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Arizona Health Insurance

Having a suitable health insurance has always been a priority in an individual’s mind. Purchasing health coverage is quite expensive which requires a thorough review of all potential risks and its impact on your financial health. In the U.S. nearly 47 million people are uninsured, among whom a majority of families are exposed to the threat of lack of proper health coverage. For those families who are not covered by their employers’ group plan, there are low-cost state sponsored health insurance programs that provide insurance to the medically-uninsurable individuals.

In 2008, Arizona stood on the 33rd position on the Healthiest States List as issued by the America's Health Rankings. The state of Arizona, with more than a 6 million population, offers both private-market and public health insurance alternatives. The private-market health insurance consists of various types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide economical health coverage to the uninsurable citizens of Arizona who meet specific eligibility requirements of age and income.

The Arizona Department of Insurance manages and administers all kinds of insurance sold through private-market health insurers as well as public health coverage programs. However, owing to the skyrocketing health care costs, approximately 19.6% of the state population is still uninsured. The access to medical care remains restricted as a result of less number of physicians, lack of proper government funding and high geographical disparity. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, roughly 32.5% of uninsured residents come above the 200% FPL category.

On the whole, Arizona’s Health System does have a room for improvement and with the proper funding from the government; health care would soon be available to a larger percentage of the Arizona population. Shopping for health insurance has never been so simple. You need the help of a licensed health insurance agent/broker to the avail the suitable health insurance options and their benefits.

Individual/Family Health Insurance

Below is the guidelines for applying for and obtaining individual health insurance in the state of Arizona. These regulations apply to all insurance companies offering individual or family health insurance in Arizona:


Medical Underwriting

Yes

Pre-Existing Condition Exclusion Period

No Limit

Look Back Period

No Limit

Look Back Standard

No Definition

Mandatory Benefits

Cancer screening for women, breast cancer screening, reconstructive surgery after mastectomy, OB/GYNs as Primary Care Providers, depression parity, eating disorder parity

Market Rate Restrictions

None

Guaranteed Issue Options

None

Small Group Health Insurance

Below is the guidelines for small group health insurance in the state of Arizona. These regulations apply to all insurance companies offering small group health insurance in Arizona:


Small Group Size

2-50 employees

Employee Qualifications

Must work for at least 6 months out of the year, and work 20 hours per week for coverage

Guaranteed Issue

Yes

Premium Rating Factors

Rate Bands

Rate Adjustment Factors

60%

Look-Back Period

6 months

Pre-existing condition exclusionary period

12 months

Mandatory Benefits

Same as individual

State Cobra Variations for Small Groups

Below are the COBRA guidelines for small groups in the state of Arizona. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:


Mini-Cobra Option

No

Eligible Group Sizes

NA

Extension of Benefits Period - Standard

NA

Extension of Benefits Period - Disabled

NA

Maximum Premium Increase

NA

State Legislation Reference

NA

Additional Notes

NA

State Sponsored Health Insurance Programs

There are several state sponsored health insurance programs in the State of Arizona to assist those without insurance in obtaining adequate coverage.

High-Risk Pools

Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. However, Arizona does not offer health insurance coverage through high risk pool for individuals who are medically-uninsurable.

Children’s Health Insurance Program

Through shared funding from the federal government, the State of Arizona provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:


Program Name

KidsCare

Website

http://www.kidscare.state.az.us/

Phone Number

602-417-5437, 877-764-5437

Apply Online

Yes

Age Limits

18

Insurance Carrier

Varies Based on County of Residence

Length of Coverage

12 months

Residency Requirements

Arizona resident, U.S. Citizen or qualified
non-citizen (regardless of parent status)

Other Eligibility Requirements

  • Must be ineligible for no-cost Medicaid or employer-based coverage
  • No health insurance for the last three months at time of application

Pre-Existing Condition Exclusions

No

Cost

$10 to $25 a month for one child or $15-$35 a month for two or more children

Medicaid

Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of Arizona:


Governing Agency

Arizona Health Care Cost Containment System

Website

http://www.ahcccs.state.az.us/site/

Phone Number

602-417-4000

Residency Requirements

Arizona residents

Federal Poverty Line Income Limits

Income up to 100% FPL

Additional Resources

Arizona Health Care Options Matrix™ Guide

Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines Arizona’s public and private health care choices for individuals and groups with various demographic profiles.

Family Health Insurance Guide by HealthInsuranceFinders.com

The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.

Arizona: At-A-Glance

Provides all-inclusive health data of Arizona. Statehealthfacts.org is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.


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