For all the focus that Arizona and the national debate has placed on health insurance, this vital type of protection remains complex, confusing and down-right frustrating to most. Are you better off going with your employer's health benefits, or striking out on your own? What type of health insurance policies are right for you and your family? The questions are endless, and the answers elusive.
Before you search for health insurance quotes, there are several factors to consider.
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How Arizona Fares in Health Insurance
According to Arizona media reports:
- 1.3 million residents, or more than one-fifth of Arizona's population, were without health insurance in 2011.
- Fewer than half of Arizona's residents now get health insurance through an employer, the lowest level in a decade, according to census figures.
- In some cases, a person drawing $240 a week in unemployment makes too much to get insurance through the Arizona Health Care Cost Containment System (AHCCCS), the state's Medicaid program. However, the $240 is typically not enough to pay for health insurance.
- The state's Medicaid program does not cover dental care, and many people with conventional medical insurance also lack dental coverage.
Am I Required to Carry Health Insurance?
As of 2014, the Affordable Care Act, signed into law by the U.S. Congress, requires all individuals to carry a minimum of health insurance or pay a fine.
This penalty is $95 per adult and $47.50 per child, or 1 percent of household income, whichever is greater. These penalties increase every year for which the household does not secure health insurance coverage.
There are numerous exemptions to the mandate, including:
- Having income below 100 percent of the federal poverty level
- Not being required to file income taxes
- If the purchase of insurance would cause financial hardship
- Having religious objections
- Having a coverage gap shorter than three months
- Being an American Indian, undocumented immigrant, or incarcerated person
What Does Health Insurance Cover?
Health insurance covers a variety of things, from your regular checkups and family care, to major surgeries and treatments. The types of services that are covered will vary with different Arizona healthcare providers and plan types, so it is important to identify your needs before buying a specific health insurance policy.
Doctor visits are one of the most common things that health insurance covers. Other commonly covered services include hospital room and board, emergency room visits, and inpatient substance abuse treatment. Some things that you may think are covered may not be; some of the common excluded health care needs are maternity care and chronic illness care management.
Some health insurance policies include vision and dental coverage, while others will not. There is normally an out-of-pocket expense, through a co-pay, coinsurance or deductible.
Make sure that you are familiar with what your policy covers, whether all of your family members are covered, and how the doctor or hospital will be reimbursed. Some HMOs will only cover procedures performed by certain professionals considered "in network," and any treatment sought "out of network" will not be covered. A PPO will allow you to choose your provider and then pay based on that provider’s preferred status.
How Does Health Insurance Work?
Most Arizona residents secure their health insurance from their employer, but this number is quickly falling. Whether your health insurance is provided by your employer, the state or the federal government, or you are considering purchasing a policy on the individual market or exchange, it generally has various compensation methods. Depending on your type of plan, you will most likely have co-pays, deductibles and, in some cases, coinsurance.
- Co-payments: This is the cost you pay every time you schedule a service such as a doctor's visit, a blood test or a check-up. The most common cost is about $25, but co-pays can be lower or higher depending on the plan.
- Deductibles: A deductible is the cost that you are required to pay before your insurance begins to cover services. For example, if your deductible is $5,000, that is the amount you will need to pay throughout the year for medical services. Anything above $5,000 will be covered by your insurance.
- Coinsurance: Some policies may have coinsurance, which requires you to pay a certain percentage of services rendered. Your coinsurance may be an amount you pay in addition to your co-pay and may apply towards your deductible.
Why is Health Insurance Important?
Not only does the failure to obtain health insurance reek financial ruin on the individual, but states like Arizona are burdened with more than $1 billion annually in costs due to the uninsured.
Lack of health insurance is the number one reason for bankruptcy in Arizona. Just one major illness or injury can put your family into dire financial straights.
The uninsured also drive up the insurance premium costs for those who do carry health insurance. By 2010, health insurance premiums for families in Arizona with private, employer-sponsored coverage was $2,028 higher due to the unpaid cost of health care for the uninsured. Premiums for individual health insurance coverage in Arizona was $726 higher per year in 2010 due to the uninsured.
What Will My Health Insurance Quote Look Like?
The health insurance quotes you will receive depend on several factors. Quotes vary based on your plan type, whether you have insurance through an employer or private insurer, and how much of the insurance you cover.
On average, individual policies can be quoted anywhere from $150 to $200 per month, and family policies quotes can be between $350 to $500 per month. With some plans, you will pay these premiums entirely out of pocket and for others, the majority of premiums are covered by an employer. You can adjust your premium based on your coverage amounts, as well as your deductible amount. A higher deductible can mean a lower quote, but be sure the deductible you choose is one that you can comfortably afford to pay.
How Can I Find Health Insurance?
The last thing you want to worry about as you are racing to the emergency room is whether or not your health insurance will pay for your treatment. As complex and confusing as health care insurance can be, it's best to work with a knowledgeable insurance agent. Independent agents on the Trusted Choice network are always here to help you navigate the complexities of health insurance, suggest coverage options, and even assist you in filing a claim. These agents have years of experience working with Arizona insurance providers and are up-to-date with all the new federal laws. Their experience enables them to find a variety of quotes from a number of Arizona providers, ensuring you only receive quotes with the best coverage at the lowest rates. Contact a Trusted Choice agent near you to find out how you can secure a health insurance policy that meets your needs and budget.