Updated 11.10.18. We will continue to update this page with the latest plan information. Stay tuned!
Good news, Arizona! Not only is your state one of only a few that will see premium decreases this year, two new insurers are entering the marketplace, giving more choices to Maricopa and Pima counties on the ACA marketplace who only had one carrier to choose from last year.
For a state that was at one time President Trump’s poster child for the failure of Obamacare, with years of double and triple digit premium increases, this is a big step forward for the nearly 200,000 Arizonans enrolling in individual health insurance through the marketplace.
Especially for those who don’t qualify for the government subsidies designed to help with premium costs.
What’s different this year
- Availability of short term plans that can last a year. These short term, limited duration plans (STLDs) come with more restrictions, such as limits on preexisting conditions, and offer less coverage (i.e., good bye well-visits and maternity coverage), but their lower price point can be attractive to those that are relatively healthy and looking for more affordability.
- Association health plans: While recent legislation has opened the doors for association health plans, where small businesses and individuals can come together to buy group plans, we don’t expect this to have much of an impact this year since people are still trying to figure it out.
- Premiums have stabilized. Premiums are predicted to drop 10% for 2019 in Arizona. In contrast to the startling jumps in premium pricing the past few years, Modern Healthcare reports that 16 states will see premium declines, two will see no change, and the rest see marginal, single digit increases. On average, CMS reports that rates are dropping 1.5 percent on average across the country.
- Individual mandate disappearing. Beginning in 2019, the Individual Mandate which fines Americans who skip out on health coverage will no longer be in effect. While some think this measure could send premium prices up as the markets adjust for an exodus of healthy young people, it might have less effect than people think. You see, healthy young peeps weren’t buying plans the way families and older folks so and the markets are priced for that. Even with the individual mandate in place, healthy young people could decide to pay $200 a month for health insurance they didn’t think they needed or a $200 fee once a year.
- QSEHRAs are becoming more popular. For small companies and startups that can’t afford traditional group plans, QSEHRAs (aka Qualified Small Employer Health Reimbursement Arrangements) offer a new way to reimburse for premiums and medical expenses tax-free. Plus, in addition to being reimbursed for plans and alleviating the financial burden of individuals buying their own health insurance, employees can choose their own plan that works best for them instead of fitting into a one-size-fits-all group plan! If you or your employer wants to learn more about this, we have a first-of-its-kind QSEHRA guide that explains everything you need to know!
What’s the same
Despite a lot of talk in Washington, the Affordable Care Act (also known as Obamacare) is still intact.
- Doctor networks continue to stay small: An ongoing trend since the start of Obamacare, many plans will cover an increasingly smaller percentage of doctors in a given area. That leaves the consumer with fewer choices and a greater chance of having to go out of network to get the care they need. This is a strategy used by carriers to keep costs down, but it leaves consumers financially vulnerable for shouldering those scary and sky-high out-of-network costs. Even if your doctor is on your plan this year, it’s worth double checking for this coming year, since things might have changed. Our doctor search tool on our website is a simple way to do that!
- Shortened enrollment period: Just like last year, open enrollment is only 6 weeks—Nov 1 to Dec 15.
- Slashed funding: Funding for the marketplace has been further reduced, which means there will be less advertising and awareness campaigns helping people make smart choices. Federal 'navigator' grants to states that are meant to help educate and enroll people in health insurance were slashed by more than half this year. Arizona's allotment of money went down by 74 percent — from $1.17 million last year to this year's $300,000.
- Subsidies: Federal subsidies are expected to be available to those who qualify.
- Outages: Just like last year, there are 60 hours of scheduled downtime for scheduled maintenance that could get in the way of individuals researching and signing up for plans. Take note that from 12 a.m. to 12 p.m. every Sunday, except for the last Sunday of open enrollment, you can’t access healthcare.gov.
Who’s in, who’s out for individual health insurance in Arizona 2019
Two new insurers have joined the market for 2019: Minnesota-based Bright Health and New York-based Oscar, bringing the grand total of options to 6 carriers and 55 plans confirmed so far.
Here's the full lineup for individual health insurance options in Arizona this year, including on-exchange plans (aka the plans you can access through the Affordable Care Act's Marketplace, and off-exchange plans that aren't available on the Exchange and are purchased directly from the carrier or a broker. Remember: If you are eligible for a tax credit, purchasing an on-exchange plan is the only way to utilize it.
Use TakeCommandHealth.com to estimate your tax credit, search for your doctors, and compare on and off-exchange options in your zip code. If using a tax credit, we will automatically route your applications to healthcare.gov.
Status: On and off exchange
- Bright Advantage (HMO) $0 premium with high out of pocket
- Bright Advantage Plus (HMO) $55 premium with lowest out of pocket
- Bright Advantage Assist (HMO) $39 with high out of pocket
A new player in the Arizona insurance market, Minnesota-based startup insurer Bright Health is expanding its footprint this year with a promise of delivering simple, affordable solutions with top-notch doctors. After doubling its enrollments last year, it’s quickly gained industry recognition as a mover and shaker and has pretty aggressive growth plans for 2019.
Status: on and off exchange
- Simple Bronze “just in case” plan
- Simple Silver: generally healthy
- Classic Silver : great for families
Another new carrier in town. We love Oscar. They are affordable, technology enabled, and frankly pretty refreshing in a world of clunky old insurance companies. What’s more, they are expanding to three new states this year and growing their footprint in others.
Status: on exchange only
- Ambetter Essential Care (Bronze)-low premiums, higher out of pocket costs
- Ambetter Balanced Care (Silver)-best if eligible for government assistance. Balanced premiums an out of pocket costs
- Ambetter Secure Care (Gold)-higher premiums, lower monthly costs
Previously known as Health Net of Arizona and the sole marketplace carrier for Pima and Maricopa counties, Ambetter and in the past has covered 95,000 Arizonans with individual plans.
Status: on and off exchange
- Multiple HMO Gold, Silver and Bronze plans in network
Blue Cross remains committed to the individual insurance market in Arizona, last year covering 13 rural counties and 45,000 Arizonans under the ACA plans. This past year, these plans were available both on and off the exchange. About 90 percent of the people Blue Cross covers with its marketplace plans get tax credits to help offset their premiums.
Status: on and off exchange
- Bronze: low price tag- plan pays 60% and you pay 40%
- Silver: medium price tag- plan pays 70% and you pay 30%
- Gold: high price tag- plan pays 80% and you pay 20%
- Platinum: highest price tag- plan pays 90% and you pay 10%
Last year, Cigna’s HMO plans were only available off-exchange and suffered increases of around 62% (with no chance of tax credits to lessen the financial load). If their HMO is available this year, it could be a great option if you don't mind seeing Cigna's doctors (or if your doctor is already in the Cigna HMO network) and are looking to save on your monthly premiums.
Affordable Alternatives You Should Know About
An increasing number of our customers are opting for alternatives to traditional insurance. Here’s a couple of our top picks. They might not be for everyone, but they are worth checking out and comparing to major medical plans on our platform.
Pivot short term plans: Pivot provides short term medical insurance solutions until a qualified major medical health plan is chosen, helping reduce your financial risk. Pivot plans are renewable 90 day plans which in most states can be automatically renewed 4 times without additional medical screening to provide up to 12 months of continuous coverage.
Faith-based: Faith-based Medi-Share has a state-wide PPO network available in 2019 managed by PHCS (Private Healthcare Systems, now owned by Multiplan). It’s smaller than some of the PPO networks in the past, but it does provide flexibility to see your doctors and will cover out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone, but is a worthy option to consider if it fits your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.
Next steps: What's my best option?
While more choices are a welcome change, hunting down and comparing all of these options can feel overwhelming. However, at TakeCommandHealth.com we help you compare all of your options side-by-side including off-exchange plans, marketplace plans, and faith-based options. You can use our award-winning tools to search for your doctors, check your prescriptions, and even simulate conditions and health needs to make sure you get the most of for your money.
A few other updates we'd like to tell you about:
We've expanded the capabilities of our doctor search tool to search doctor networks from all of the carriers above (no matter if the plan is off-exchange, on the marketplace, or faith-based).
We've negotiated some pretty awesome deals for our members. Call a doctor 24/7 for $0, enjoy medical bill negotiation support, a personal health advocate, dental, vision, and pharmacy discounts, etc. These really help save money with some of the higher deductible plans.
We're pretty confident we have the biggest, most complete line-up of plans in Arizona this year.
With growing demand, we've also put together a bigger support team ready to help you tackle any issue. You can get started by chatting with one of our licensed professionals on our website or emailing us at email@example.com.
Once open enrollment begins, you can visit our website and we'll walk you through your options. Our goal is to help you get the most out of your money and find the plan that really works for you and your family.
Remember you have until Dec 15th to select a plan that starts Jan 1st, 2019.
For reference, here's the 2018 guide from last year.
I wrote this blog because I care about ideas (big and little) that can help fix our healthcare system. I used to work on projects for Kaiser Permanente and the Parkland Health & Hospital System so I've seen the system inside and out. It's so important that consumers keep up with industry shifts and changing health insurance regulations. I'm also Take Command Health's Content Editor and a busy mom. Learn more about me and connect with me on our about us page. Thanks!