Health insurance Arizona

Health insurance Arizona

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Blake Insurance Group LLC offers a wide range of Arizona health insurance plans to meet the diverse needs of individuals and families. We represent top health insurance companies in Arizona that provide Affordable Care Act (ACA)-compliant individual and family health plans, available both on and off the Exchange. These companies include Oscar, Banner Health, Aetna Health Plan Inc., Blue Cross Blue Shield (BCBS), UnitedHealthcare, and Ambetter. Our goal is to help you compare the details of health insurance plans available in your area and find the best coverage for your needs.

Understanding Health Insurance in Arizona

Navigating the complexities of health insurance can feel overwhelming, especially when factoring in Arizona’s unique healthcare landscape. From government programs like Medicare and Medicaid to private insurance options, numerous choices are available for residents. Below is a comprehensive guide to understanding health insurance in Arizona:

**The Affordable Care Act (ACA) in Arizona**

The ACA has significantly expanded access to health insurance in Arizona. It provides subsidies to eligible individuals and families, making coverage more affordable. ACA-compliant plans cover essential health benefits such as:

– Preventive care

– Prescription drugs

– Maternity care

– Mental health services

These plans are available through the federal Health Insurance Marketplace or directly from private insurers.

**Medicare in Arizona**

Medicare in Arizona offers beneficiaries a choice between Original Medicare with the addition of Medigap (Medicare Supplement Insurance) or Medicare Advantage plans, often including additional benefits such as prescription drugs, dental, and vision care.

Medigap in Arizona

Medigap plans are supplemental policies that work alongside Original Medicare (Parts A and B) to cover copayments, coinsurance, and deductibles. These plans are standardized by Medicare but are sold and administered by private insurance companies. In Arizona, Medigap plans are available to those enrolled in Medicare Part A and B, and the most popular and comprehensive plans are F and G. However, Plan F is unavailable to new Medicare enrollees after December 31, 2019. Medigap plans in Arizona can range from approximately $75 to $471 per month, depending on the specific plan, the enrollee’s age, and the insurance provider.

Medicare Advantage in Arizona

Medicare Advantage (Part C) plans are an alternative to Original Medicare and are offered by private insurance companies approved by Medicare. These plans must cover all the services that Original Medicare covers but can also provide additional benefits, including prescription drug coverage, dental care, and vision care.

In Arizona, a variety of Medicare Advantage plans are available, with 155 plans offered in 2024. The average monthly premium for a Medicare Advantage plan in Arizona in 2024 is $12.14. These plans can vary significantly in coverage and cost, so beneficiaries must compare options to find the best option.

Medicare Advantage plans can include coverage for dental and vision health items; most also have prescription drug coverage. However, the specifics of what is covered and any associated costs will depend on the beneficiary’s chosen individual plan.

Applying for Assistance

To apply for help with Medicare costs, individuals should contact their State Medical Assistance (Medicaid) office. It’s important to apply even if the individual’s income or resources are slightly higher than the listed amounts, as some states have more generous eligibility criteria or do not count certain types of income or resources.

In Arizona, residents can access various health plans, including the AHCCCS Complete Care Health Plan, Mercy Care, and Care 1st.

AHCCCS Complete Care Health Plan

The Arizona Health Care Cost Containment System (AHCCCS) Complete Care Health Plan is an integrated health plan for most AHCCCS members. This plan includes physical and behavioral healthcare service providers, aiming to provide comprehensive managed care for the whole person. The benefits of this integration include a single plan, payer, and provider network, making it easier for members to navigate.

Mercy Care

Mercy Care is a not-for-profit health plan serving AHCCCS members throughout Arizona. It provides coverage for people who qualify for AHCCCS and offers services and support through five Medicaid or Medicaid/Medicare plans. These plans include coverage for general mental health and substance use concerns, long-term care and services for developmental or cognitive disabilities, and physical and behavioral health care coverage for children and youth in foster care.

Care 1st

Care 1st Health Plan Arizona is part of the Arizona Complete Health family of health plans. It serves families in Apache, Coconino, Mohave, Navajo, and Yavapai Counties. Care 1st is one of two Medicaid plans under the Arizona Complete Health family, with Care 1st serving northern Arizona and Arizona Complete Health-Complete Care plan serving central and southern Arizona.

Enrollment in Health Plans

AHCCCS members may enroll in any health plan that serves their county. This allows members to choose a plan that best fits their needs and ensures access to healthcare services within their local area.

Arizona’s State Health Insurance Assistance Program (SHIP) is a free health benefits counseling service for Medicare beneficiaries. Its mission is to empower, educate, and assist Medicare-eligible individuals, their families, and caregivers through objective outreach, counseling, and training to help individuals make informed health insurance decisions that optimize access to care. SHIP provides unbiased help to Medicare beneficiaries, their families, and caregivers, offering information on Medicare, AHCCCS, Medigap, Medicare Fraud, Error and Abuse, and Part D-Prescription Drug Plan.

Shop Health Insurance Premiums in Arizona

In Arizona, the Small Business Health Options Program (SHOP) provides health insurance plans tailored for small businesses with 1 to 50 full-time equivalent employees. Monthly premiums for SHOP health insurance plans vary by age group. For instance, the lowest premiums start at $225.76 for a 21-year-old enrollee and $612.70 for a 60-year-old enrollee.

Employers have the flexibility to share the cost of these premiums with their employees. Typically, this involves the employer covering a portion of the premium while the employee pays the remaining balance. While the employer determines their contribution amount, specific conditions must be met to qualify for the Small Business Health Care Tax Credit.

Eligibility for the Small Business Health Care Tax Credit

To qualify for this tax credit, which can cover up to 50% of the employer’s premium contributions, businesses must meet the following criteria:

Employ fewer than 25 full-time equivalent employees.

Have average annual wages of less than $50,000 per employee (adjusted annually for inflation).

Pay at least 50% of the premium costs for full-time employees.

Purchase health insurance through the SHOP Marketplace.

Benefits of Offering SHOP Health Insurance

Providing health insurance through SHOP plans offers several advantages:

Employee Retention: Health benefits can help attract and retain top talent.

Tax Savings: Eligible employers can take advantage of significant tax credits.

Customizable Contributions: Employers can tailor their contributions to fit their budget while meeting eligibility requirements.

Getting Started with SHOP Plans

Employers interested in offering SHOP health insurance plans can easily explore their options by obtaining a custom premium quote. Answering a few questions allows them to view available plans and receive premium estimates tailored to their business needs.

Offering health insurance through SHOP supports employee well-being and provides financial incentives that can benefit your business in the long run.

Short-term Health Insurance Plans in Arizona

Short-term health insurance plans in Arizona are designed to provide temporary coverage for individuals facing gaps in their regular health insurance. These plans are ideal for those in transition, such as between jobs, waiting for employer-sponsored coverage, or missing the open enrollment period for ACA-compliant plans. However, recent federal regulations have significantly impacted the availability and duration of these plans.

Availability and Duration

As of September 1, 2024, federal rules limit short-term health insurance plans in Arizona to a maximum duration of three months, with the option to renew for one additional month, totaling up to four months. This is a significant change from previous rules that allowed plans to last up to 36 months.

Short-term plans remain available year-round, offering flexibility for those needing immediate coverage. Coverage typically begins shortly after enrollment, often as soon as the next day.

Supplementary Health Insurance Plans in Arizona

In Arizona, supplementary health insurance plans provide additional coverage options beyond traditional health insurance. These plans can offer services like telemedicine, discounts on medical procedures, and preventive care. Two examples of such plans are offered by Ally Health and Safeguard Health Plans.

Ally Health Plans

Ally Health offers telemedicine-based health services, which can benefit individuals seeking convenient and affordable healthcare options. The Ally Health Basic Plan includes:

– 24/7 phone or video access to doctors, coaches, and therapists.

– Unlimited doctor and pediatrician consultations.

– Virtual consultations with specialists and second opinions.

– Health and wellness coaching.

– Tools and services for saving on prescriptions, lab tests, medical imaging, and surgical procedures.

One of the key advantages of Ally Health’s services is the absence of co-pays, deductibles, or per-call charges, making it a cost-effective option for those who may struggle with the costs associated with traditional healthcare services.

SGH SecureHealth Insurance Plans

Safeguard Health Plans offers SGH SecureHealth insurance plans designed to be affordable and flexible. Critical features of SGH SecureHealth Plans include:

– Coverage for preventive care services such as annual check-ups, immunizations, and cancer screenings at no additional cost.

– Access to the PHCS PPO Network.

– A variety of plan options to suit different needs and budgets, from SecureHealth Value for budget-conscious individuals to SecureHealth Elite for more comprehensive coverage.

SGH SecureHealth Plans are recommended for comprehensive and affordable health insurance coverage, providing various benefits to help manage healthcare costs effectively.

Enrollment and Considerations

When considering supplementary health insurance plans like those offered by Ally Health and Safeguard Health Plans, it’s important to evaluate how they complement existing health insurance coverage. These plans can be particularly useful for individuals who need additional services not covered by their primary health insurance or those seeking more budget-friendly options for non-emergency healthcare services.

Prospective enrollees should review the details of each plan, understand the coverage limits, and consider how the plan fits into their overall healthcare strategy. It’s also advisable to compare these supplementary plans with other available options in the Arizona market to ensure the best fit for individual healthcare needs and financial situations.

Health Insurance in Arizona - FAQs

Health Insurance in Arizona - FAQs

What is the Arizona Health Care Cost Containment System (AHCCCS)?

AHCCCS is Arizona's Medicaid program that provides low-cost or free health insurance to eligible low-income individuals and families. It covers services such as doctor visits, hospital care, prescriptions, and preventive care. Eligibility is based on income, residency, and other criteria. For more information, visit azahcccs.gov.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace allows individuals and families to compare and purchase ACA-compliant health plans. Visit HealthCare.gov to explore your options.

What is SHOP, and how does it work for small businesses?

SHOP offers health insurance plans for small businesses with 1 to 50 full-time employees. Learn more at HealthCare.gov.

Can I have both Medicaid (AHCCCS) and Medicare in Arizona?

Yes, individuals who qualify for both programs are known as "dual-eligible" members. AHCCCS can help cover Medicare premiums, deductibles, and co-pays.

What assistance is available for children’s health insurance in Arizona?

KidsCare provides affordable coverage for children under 19. Learn more at azahcccs.gov/KidsCare.

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Blake Insurance Group

Phone: (888) 387-3687

Email: [email protected]

Hours: Mon-Fri 9:00 am to 5:00 pm

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Blake Nwosu

Blake Nwosu

Owner & Principal Agent

Expertise: All personal and commercial line insurance, including auto, home, business, health, and life insurance.

License: 16117464

Bio Page: https://blakeinsurancegroup.com/blake-nwosu/