The Grand Canyon State is best-known for its deserts and mountains, but Arizona also offers its residents more choices for health insurance than many other states. While Affordable Care Act (ACA) federal Marketplace plans are a popular option for those who buy their own health insurance, you also have other options, like short-term medical insurance, that might be a better fit if you can’t afford an ACA (also called Obamacare) plan or you can’t pay for COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage after you leave your job.1
Short-term health insurance provides temporary relief when you really need coverage and does so for less money than you’d pay with an ACA plan. Many companies offer short-term, limited-duration health insurance plans in Arizona, giving you a broad range of choices. You can enroll for as little as 30 days or keep a short-term health insurance plan for up to three years while you determine your next steps for getting permanent medical insurance.
Like other policies, temporary health insurance plans come with a variety of costs, including monthly premiums, a deductible, coinsurance and, on some plans, copays for doctor’s office and urgent care visits and prescription drugs.
In general, these policies are designed to cover unexpected accidents and illnesses. Some don’t cover preventive care, and no short-term health plans in Arizona cover treatment for preexisting conditions. Pregnancy and delivery and mental health services are typically not included, either.
How Do You Know If Short-Term Health Insurance is Right For Me?
Here are some situations for which gap health insurance may make sense:
- You lost your job.
- Your former job offered COBRA coverage but you can’t afford it.
- Your job cut you back to part-time hours, disqualifying you from the company health plan.
- You’re retiring early and not yet eligible for Medicare.
- You’re turning 26 and aging off your parents’ insurance.
- You make too much money to qualify for Medicaid.
- You just got married or divorced.
- You’re a college student needing coverage in another state.
- You’ve landed a new job with a health insurance waiting period.
Whatever the reason you’ve been left uninsured while living in Arizona, the good news is that you can get covered the very next day after applying. With short-term health insurance, there’s no Open Enrollment Period (as there is when applying for an Obamacare plan), so you can apply any time. The application takes minutes and you’ll know immediately if you qualify.
In general, if you’re healthy and don’t plan to use your health insurance often, temporary health coverage can be an affordable solution to help protect you if the unexpected arises.
When Short-Term Health Insurance May Not Be Right for You (and Better Options)
If you find yourself in any of the following situations, a temporary plan may not be the best option for coverage and/or cost:
- You have a preexisting condition.
- You have a chronic condition that requires ongoing care.
- A doctor has advised you to seek treatment or surgery, but you haven’t gotten it yet.
- You’re morbidly obese or have an eating disorder.
- You’re planning to get pregnant.
- You have a history of mental health disorders.
- The cost of your care may exceed the total coverage maximum of your policy while you’re insured.
- You want a plan that includes extensive preventive-health services.
- You haven’t lived in the U.S. for at least 12 months without returning to live in your home country or another country.
If any of these situations or conditions apply to you, an ACA plan or Medicaid (if you qualify) could be a better choice. For one thing, ACA plans are guaranteed, which means no one can be rejected due to health status, including having a preexisting condition, and all plans must include 10 “essential health benefits.”
If you’re a woman, ACA plans provide preventive health services such as well-woman annual check-ups and cancer screenings, free of charge, and birth control is also free under the ACA mandate. Men also get one free annual exam and cancer screening if you choose an Obamacare plan.
While short-term insurance plans can offer some preventive care, if your doctor orders tests and/or you have regular doctor’s visits outside preventive care, the cost of these can be as much as buying a Marketplace plan through the ACA. And if you choose an ACA plan and qualify for a tax subsidy based on your income, you’d be paying much less each month and have much better coverage.
ACA Plan Tax Subsidies
If your total household income falls between 100% and 400% of federal poverty level (FPL) guidelines, you could qualify for financial assistance — known as a premium tax credit, or subsidy — that will help pay your monthly premiums. Keep in mind that the FPL guidelines vary by state, though Arizona was one of the first states to expand Medicaid to cover more residents and continues to offer the program today.2
What Is the Average Cost of Short-Term Health Insurance in Arizona?
A 35-year-old woman living in Arizona could pay as little as $69 a month and as much as $311 a month for short-term healthcare coverage.3
The wide range reflects the flexibility you have in choosing a short-term medical plan. If, for example, you only need health insurance for a short period (under six months) and don’t plan to use it except for emergencies, you might pick a plan with a high deductible and low total coverage to keep your monthly costs in the lower range.
However, if you want coverage for six months or more and anticipate needing some medical care during that period, you may opt for a policy with a lower deductible and more coverage.
When picking a temporary health insurance plan, it’s helpful to be familiar with insurance terminology to understand what you’ll be financially responsible for. Understanding the following terms will help you plan for out-of-pocket costs:
The monthly cost of having insurance coverage. (Note: Your premium does not go toward your deductible.) You have to pay your insurance premium every month to remain insured.
A deductible is what you pay for treatment before the insurance company is responsible for paying any medical claims. In most cases, the higher the deductible, the lower the monthly cost (premium). If you anticipate seeing the doctor regularly, or even often, or that you might be hospitalized, a higher-cost plan with a lower deductible might be better for you overall.
Once you hit your deductible amount, the insurance company starts sharing a majority of your medical costs with you. Typically, your carrier will pick up 70% or more of your medical bills and you’re responsible for paying the remaining amount. In one case, an insurer in Arizona offers 100% coinsurance.
This is the cost some short-term health plans require for doctor’s visits and prescription drugs.
All short-term medical plans have an out-of-pocket maximum, which is the insurance company’s commitment that you won’t have to pay more than that amount for medical services while insured under their policy. (Note: Some short-term plans have coinsurance out-of-pocket maximums and some just have a general maximum. Coinsurance out-of-pocket maximums mean you have to pay your deductible first and then share payment responsibilities with your insurance company up to the maximum amount. General maximums allow you to pay your deductible and then stop paying once you’ve hit the maximum.) For example, if you have a $10,000 deductible and a $10,000 coinsurance maximum out-of-pocket, you are responsible for paying up to $20,000 of your medical bills. If you have a general out-of-pocket maximum, you only pay your $10,000 deductible and no more. After that, the insurance company is responsible for paying any medical claims.
Total Coverage Maximum
This is the total amount of medical expenses an insurance company will guarantee to pay during your coverage period. Coverage limits can start at $100,000 and run up to $1 million or more.
Knowing these terms will make it easier to decide how you want to structure your temporary insurance coverage.
How Do You Buy Arizona Short-Term Health Insurance ?
Armed with new knowledge of how health insurance policies work, perhaps you’re ready to buy a short-term medical insurance plan. So, what do you do next?
You can work with a health insurance agent, purchase online, or buy through other online aggregators selling short-term healthcare coverage. The online application and payment process takes about five minutes.
Short-term health insurance carriers in Arizona include:4
- Companion Life Insurance Company
- Golden Rule Insurance Company
- Everest Reinsurance Company
- Freedom Life Insurance Company of America
- Independence American Insurance Company
- LifeShield National Insurance Company
- Madison National Life Insurance Company
- National Health Insurance Company
- Standard Security Life Insurance of New York
When you start your application, you’ll need to answer a few medical questions to see if you qualify for a short-term health plan. If you pass the medical questions, you’ll be asked for contact information and, finally, your first month’s premium payment. Many companies accept direct withdrawal from your bank account or payment by credit card, and within minutes you should have confirmation that you’re covered.
What If You Need Extra Coverage?
If you don’t have enough money socked away for a rainy day (many of us don’t; the average American their 30s has saved only about $8,500),5 one accident could wipe out your savings and leave you in serious debt.
That’s when you might opt to buy supplemental insurance for accidents and illnesses to ease your mind. For less than $30 a month, you can supplement your short-term health insurance policy with a plan that pays a flat cash rate if you suffer an unexpected accident or are diagnosed with a critical illness.6 Some plans also include hospitalization coverage. The money received from a qualified claim can be used for medical bills or other needs like paying the mortgage or child care. The check is yours to use as you see fit.
Making the Decision That’s Right for You
Temporary short-term health plans are readily available to Arizona residents, allowing you to customize plans to fit your budget and health during the period you’ll need this gap coverage.
Most policies have supplemental health insurance or dental and vision insurance you can add on, giving you more complete coverage while you wait for permanent individual health insurance.
Take your time, read everything you can about any policy you’re considering (including its exclusions and limitations) so you have a full understanding of what the plan will cover.