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Individual Health Insurance Regulations
Arizona Insurance companies 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. Under these plans the premiums may be substantially higher than standard issue plans for healthy individuals. There are a lot of different levels of health plans available that range in premium, deductibles, co-payments and covered services. Arizona 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.
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 KidsCare
A child whose family has a household income at or below 200% of the federal poverty level is eligible for KidsCare. To be eligible, a child must not have health insurance for the last three months at the time of application. Eligibility is determined for one year unless the child moves from the state, enrolled in Medicaid, is found to have other insurance health insurance coverage, or becomes financially ineligible. The same wide array of medical care services, including behavioral health services that are provided under AHCCCS are also offered under KidsCare. Applications for KidsCare are available statewide at various outreach sites, including physician's offices.
For Questions Concerning:
Arizona family and individual health insurance
Arizona group health insurance
Arizona self employed health insurance
Arizona small business health insurance
| Contact:
Arizona Department of Insurance
(800) 325-2548 (Arizona calls only)
(602) 912-8444 (Phoenix)
(520) 628-6370 (Tucson)
http://www.state.az.us/id/ | Healthcare Group of Arizona
Medicaid
| (602) 417-6755
Arizona Health Care Cost Containment System
(602) 417-4000
(800) 654-8713 (In-state only)
(800) 523-0231 (Out-of-state calls)
http://www.ahcccs.state.az.us | KidsCare
| KidsCare (877) 764-KIDS (Statewide)
(602) 417-KIDS (Phoenix)
http://www.ahcccs.state.az.us | Premium Sharing Program
| Premium Sharing Program (602) 417-6700 (Phoenix)
(888) 308-6516 (Toll-free)
Premium Sharing Program 700 East Jefferson Street, Suite 200 Phoenix, AZ 85034
http://www.ahcccs.state.az.us |
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