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.

*All plans for individuals and families do not cover services outside of the network, except for emergencies and other limited situations with BCBSAZ pre-approval. All plans have limits, exceptions and members cost share requirements.
**Applies to covered services submitted with a preventive diagnosis.
***The monthly premium factors in a premium subsidy from the federal government. An applicant’s household income will determine whether they qualify for a federal premium subsidy. In addition, rates will vary depending on the specific plan, the applicant’s county of residence, and age.

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.

Short-term medical (STM) insurance is temporary coverage with limited benefits. It is not ACA-compliant, doesn't cover pre-existing conditions and is not guaranteed-issue. You may still be subject to a federal tax penalty.
STM plans are offered by The IHC Group and underwritten by Standard Security Life Insurance Company of New York (SSL). The IHC Group and SSL are independent companies that do not provide, offer or sell BCBSAZ products or services and are solely responsible for the products and services they provide.
*One office visit copay per person per 30-90 day coverage.

• 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?

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

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).

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.

• Up to 2.5% of your household income*

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.

*Current flat fee amounts as of July 2016. The flat fee amount may be adjusted annually for inflation. ** Based on internal BCBSAZ data for claims incurred in 2015. Generally includes hospitalization, surgery and other professional services. Procedures are without complications and comorbidities. ^† Based on average member cost share across all plans and plan types. Actual cost share for individual members will vary based on benefit plan terms and individual circumstances.