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Arizona Short-Term Health Plans
As of 2019, Arizona short-term insurance coverage differs somewhat from that provided in other states due to changes in rules that have recently been put in place. States that don’t adopt their own guidelines must follow federal rules.
The “Grand Canyon State” is one of a few states with regulations that significantly differ from those at the federal level. The Arizona legislature has adopted a complex set of laws for healthcare coverage.
While many states limit short-term health plans to 90 days, Arizona has made these plans last 185 days. Temporary plans may be renewed, but they’re capped at 180 days.
However, nothing in the Arizona law prevents consumers from purchasing new short-term plans back-to-back. These would be new policies with the same restrictions and limitations as if they were an initial plan.
Arizona short-term health plans are offered for a limited period, but consumers find that they’re often more affordable than a major medical plan would be on the state’s healthcare marketplace exchange. While short-term plans don’t comply with federal guidelines for the Affordable Care Act (ACA), they’re seen as a welcome solution to a state beleaguered by healthcare issues.
Arizona has been beset with problems in the weeks leading up to the start of the 2017 Open Enrollment period. Rising premiums, a lack of insurers, and the possibility of no participating companies in Pinal County caused a stir in Washington.
From 2016 to 2017, Arizona had the highest average monthly premium increase for the second-lowest cost silver or “benchmark” plan (SLCSP) at 117 percent increase. However, the state’s benchmark premiums have decreased for 2019, a trend seen across the nation.
Many people turn to temporary health plans while they wait for coverage to start or experience life changes such as a divorce or the death of a spouse. In Arizona, many consumers have turned to short-term health plans so as to have healthcare coverage outside of the marketplace at a cost they could afford.
In October 2017, Trump signed an Executive Order to direct various federal agencies to “consider proposing” new regulations in order to promote greater choice in healthcare and to encourage more competition. These new regulations would reverse an earlier Obama-era rule limiting short-term plans to 90 days with no renewal.
Under this new approach, Arizona short-term health plans could follow federal rules or establish the state’s own temporary plans. The state opted to adopt its own definitions for what would be considered short-term healthcare coverage.
Surprisingly, Arizona has seen an influx of insurers to the ACA marketplace exchange as well as those offering short-term plans, providing many more options for Arizona consumers seeking coverage.
What Isn’t Covered
Under federal rules, short-term health plans must carry a disclosure that they don’t comply with the ACA, and aren’t “minimum essential coverage” (MEC). MEC consists of a set of benefits that must be met as a standard of coverage for inclusion in marketplace exchanges.
Short-term plans can have lifetime or term benefit limits, but when their terms end, they won’t trigger a Special Enrollment Period (SEP) for reentering marketplace exchanges.
Consumers find that Arizona short-term health plans are more affordable due to differences in covered services. Benefits offered are typically limited to emergency care and appeal to those who are young.
Since Arizona has a large retirement population, this may eventually become an issue. For those consumers who don’t require regular medical service, such as visits to their primary care physician or many prescriptions, short-term health plans are worthy of consideration.
For many Arizona consumers, temporary plans have become an option for having healthcare coverage as major medical plans are too expensive, especially in a state with low wages. As many people flock to Arizona’s warmer climate and growing economy, temporary plans may be a solution while waiting for employer-sponsored healthcare plans to begin.
Also, in most cases, short-term plans don’t cover preexisting conditions such as diabetes, stroke, heart attack, asthma, among others. It also doesn’t necessarily have to be a chronic condition.
Temporary plans don’t guarantee coverage, and applicants may be rejected based on their health history. If consumers develop a health condition on a short-term plan, it may be deemed a preexisting condition, making them ineligible for renewal or another temporary health plan.
Arizona Short-term Plans
There are nearly 150 different Arizona short-term health plans with a wide range of benefits and covered medical expenses.
Deductibles range from $250 to $10,000. Coinsurance ranges from zero percent to 20 percent, 30 percent, or even 50 percent. Maximum coverage amounts are from $250,000 to $2 million.
Arizona consumers should be aware that these plans don’t meet the ACA’s guidelines for minimum essential coverage (MEC). Be sure to review plan details for exclusions and limitations.
With so many options, Arizona consumers have plenty of choices to get customized healthcare coverage for most temporary situations.
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