Arizona Health Insurance

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Health Insurance for the Well Informed

Health Net of Arizona

The number of uninsured adults in Arizona has reached 796,980 or 23% of the population according to Kaiser’s State Health Facts while health care premiums rose 56.6% from 2000-2006 and continue to rise according to Families USA. With statistics such as these, it is essential that you research and search various options to find the most affordable and best health insurance plan for you.

In Arizona, medical underwriting is allowed without restriction. Medical underwriting is the process of allowing insurance carriers to review the medical history of prospective members.

Unfortunately, Arizona law allows insurers to reject applicants for having preexisting medical conditions, unless they are HIPAA-eligible. HIPAA-eligible individuals are people who have left job-based group coverage and have elected and fully exhausted any COBRA or state-operated continuation coverage they were offered. In Arizona, medical underwriting is allowed without restriction. Medical underwriting is the process of allowing insurance carriers to review the medical history of prospective members.

For the medically uninsured, those exercising their HIPAA group-to-individual health insurance rights are able to gain health insurance through any individual health insurance carrier. There is currently no program for those uninsurable individuals not in a group plan or not able to exercise their rights under HIPAA.

Medical underwriting is allowed with group insurance as well in Arizona. Rates may vary by plus or minus 60% of the indexed rate based on the health status of the group. For pre-existing condition requirements, the carrier may look back in a consumer’s medical history 6 months and impose a 12 month exclusionary period for those that did not have prior medical coverage.

There are some factors that determine eligibility for group and small business health insurance in Arizona which include:

Company size 2-50 employees
Two employees must work for at least 6 months out of the year, and work 20 hours per week for coverage
Owner can count as an employee
Owner name on business license must draw wages from the company

www.coverageforall.org

Arizona offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. COBRA gives employees who lost their health insurance benefits the right to choose to continue group health benefits provided by the plan under certain circumstances. COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their dependents the opportunity for a temporary extension of health insurance coverage in certain instances where coverage under the plan would otherwise end.

Medicaid is a joint state and federal medical bills assistance program that pays medical bills for eligible, needy persons. These individuals must meet certain income and other requirements.

Children
Ages 1-5: 133% of the Federal Poverty Level
Ages 6-19: 100% of the Federal Poverty Level

Doctor visits, specialist care, emergency services, maternity services, surgery, limited vision and dental care, x-rays and lab work, hospital care, immunizations, dialysis, prescriptions, and family planning.

Prescription co-pays range from $0-10, doctor visit co-pays range from $0-5, and non-emergency use of the emergency room ranges from $0-30. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

Kids Care is available to children under the age of 18 who are residents of Arizona and are U.S. citizens or eligible immigrants. Their family income must fall between 100-200% of the federal poverty level and they must not be covered by any other health insurance. Please visit the Kids Care website for more detailed information.