Call or Text

Office visit by appointment Only

Health Insurance Agency Tucson AZ: Your Trusted Local Partner

Welcome to Tucson, AZ, a city rich in history, culture, and a competitive insurance marketplace. Amidst the bustling streets and vibrant businesses, the Blake Insurance Group is a beacon of trust and reliability for all your insurance needs. As your local health insurance broker in Tucson, we’re not just in the business of policies and premiums. We’re here to deliver peace of mind and financial protection that aligns with your lifestyle and budget.

Our insurance brokers go beyond just selling policies. We share the same neighborhoods, visit the same doctors, and are part of your communities. This proximity lets us offer you the perfect blend of personalized service, local understanding, and industry expertise, making us the go-to health insurance agency in Tucson, AZ, locals trust.

2024 Free Health Insurance Quote

Start a free No Obligation Online Health insurance quote • Safe and secure • Compare Top Companies side by side • Free No Obligation Quote Instant

Understanding Health Insurance Plans

Health Insurance Agency Tucson AZHealth insurance plans come in various forms, each with its rules and benefits. Here are four common types of health insurance plans:

**Health Maintenance Organization (HMO)**: An HMO is a type of health insurance plan that provides coverage through a network of physicians. In an HMO, you must choose a primary care physician (PCP) to oversee your care and refer you to specialists within the network. HMOs often focus on integrated care and prevention and usually won’t cover out-of-network care except in emergencies. HMOs are known for their lower premiums compared to other types of plans.

**Exclusive Provider Organization (EPO)**: An EPO is a health insurance plan that only allows you to get health care services from doctors, hospitals, and other care providers within its network. Unlike an HMO, an EPO does not require you to select a primary care physician or get referrals to see specialists. However, EPOs do not provide out-of-network benefits except for emergencies. EPOs typically cost less than HMOs and PPOs.

**Preferred Provider Organization (PPO)**: A PPO is a health insurance plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers in the plan’s network. However, unlike HMOs and EPOs, PPOs allow you to use doctors, hospitals, and providers outside the network for additional costs. PPOs tend to have higher premiums than other types of plans.

**Point of Service (POS) Plans**: A POS plan is a type of health insurance plan where you pay less if you use doctors, hospitals, and other health care providers in the plan’s network. POS plans require you to get a referral from your primary care doctor to see a specialist. They offer more flexibility than HMOs but less than PPOs.

Each of these plans has advantages and disadvantages, and the best choice depends on your individual health needs, budget, and preferred level of flexibility.

Health Insurance Plan Categories

Health insurance plans in the Marketplace are categorized into four metal levels: Bronze, Silver, Gold, and Platinum. These categories are based on how costs are shared between the insurance company and the policyholder.

 Bronze Plans

– **Insurance Company Pays**: 60%

– **You Pay**: 40%

– Bronze plans have the lowest monthly premiums but the highest costs when you need care. They are designed to protect you in worst-case medical scenarios, with low monthly premiums but high deductibles and other out-of-pocket costs. These plans are a good choice if you want a low-cost way to protect yourself from serious sickness or injury.

Silver Plans

– **Insurance Company Pays**: 70%

– **You Pay**: 30%

– Silver plans have moderate monthly premiums and moderate costs when you need care. They are a middle ground between Bronze and Gold, balancing monthly premiums and out-of-pocket costs when you receive medical care. If you qualify for cost-sharing reductions, a Silver plan may provide additional savings, effectively offering coverage similar to Gold or Platinum plans for a lower cost.

Gold Plans

– **Insurance Company Pays**: 80%

– **You Pay**: 20%

– Gold plans have high monthly premiums but low costs when you need care. Deductibles are usually low, making them a good choice if you pay more monthly to cover more costs when you get medical treatment. A Gold plan could be a good value if you frequently use healthcare services.

Platinum Plans

– **Insurance Company Pays**: 90%

– **You Pay**: 10%

– Platinum plans have the highest monthly premiums and the lowest costs when you get care. They are suitable for those who need regular medical care and are willing to pay the highest premiums to cover most of their healthcare costs. Deductibles and out-of-pocket costs are significantly lower compared to other plans.

When choosing a plan, consider how much you’re willing to pay for monthly premiums versus out-of-pocket costs when you need medical care. The right category for you will depend on your healthcare needs and financial situation.

Enrollment Process: Open Enrollment and Special Enrollment

The enrollment process for health insurance through the Health Insurance Marketplace, such as, involves two primary periods: Open Enrollment and Special Enrollment.

Open Enrollment Period

Open Enrollment is when individuals can enroll in a health insurance plan for the upcoming year. For coverage in 2024, the Open Enrollment period began on November 1 and ended on January 16. Anyone can enroll, re-enroll, or change health plans through the Marketplace during this time.

Special Enrollment Period (SEP)

Outside of the Open Enrollment Period, individuals can only enroll in or change their health insurance plans if they qualify for a Special Enrollment Period. SEPs are triggered by certain life events, such as losing health coverage, moving, getting married, having a baby, or experiencing a significant change in income. Typically, there is a 60-day window surrounding the event during which one can enroll in a new plan.

Role of Agents Like Blake Insurance Group

Agents and brokers, like those at Blake Insurance Group, play a crucial role in assisting individuals and small businesses with the enrollment process. They provide expert guidance on plan options, help compare costs and coverage, and assist with applying for financial assistance. Agents and brokers can recommend specific plans that are best suited for individuals and families, and they are instrumental in driving greater participation in the individual health insurance market.

Free Service for Consumers

The service provided by agents and brokers is free for consumers. Agents make money through commissions already included in the cost of every health insurance plan, regardless of where it is purchased. This means that individuals and small businesses do not pay extra for the services of an agent or broker. These professionals can help navigate federal and state Marketplace exchanges and offer guidance about public programs and premium tax credits.

Benefits for Individuals and Small Businesses

Working with agents like those at Blake Insurance Group is particularly beneficial for individuals and small businesses because they can receive personalized help and recommendations while still being eligible for any subsidies through the Marketplace. Agents can also help with the entire online process, from filling out applications to completing enrollments and handling renewals.

Health Insurance Costs: Premiums, Deductibles, and Out-of-Pocket Costs

Health insurance costs typically include premiums, deductibles, and out-of-pocket costs.


Premiums are the amount you pay to your insurance company each month to have health insurance. The average premium for a single person is about $117 per month for employer-sponsored coverage and $477 per month for a plan before any subsidies. However, these costs can vary significantly based on several factors.


A deductible is the amount you spend for covered health services before your insurance company pays anything. In 2023, the average deductible for an employer-sponsored plan was $1,992 for an individual plan. The average deductible for plans purchased through the Health Insurance Marketplace was $2,825 for single coverage.

Out-of-Pocket Costs

Out-of-pocket costs include deductibles, coinsurance, copayments for covered services, and all costs for services that aren’t covered. The average out-of-pocket maximum for an ACA marketplace plan in 2024 is $9,450 for individual plans.

Factors Affecting Health Insurance Costs

Several factors can affect the cost of health insurance, including age, plan type, and individual health needs.


Health insurance premiums can be up to 3 times higher for older people than for younger ones. Rates rise gradually to age 50, then show a steeper increase for people age 51 and older.

Plan Type

There are five plan categories – Bronze, Silver, Gold, Platinum, and Catastrophic. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.

Individual Health Needs

The scope of benefits included in a plan and the insured’s health status can also affect the cost of health insurance. For example, individuals with chronic conditions or requiring regular medical care may have higher healthcare costs.

Provider Networks: In-Network vs. Out-of-Network

Provider networks are essential components of health insurance plans, consisting of healthcare professionals, hospitals, and other providers contracted with an insurance plan to offer medical care to its members at negotiated rates.

In-Network Providers

In-network providers, also known as network providers, have agreed to provide services to plan members at pre-negotiated rates, which generally means lower costs for the insurance company and the members. When you receive care from an in-network provider, you typically pay less out of pocket due to these agreed-upon rates. For example, a surgery that costs $15,000 might be contracted at $10,000 with an in-network provider, resulting in lower costs for the insured.

Out-of-Network Providers

Out-of-network providers do not have a contract with your health plan, which often means you will pay more for their services. In some cases, out-of-network care can cost significantly more because these providers can charge full price for their services. For instance, the same $15,000 surgery could lead to higher out-of-pocket expenses if performed by an out-of-network provider because the insurance may cover less, leaving the patient responsible for a larger portion of the bill.

Impact on Coverage and Costs

The difference between in-network and out-of-network providers can substantially impact your healthcare costs. In-network care is typically associated with lower copayments, deductibles, and coinsurance. Conversely, out-of-network care may result in higher out-of-pocket expenses, including higher deductibles, coinsurance, and potentially the full cost of care if the plan does not cover out-of-network services at all.

Emergency and Urgent Care

It’s important to note that all health insurance plans must cover medically necessary emergency and urgent care services, whether the provider is in-network or out-of-network. However, for non-emergency services, HMO plans generally do not include out-of-network benefits, meaning higher costs if you choose an out-of-network provider. On the other hand, PPO plans include out-of-network benefits but still result in higher costs than in-network services.

Average Cost of Health Insurance

The cost of health insurance varies significantly based on the type of coverage (individual, family, or small business), location, age, health status, and the plan’s specific benefits. Here are the average costs for each category:

Individual Health Insurance

In 2023, the average national cost for individual health insurance was $456 per month. However, this can vary significantly by state. For example, in Florida, residents can expect to pay an average of $467 per person for a major medical individual health insurance plan. The average monthly health insurance cost for a bronze plan for a single 30-year-old person was $373, while the same person paid an average of $488 for a Silver plan and $634 for a Gold plan.

Family Health Insurance

The average premium for non-subsidized health insurance for a family of four was $1,437 per month 2022. By 2023, the average annual health insurance premiums for family coverage had risen to $23,968, approximately $1,997 monthly.

Small Business Health Insurance

The average owner paid $6,584 a year for small businesses to cover a single worker’s health insurance in 2023. For family coverage, that cost jumped to $16,357. The average monthly premium for single coverage per covered worker in small firms was $651, and for family coverage, it was $1,817.

It’s important to note that these are average costs, and actual premiums can vary based on various factors, including the specific plan, the health of the insured individuals, and the location of the business or individuals. Additionally, these costs do not consider any potential subsidies or financial assistance that individuals, families, or small businesses may be eligible for, which could lower the out-of-pocket costs.