The Grand Canyon State has more than desert landscapes. It is also home to the 24th best health care in the country. This study by US News looked at health care access, quality, and good public health.
Health care options in Arizona
According to the Arizona Department of Insurance, health insurance is available through several platforms:
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Arizona residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 44% | ||
| Individual or family | 5% | ||
| Medicaid | 22% | ||
| Medicare | 16% | ||
| Military | 1% | ||
| Uninsured | 11% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
About 11 percent of Arizonians are uninsured, a few percent above the national average. This is bad news for policyholders, as higher rates of uninsured people leads to higher costs for insured people.
Arizona health insurance companies
Arizona residents have plenty of options when it comes to health insurance providers. Here are some of the top insurers in the state:
- BlueCross BlueShield of Arizona
- Cigna
- Health Net of Arizona
- Oscar
- Bright Health
These providers offer individual and family plans. Do some research to find out what plans fit your needs best and how coverage varies based on where in the state you live.
Arizona insurance costs and rate factors
According to KFF.org, Arizona residents spend an average of $6,452 on health care every year. That number falls short of the national average of health care expenditures. How much should you expect to pay for health insurance in Arizona? Factors vary from person to person, but here's what insurers will look at to price your policy:
Health insurance plan type
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. If you want a higher level of coverage, you'll have to pay more in monthly premiums.
Curious about how much you'll be paying per month for health insurance in Arizona? These are the average costs for each plan type for a middle-aged AZ resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $363 | $435 | $579 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Jumping from a bronze plan to a gold plan will cost you about 60 percent more. That's because gold plans cover 80 percent of health care costs, versus 60 percent coverage with a bronze plan.
The lowest level of coverage available is a catastrophic plan. These types of plans are usually only available to people under 30 or with certain exemptions. They have very low monthly premiums but a high yearly deductible of $8,150. Even though you would be paying more monthly, a bronze or silver plan could save you money if you need to use your insurance.
Body mass index
According to the CDC, a high body mass can lead to numerous health conditions. That's why insurers will look at your BMI to assess your risk-level and price your policy. A higher BMI often leads to higher monthly premiums.
In 2017, Arizona had a 29.5 percent obesity rate, the 30th highest in the country. Out of the many AZ residents who use QuoteWizard to shop for health insurance, 30 percent have a BMI in the obese range.
Tobacco use
It's no secret that smoking can cause some serious health conditions. That's why whether you're a smoker plays a big role in how much you will be paying for insurance. According to America's Health Rankings, 15.6 percent of AZ residents are tobacco users, the 16th lowest rate in the country.
Age
Unfortunately, a health insurance plan can cost up to three times more for an older person than a younger person. On average, Arizonians who used QuoteWizard to compare health insurance rates are 41 years old.
Location
Location plays an important role in how much you'll be paying for health care. This is because the laws, regulations, and providers surrounding the health insurance marketplace vary from state to state.
Also, health insurance costs are often community rated. That means they're partly based on the claims that everyone files. If your neighbors file a high number of claims, your prices could spike.
So, living in a healthier state could keep your premiums low. According to America's Health Rankings, Arizona is the 31st healthiest state in the country.
Arizona health care laws
The Affordable Care Act doesn’t allow insurance companies to consider certain factors to price your policy.
- Pre-existing conditions: Providers can’t charge you more for having a pre-existing condition. According to HHS.gov, this used to be a big factor in your monthly premium costs.
- Gender: According to a study by Health Services Research, women historically pay more for health care. Luckily, the ACA mandates that providers cannot charge men and women different premiums for the same plan.
- Insurance and medical history: People also used to pay more if they had previous medical problems or lapses in insurance coverage. But with the ACA, insurers can't analyze these factors.
There's a limit to how much you'll be paying out-of-pocket for a marketplace plan. The out-of-pocket maximum for 2020 is $8,150 for an individual plan and $16,300 for a family plan.
Arizona law requires insurance companies to provide at least some coverage for the following services:
- Maternity care
- Emergency transportation
- Autism treatment
- Speech therapy
- Home health care services
- Emergency room services
- Clinical trials
There are additional services that providers need to cover. Find the complete list here.
Medicare and Medicaid in Arizona
Medicare and Medicaid are government-funded programs that offer health care options. Medicare is available to seniors, whereas Medicaid assists low-income families and children.
Medicare
Medicare is available to residents 65 years and older. There are several different options within the program. These include parts A, B, C, D, and supplemental coverage plans. As an Arizona resident, you may qualify for a Medicare Savings Programs if you meet these financial requirements:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
The rate of uninsured Americans has substantially improved since 2010 when the Affordable Care Act (ACA) was passed. Medicaid expansion was a huge part of reducing Arizona’s overall uninsured rate.
In 2013, 17.4% of Arizona’s residents did not have medical insurance. Arizona expanded its Medicaid program in 2014, and between 2014 and 2019 the state’s uninsured rate dropped by 12%. The primary cause of this was an 11% increase — or 147,800 Arizona residents — in Medicaid enrollment from 2014 to 2019.
Medicaid in Arizona is called the Arizona Health Care Cost Containment System (AHCCCS). These are the state's Medicaid financial requirements:
| Household size | Maximum monthly income |
|---|---|
| 1 | $1,415 |
| 2 | $1,911 |
| 3 | $2,408 |
| 4 | $2,904 |
| 5 | $3,401 |
Arizona department of insurance
- Website:
- Homepage
- Insurance Commissioner:
- Keith A. Schraad
- Insurance Hotline:
- (800) 325 - 2548
- Office Hours:
- Monday - Friday
8:00 am to 4:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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