Arizona Health Insurance

There are relatively few regulations imposed on health insurance companies by the state of Arizona.  If you intend to shop for coverage here, it’s important to be aware of the advantages and risks you can expect in this process.  Below is a list of the most significant health insurance facts and regulations in Arizona.

• Not all health insurers in Arizona are actually licensed by the state; you will most likely be looking for a policy offered by a licensed company, but you should still take note that other options do exist.  Unless otherwise specified, any regulations described below only apply to licensed insurers.
• Insurers operating in Arizona are permitted to charge whatever they deem appropriate for health insurance coverage, which usually means that customers with greater risk factors or worse overall health can expect to pay more for the same coverage.
• Insurance companies in Arizona may refuse to grant a new health insurance policy based on the applicant’s health, age, sex, or other characteristics, or other circumstances.  Those who are already covered by these companies may also see their rates change dramatically based on these same criteria.  Insurers may not cancel an existing policy on the grounds of illness, however.  In addition, individual health policies that cover dependents are required to cover the newly-born or adopted offspring of the insured for at least the first 31 days.
• Arizona places no substantive restrictions on its insurers’ ability to deny coverage for pre-existing health problems.  Any insurance company may stipulate in its contracts exactly how long, if ever, the insured must wait before a particular pre-existing condition will be covered under a given policy.
• It is illegal for any Arizona health insurer to prevent a current policy-holder from renewing their coverage, provided that the customer has not violated the terms of the policy.  Such violations can include failure to pay premiums, misrepresentations of fact on the original application (such as making false claims, or omitting required information), and so on.
• Any small business operating in Arizona has guaranteed access to any group health insurance policy currently offered to other small businesses within the state, so long as that company has between 2 and 50 employees.  This policy may require a certain minimum degree of enrollment in order to remain in effect, however.
• The cost of a group insurance policy offered to small businesses is not regulated, and may vary (within certain limits) based on its subscribers’ age, state of health, sex, or other characteristics.  However, as with individual health insurance, it is illegal for insurers in Arizona to cancel existing coverage due to illness among those who are covered.
• As in most states, a self-employed individual in Arizona may not purchase group health insurance offered to small businesses if he or she has no other employees.  Self-employed policy-holders can deduct a portion of the premiums for their individual health insurance from their taxes, however.

While the information above covers the most important aspects of health insurance regulation in Arizona, there may be specific details relevant to your needs that are not mentioned here.  It’s always a good idea to carefully examine and investigate any health insurance policy you are offered before making a decision.

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