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Shopping for health insurance in the state of Arizona might seem like a daunting task. Thankfully, there are many options open to residents of Arizona who are uninsured or underinsured. Whether you're healthy or not, this page will provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, Health Plan One can help. If not, review the information on this page about Arizona Medicaid, KidsCare, KidsCare Parents, and EPSDT. All of these government programs can help those who are medically uninsurable or who cannot afford private coverage obtain basic health coverage.
What Every Resident of Arizona Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer, the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.
With individual coverage you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Arizona so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Arizona each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
Small Group Plans
If you are self-employed you can apply for a small group plan to cover some or all of the employees of your small business. You must have 2 or more eligible employees who each work at least 25-30 hours per week (this number varies by carrier). Small group plans are medically underwritten by all carriers in Arizona. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling. Health Plan One can help you by quoting plans for small groups. Simply call us toll-free (877) 567-5267.
For more information on small group plans for this state please see our Arizona Small Group page.
If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
Arizonaâ€™s Medicaid Program â€“ AHCCCS
In Arizona, the Medicaid program is known as AHCCCS, or Arizona Health Care Cost Containment System. Medicaid works in practice much like having regular health insurance; if you qualify you'll receive a Medicaid card which you can show your doctor at an appointment. If your doctor participates in Medicaid, the State will pay the bill for the appointment. The program pays for many medical services including acute care services, prescription drugs, and long-term services and supports, depending on need. Families with children under 19 in Arizona are eligible for AHCCCS if they meet income and certain other requirements. There are no monthly premiums for those who qualify. To be eligible, and individual must:
- Be an Arizona resident and a US citizen or qualified immigrant with a Social Security number (if you do not meet the citizenship/immigration requirement, you may still be eligible for emergency services)
- Cooperate with the Division of Child Support Enforcement if necessary
- Apply for all potential income available (e.g. unemployment, pensions, and Social Security)
- Have a family income below the limits described here:http://www.azahcccs.gov/applicants/categories/families.aspx#Income_Guidelines
For information on Arizona Medicare, visit MedicareSolutions.com
KidsCare is Arizona's version of the federally mandated SCHIP program. The program is meant to give basic health coverage to uninsured children in the state whose family income is too high to qualify them for AHCCCA insurance. The program requires a only very low monthly premium of the family. Benefits include doctor office visits, well-child visits and immunizations, lab tests and x-rays, specialist care, eye exams and glasses, dental care, behavioral health, and much more. For more information on all aspects of KidsCare, visit their website at http://www.azkidscare.gov/ Here is the same site in Spanish:http://www.azkidscare.gov/Spanish/Home.aspx
Parents of children enrolled in KidsCare may also qualify for coverage through the program. Parents may only be covered as long as their child is enrolled, but during that time they receive the same quality of care as their child. When an entire family is enrolled, the program will charge a family level premium based on the number of people in the family and their monthly income. For further information on specific income requirements, average premiums, and application requirements, click here:http://www.azkidscare.gov/parents.aspx
Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT)
Anyone enrolled in AHCCCS or KidsCare is also eligible for the Arizona Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT). This program is meant to detect and treat illness before they progress into major health problems, and offers screening and care for illnesses detected. To learn more, watch the informational video on this page:http://www.azkidscare.gov/services.aspx It is also available here in Spanish: http://vimeo.com/2740145
HIPAA Plans - Arizona's High Risk Pool Alternative
For information on HIPAA plans available in Arizona to those residents who are for medical reasons uninsurable on the private market, check out our HIPAA Insurance page.
For information on other programs available through Arizona's Department of Health Services visit the AZ DHS website's listings at http://www.azdhs.gov/com_dir.htm For listings specifically related to mental and behavioral health, click here:http://www.azdhs.gov/mntl_dir.htm For listings of women's programs such as free cancer screenings for women etc. click here:http://www.azdhs.gov/wmn_dir.htm