Medical Plan Options

There are many reasons health insurance costs continue to increase. In some cases, you might think you can’t afford health coverage. Now more than ever, it’s important to review your health insurance options.

Youtube Medical Plans

Medical Plan Options
2:22 min.

Affordable Care Act (ACA) Plans

BCBSAZ offers ACA plans in all counties except for Maricopa and Pima. You can find these plans on the Health Insurance Marketplace. Plans include:

  • Comprehensive medical coverage including doctor visits, urgent care, etc.*
  • $0 preventive services such as well woman visits, immunizations, flu shots, etc.**
  • Coverage for pre-existing conditions

See if you qualify for a $0/month health plan with financial help***

For more information, please contact your Broker.

Short-term Medical Plans

You may want to consider an alternative health plan option such as short-term medical. This type of plan is available for 30 – 90 day temporary coverage. Plans include:

  • Includes doctor visits*, hospital stays and more
  • Options to add Rx drug benefits, out-of-pocket expense coverage, and telemedicine
  • Enroll any time of the year; there’s no deadline
  • Reapply for another 30-90 days of coverage anytime
  • Excludes pre-existing medical conditions
  • Plans are not ACA-compliant, which means you may pay a tax penalty

For more information, please call your Broker.

How to Pick an ACA Plan

It’s important to do your research before making any decisions about the type of ACA plan that could be right for you and your family. Consider these points when deciding:

  • Review your health. How much healthcare you need is an important factor in choosing a health plan. If you know you’re going to need a medical procedure or you have a health condition, consider those costs when choosing a health plan.
Youtube BCBSAZ Video - How to pick an ACA plan

How to Choose a Healthcare Plan
2:18 min.

  • Know what’s included. Every health plan has a Summary of Benefits and Coverage (SBC). It provides information about deductibles, out-of-pocket limits and covered services. It’s like a nutritional label for a health plan.
  • Check the plan’s network. Check to see if your doctor is in the plan’s network. If not, are you okay with changing doctors? Not all doctors are in all BCBSAZ networks. It’s important to know that visits to doctors who are not in your plan’s network are not covered.
  • Plan your spending. Spending less on monthly premiums typically means you pay more when you need medical services. Plus, you may have a higher deductible. On the other hand, paying more each month for your premium may mean you have a lower deductible and spend less out of pocket. What works best for you?

Financial Help

9 out of 10 Arizonans are eligible for financial help*. Find out if you qualify for subsidies available from the federal government:

  1. Premium tax credit - helps pay for all or part of your monthly premium depending on your household income. Income ranges that qualify for a $0 premium health plan or financial help are outlined in the chart below.
  2. Cost-share reduction - a discount on your deductibles, copayments, and coinsurance; available on Silver plans only for those who make less than 250% federal poverty level (FPL).
Youtube Low Cost Options

Low Cost Options
1:03 min

Take a look at this chart to see if you may qualify for a subsidy:

Number of people in your household

The poverty guidelines may be formally referenced as "the poverty guidelines" updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2).

How to Enroll on the Marketplace

The Health Insurance Marketplace, or “Marketplace” as it’s often called, is a website where you can shop for and enroll in a health plan, and apply for subsidies and other financial help.

In Arizona, the Marketplace is run by the U.S. Department of Health and Human Services. They ensure that all of the plans featured on the site meet the requirements of the Affordable Care Act (ACA).

Youtube Video How to enroll on the Marketplace

How to enroll on the Marketplace
2:22 min.

When you visit the Marketplace, you can:

  • Compare different health insurance plans
  • Get answers to questions about health plan features
  • Find out if you can sign up for programs such as Medicaid and the Children’s Health Insurance Program
  • Find out if you qualify and apply for a subsidy or other financial help
  • Enroll in a health plan that meets your needs

Keep in mind that it can take up to one hour to complete an application. If you have to step away, simply save your information. When you log in again, you can pick up where you left off.

The Cost of Being Uninsured

Whether it’s a visit to the emergency room or a prescription, you could face large medical bills if you don’t have insurance. Plus, you may need to pay a tax penalty for being uninsured. If you’re uninsured you’ll pay whichever of these amounts is greater:

  • $695 per adult plus $347.50 for each child (up to $2,085 per household)
    per household) 
Youtube The cost of being uninsured

The Cost of Being Uninsured
1:55 min.

  • Up to 2.5% of your household income*

Insurance reduces the cost of medical care

Let’s compare! For a fractured bone without surgery:

The average amount billed is $7,329.40.* The average amount paid by Blue Cross Blue Shield of Arizona insured members is $558.11 That’s a difference of $6,771.29!

As you can see, health insurance can make it more affordable to get the medical treatment you might need.