of Arizona to bring consumers subsidized plans, but they are designed for seniors and individuals with disabilities only.
Family and individual plans are private plans that you can purchase according to your needs. They have different levels of premiums, deductibles, benefits, and out-of-pocket expenses.
Small business health insurance plans have PPO and HMO plans that you can take to give your employees health benefits.
Large employer health plans are for large groups of people who can benefit from a shared plan under their employer.
Oscar Health Insurance offers Medicare, small businesses, individual and family plans for the people of Arizona.
Their Oscar Care feature offers personalized care online. They also have virtual primary and urgent care options with doctor visits for $0.
Their $0 prescription feature can help people with sudden medical conditions or accidents. Oscar has partnered with top-rated doctors, specialists, and hospitals in your area to ensure that you can get healthcare whenever you need it.
The Oscar application can even sync up with Apple Health and Google Fit so that you earn money for hitting your step count goals.
Bright Health offers Medicare options and business plans, too, but their individual and family plans are the most popular.
Gold offers predictable costs and generous coverage options. It is best for anyone who visits the doctor regularly and has ongoing prescriptions. There are copays available, so costs are often predictable.
Silver has moderate costs and premiums. It is best for people who expect that they will only use the plan occasionally. There are reduced deductibles and plenty of benefits under this plan.
Bronze features higher costs when used but low premiums. This plan is best for folks who don’t visit the doctor too often and don’t want to pay high premiums.
Catastrophic has the lowest premiums. It is good for individuals under 30 who don’t expect high medical incidents and want low premiums.
Cheapest Health Insurance Plan by County in Arizona
Cheap health insurance in Arizona can depend on where you reside. The healthcare options can vary depending on the county you live in. Here is a breakdown of the most affordable health insurance in Arizona by county.
|County||Cheapest Plan Name||Adult, Aged Under 40 Yrs||Couple, Aged 40 Years||Couple Aged 40 Years With Child|
|Pima||Blue Advance Health Silver Plan||$330||$660||$857
|Santa Cruz||Ambetter Balanced Care||$353||$707||$918
|Maricopa||Blue Advance Health Silver||$381||$762||$990
|Pinal||Oscar Silver Saver 2||$433||$867||$1,126|
|Gila||Ambetter Balanced Care||$494||$988||$1,283
|Cochise||Ambetter Balanced Care||$505||$1,011||$1,313|
|Graham||Ambetter Balanced Care||$505||$1,011||$1,313
Average Cost of Health Insurance by Family Size in Arizona
The average health insurance cost in Arizona per person is $6,215 per year. It is actually $766 cheaper than the national average for medical coverage.
Insurance costs can also change based on your family size since more individuals will need to be covered. The breakdown according to family size for average monthly costs is as follows:
Family Size Monthly Cost for Health Plans On Average
Individual with child $810
Couple aged 40 years $1,014
Adult couple with one child $1,317
Adult couple with two children $1,621
The health insurance quotes in Arizona differ according to the copays, deductibles, and monthly premiums you choose. The above estimates are based on the average monthly costs for basic packages only.
Arizona Health Insurance Guide
Depending on your needs, there are different types of health insurance in Arizona.
Employer Health Insurance
While there aren’t any laws that make it mandatory for employers to provide health insurance for their employees in Arizona, a lot of employers still offer it as an added benefit. Many employers offer group insurance plans that you can take advantage of.
Private Health Insurance in Arizona
Arizona individual health insurance plans are there for families and individuals. Make sure to do proper research before investing in a plan since all of them have different premiums and benefits. Check their plan properly for policies on primary care, visits, physicians, medication, etc. to make sure you get the one most suitable to your needs.
Obamacare or ACA expanded Medicaid and Medicare benefits to more people. Medicare offers coverage to individuals with disabilities and seniors over the age of 60, while Medicaid offers health benefits to pregnant women, children, seniors, parents, and people with disabilities. If you have a low income, you can also avail of Medicaid benefits in Arizona.
To be eligible for the Medicare program, you need American citizenship or legal permanent residence in America for a minimum of 5 years. For Medicaid, the requirement is to be a citizen, legal alien, US national, or have permanent residence.
Arizona health insurance is impacted by various factors that you may not have considered before:
- Body mass index (BMI)
- Tobacco use
- Cost-sharing reductions
- Individual or family
- Pre-existing conditions
- Insurance and medical history
By taking better care of your health, such as quitting smoking, you will actually be able to get a better deal on your insurance plan.
Is health insurance mandatory in Arizona?
There is no law in Arizona that makes insurance mandatory, even for employers. Still, there are many options for cheap health insurance in Arizona if you need it.
What is the income limit for Medicaid in Arizona?
The income needs to be below or at 138% FPL to qualify for Medicaid. Income under $36,156 for families of 4 and $17,609 for individuals is the income limit for 2021.
What are short-term health insurance conditions?
The short-term health insurance in Arizona has coverage options for a full year with renewal options for 36 months.
It is a good option for people between jobs, unemployed persons, waiting for a group coverage period to start, or planning on moving out of the state in a few months.
What is the uninsured population rate in Arizona?
Overall, 11% of Arizona’s population is uninsured.