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Arizona Health Insurance

According to the Center for Disease Control, between the years 2004 and 2006, 22.7 percent of the population under age 65 in Arizona was without health insurance coverage and 16.7 percent had been without health insurance for more than a year. According to a report by Families USA (2006 - 2007), Arizona ranked third in the nation for uninsured people under age 65. Arizona has the fourth highest percentage of uninsured children in the nation (16.1 percent), according to the most recent census data. Most of the uninsured children in Arizona (84.5 percent) come from families where at least one parent works. In the past, employers usually offered health insurance as a benefit for their full-time employees; however, due to rising health insurance premiums, many small employers cannot afford to offer health benefits. Companies that do offer health insurance, often require employees to contribute a larger share toward their coverage. As a result, an increasing number of Americans are choosing not to take advantage of job-based health insurance because the cost is too high.

Arizona Health Insurance Regulations

Arizona health insurance companies can either be licensed by the state or not. If the insurance company has met Arizona health insurance regulations, then it can be licensed. All licensed Arizona health insurance companies must abide by the guaranteed renewability provision, which means that the insurance provider cannot terminate the contract due to illness. Arizona health insurance companies can permanently exclude coverage for pre-existing health conditions and sometimes implement a pre-existing condition waiting period. There are no limits as to the types of illness or waiting periods that Arizona health insurance companies can and cannot exclude for their permanent exclusion provisions. In Arizona, the Insurance Commissioner compiles statistics for insurance companies that report their annual expenses and loss experience. The Arizona Department of Insurance (ADOI) uses this information to determine whether rates are reasonable and lawful and to create guidelines. Insurers are required to report what they charge for premiums to the ADOI. Although most states, including Arizona, have enacted price guidelines, no state sets an actual ceiling for rates or rate increases.

Small Business Health Insurance in Arizona

Fully 94 percent of businesses in Arizona have 50 employees or less and 97 percent have 100 employees or less. This compares to a national average of 41 percent for companies with 100 employees or less according to a paper prepared for the Arizona Health Care Cost Containment System (AHCCCS) in 2001. There is a guaranteed issue requirement in Arizona, which means that companies who sell health insurance to medium and large employers must also offer at least one policy to small employers, whether the product is a health maintenance organization (HMO), preferred provider organization (PPO), point of service plan or conventional insurance. They cannot refuse to provide coverage or renew a policy. Most states impose a guaranteed issue requirement, and ADOI reports that this keeps insurers in the small business health insurance market.

Alternative Arizona Health Insurance Options

Depending on the eligibility of the individual, the resident may qualify for one of the following Arizona health insurance plans:

  • Arizona Medicaid is available to Arizona residents who meet the eligibility criteria.
  • Healthcare Group of Arizona is a state-sponsored Arizona health insurance plan that provides coverage to employers with less than 50 employees as well as self-employed individuals.
  • KidsCare, the Arizona State Children's Health Insurance Program (SCHIP) is designed to provide health and medical insurance to children under the age of 19. To qualify for KidsCare, the family must be ineligible for Medicaid and unable to afford Arizona medical insurance. KidsCare allows children to visit the doctor, get eye exams, visit the dentist and receive emergency care if needed.

Arizona Department of Insurance:
2910 N. 44th Street
Suite 210
Phoenix, AZ 85018-7269

Arizona Health Insurance Consumer Assistance:
Phoenix Area: (602) 364-2499
Tucson Area: (520) 628-6370
Statewide Toll free: (800) 325-2548

For other Arizona Insurance Resources, See:

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