Arizona Health Insurance (AZ)

Arizona (AZ)
Individual Health Insurance Regulations

Learn more about Arizona Individual Health Insurance

Insurance companies offering individual health insurance in Arizona are permitted to refuse coverage to any person that has a pre-existing medical condition. The exception to this is those individuals that are HIPAA eligible under federal law are guaranteed coverage on a select number of individual health plans. The premiums charged under these plans may be substantially higher than standard issue plans for healthy individuals. There are many different levels of health plans available that range in premium, deductibles, co-payments and covered services. Insurance companies are allowed to impose exclusionary periods on pre-existing medical conditions and may deny future claims if they determine your medical treatment was related to a medical condition that existed prior to your application for insurance. There are no state regulations that require an insurance company to provide credit from prior health insurance coverage to the pre-existing condition exclusionary period.

Arizona (AZ)
Small Group Health Insurance Regulations

Arizona law defines a small group as any employer with 2-50 employees. Coverage is guaranteed issue to small groups, meaning that the insurance company must accept the group for coverage, regardless of overall health status. Insurance companies offering small group health insurance can place a 12 month exclusionary period on pre-existing conditions. Prior creditable health insurance must be applied to the exclusionary period. Insurance companies are allowed to adjust their published rates for smaller groups or groups with a higher percentage of employees with existing medical conditions or risk factors.

Arizona COBRA and Continuation Coverage

Arizona does not have a state mini-COBRA regulation. Federal COBRA laws apply to companies with more than 20 employees. Your coverage under the COBRA option is the same coverage you had while you were covered under your group plan. Most COBRA plans last for 18 months, but certain qualified beneficiaries may remain on COBRA for 36 months, such as a widow of a primary insured. The premium amount, plus a 2% administration fee will be charged directly to the insured. COBRA coverage will end if the group health plan that it is tied to is terminated because the company goes out of business or stops offering health care benefits to their employees. If you loose your group coverage, you may also be able to purchase a conversion policy that is offered by the insurance company that managed your group plan. These are permanent individual health plans, but the premiums may be considerably higher than COBRA coverage or other individual health plans.

Additional Arizona Resources

• Arizona KidsCare
  Provides health care coverage to children in Arizona that are under the age of 18 that do not have access to other medical insurance and whoes families fall within the low-income guidelines
• Arizona Health Care Cost Containment System
  Provides medical insurance and other services to low-income families that are residents of Arizona.
• Arizona Medicare Assistance
  The Health Services Advisory Group is a Medicare Quality Improvement Organization that provides assistance to the elderly and disabled in understanding their Medicare rights and those that have complaints about their insurance company.
  

AZ Medical Insurance Statistics

Total Population: 6,047,000
With Health Insurance: 4,828,000 / 79.8%
Without Health Insurance: 1,219,000 / 20.2%
*According to 2005 CPS Reports / U.S. Census Bureau

Note: There perecentage of Arizonans without health insurance increased by 3.1% from 2004.

Arizona Department of Insurance
Phone: 800-325-2548
Regulates the insurance laws in the state of Arizona, provides consumer assistance, hears and investigates complaints and review and approves license application for insurance agents and insurance companies wishin to conduct business in the state.

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