Arizona Health Insurance
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Facts and Figures
-
Place in State
Health Report Card 29th - Insured 5,208,960
- Uninsured 1,273,300
-
Insurance
Carriers 14 -
Number of
Primary Care Physicians 10460 -
Number of
Hospitals 100 -
Average Cost of
Health Insurance* $156/month
Breakdown of Insureds
- Employer-sponsored health insurance 55%
- Private plans 6%
- Medicaid 24%
- Medicare 14%
- Others 1%
Insurance Carriers
- Aetna
- Aetna AARP
- Assurant Health (Formerly Fortis)
- Celtic
- Companion Life
- Fairmont Specialty / TIG
- Golden Rule
- Humana One
- John Alden
- MEGA Life and Health Insurance Company
- Premera Blue Cross Blue Shield of Arizona
- Principal Life
- Security Life
- United Healthcare
State Health Report Card
Cases of obesity in Arizona is more common among Hispanics (32.3%) and non-Hispanic American Indians (40.8%) than non-Hispanic whites (23.3%)
Diabetes is more prevalent among non-Hispanic black (12.4%) and non-Hispanic American Indians (15.4%) compared to non-Hispanic whites (8.6%).
Arizona Health Insurance Laws and Regulations
Arizona insurers have the liberty to set up their policies and premium rates; They can deny coverage depending on some factors like medical condition.
Premium rates are based on the applicants age or health status.
Insurance companies set higher premiums for those with pre-existing condition.
Applicants can opt for temporary health plans but renewal for these plans are not guaranteed.
If a parent’s policy covers dependents, their newborn or adopted children will be automatically covered for up to 31 days.
Policyholders who are about to lose their group plan and want to purchase an individual plan are protected under HIPAA law. The law guaranties their coverage even if they have a pre-existing condition and coverage will be effective immediately.
Arizona state laws prohibits health insurers from dropping coverage for members who get sick or injured.
Health coverage renewal is guarateed unless a member has breached contract.
Small group plan applications are guaranteed issue.
Coverage for the following services are mandated by the Arizona health law: health care services for pregnant women, contraceptives, breast cancer screening, treatment and care for diabetes and diabetes-related illnesses.
Employees who are about to lose their Arizona health insurance due to any qualifying reason can still continue coverage for up to 18 months through COBRA.
Arizona has a guaranteed renewal policy which prevents health insurers from terminating policy due to an illness. Insurance companies must renew contract as long as policyholders do not violate the agreed upon terms.
Heath Care Reform
Small business owners who search the market for Arizona Health Insurance quotes are now able to provide their employees with health coverage at a more affordable premium throug tax credits.
Medicare policyholders who fall into Part D Medicare doughnut hole shall be issued a $250 rebate check.
Early retirees who are waiting to be eligible for Medicare can be assured of continued coverage because of a $5 billion support for health plans providing early retirement coverage.
Funds for health care reform includes a $1.5 billion package for scholarships and loan repayments for health care providers who want to work in areas where medical professionals are very few.
Uninsured residents with a qualifying pre-existing health condition can now get quality and affordable health coverage via a transitional high-risk pool. This is in preparation for health insurance exchanges in 2014 when health insurers can no longer deny coverage to applicants with pre-existing condition.
Children until the age of 26 can stay on their parent’s policy as dependents regardless if they are still students, working (for as long as their employer doesn’t offer health insurance benefits) or still living with their parents.
Lifetime limits on Arizona health insurance plans will be eliminated. Annual limits shall be strictly imposed.
Easier access to physicians and emergency care will be available to patients. In order to visit a gynecologist, women no longer need to get approval from a primary care physician.
State Government Insurance Programs Offered
Medical Expense Deduction Program
602-417-4000
800-352-8401
Provides medical coverage for individuals who do not qualify for other AHCCCS programs due to income. May be eligible if they have medical expenses in the month of application (or the previous month) that reduce their monthly income to 40% FPL
Pre-existing Condition Insurance Plan (PCIP)
866-717-5826
The Pre-Existing Condition Insurance aims to provide health insurance to those who have difficulties getting coverage because of a pre-existing condition ( those that have shopped for Arizona health insurance quotes know how difficult this can be ). Coverage includes a wide range of benefits which includes hospital care, primary care, specialty care, and prescription drugs. Eligibility: 1. Must be a U.S. resident living in Arizona. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.
AHCCCS – Arzona Health Care Cost Containment System
602-417-4000
800-654-8713
Benefits for this plan include preventive care, doctor’s visits, hospital services, emergency care, lab and x-rays, surgery, dialysis, podiatry, behavioral health services, family planning, maternal care, annual well-woman exams, immunizations, physical exams, specialist care, and prescription drugs for non-Medicare recipients. Children under the age of 21 also receive dental, vision, hearing services, and Early and Periodic Diagnosis and Treatment (EPDST).
KidsCare
877-764-5437
602-417-5437
This plan is intended for children who belong to low-income families but are not eligible for Medicaid coverage. This plan is intended for children under the age 19.
Well Woman Health Check Program
888-257-8502
This plan is designed to assist low-income women without Arizona health insurance or is underinsured cervical cancer screening, and diagnostic tests, which include: mammograms, clinical breast exams, Pap smear, pelvic exams, ultrasounds, and biopsies. If the results indicate an abnormality, the attending physician will make the necessary referrals.
Baby Arizona
800-833-4642
This plan gives pregnant women an easier and faster access to AHCCcS. Eligibility: -Resident of Arizona -Have very little to no income
Indian Health Services
Navajo
928-871-4811
Phoenix Area
602-364-5179
Tucson Area
520-295-2405
Indian Health Service (IHS) provides medical and public health services to American Indians and Alaska Natives. IHS provides a broad range of inpatient and outpatient services through health facilities which include hospitals, health centers, field clinics located near population centers. Eligibility Members of a Federally recognized Tribe are eligible for IHS health services. You may qualify if you are not excluded by law, and: 1. Are of Indian and/or Alaska Native descent; or 2. Are an Indian of Canadian or Mexican origin; or 3. Are a non-Indian pregnant woman carrying an eligible Indian’s child. Coverage can be up to 6 weeks post partum; or 4. Are a non-Indian who belongs to an eligible Indian’s household and the medical officer decides that services are needed for public health safety.
Medicare
800-633-4227
This health care system is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverge. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.