The Department of Insurance and Financial Institutions (DIFI) has a special message for individuals and families who may no longer be eligible for Arizona Health Care Cost Containment System (AHCCCS) coverage when their renewal comes due in the next year.
If you are no longer eligible for AHCCCS, you have other health insurance options! Anyone who loses AHCCCS coverage in the next year can use the special enrollment period to enroll in Marketplace coverage. Many individuals will also be eligible to receive financial assistance which can dramatically reduce premiums. Consumers can call the Marketplace at 1-800-318-2596. Individuals may have other options, continue reading below for more information.
- Your AHCCCS plan may also offer Marketplace coverage which may allow you to see some of the same providers
- Visit healthcare.gov to create (or update) an account and shop for plans
- Contact one of the 8 insurers offering Marketplace coverage in Arizona
- Contact Medicare or Social Security if you are 65 or older, or someone with a disability
- Veterans can contact the Veterans Administration
- Talk to your employer about coverage. Loss of Medicaid is a qualifying life event. Under federal law, your employer must provide you with a 60-day special enrollment opportunity from the date you lost Medicaid eligibility to sign up for their plan. Your employer should ensure that your enrollment in the group plan begins no later than the first day of the month following your request for a special enrollment opportunity.
- Visit or call the following for help finding health insurance options:
Individuals who are no longer eligible for AHCCCS and who turned 65 during the PHE, but did NOT enroll in Medicare Part B will be eligible for a special enrollment period from the Social Security Administration to enroll in Medicare without a penalty.
And, it’s important to remember that everyone over the age of 65 has a 6-month window beginning on the date they enroll in Medicare Part B to choose a Medicare Supplement policy from any insurer offering Medicare Supplement policies. Contact the following for assistance:
- Social Security Administration - www.ssa.gov/agency/contact or 1-800-772-1213
- Medicare - Medicare.gov or 1-800-633-4227
- Senior Health Insurance Assistance Program (SHIP) - www.shiphelp.org/about-medicare/regional-ship-location/arizona
In the coming year, AHCCCS will contact you when your renewal is due. Make sure you get notifications from AHCCCS!
- Update contact information and sign up for text/email notification alerts in your www.healthearizonaplus.gov.
- Watch your mailbox and respond quickly if AHCCCS asks you for more information.
- If you are no longer eligible for AHCCCS, visit coveraz.org for free, unbiased help finding other health care coverage options.
Consumers should be extra cautious when seeking or being offered new health insurance coverage. The old saying, “If it sounds too good to be true, it probably is”, applies here.
If you visit websites other than healthcare.gov (such as healthcare.com or healthcare.org) or if you search for “affordable” or “cheap” health insurance, you will be directed to health insurance products other than Marketplace coverage which do not cover pre-existing conditions or essential health benefits, and are not eligible for premium assistance. Lower premium may also mean lesser benefits.
DIFI expects insurance consumers may also receive an influx of offers for products that may provide less coverage than their AHCCCS plan or may not be an insurance product at all. Consumers are urged to visit only credible sources such as those found at AHCCCS or Healthcare.gov or coveraz.org.
“I urge all impacted Arizonans to be abundantly cautious when seeking to find a new health insurance plan as predatory marketers and fraudsters will target vulnerable consumers. Our best advice is to rely on trusted sources which include employer plans, individual plans offered through the Marketplace on Healthcare.gov or through a trusted independent insurance agent.”DIFI Director Barbara Richardson - April 24th 2023
Health insurance decisions are very important for adults and children and should only be made after considering the best options from credible sources.
Make sure to understand the difference between a true major medical insurance product versus products like these:
Health Sharing Plans: You may receive offers to join a group or association that will take your monthly payments, put them in a savings account or trust with other participants’ money, and then help pay some of your health care costs, as needed. Such arrangements are not insurance and the participants do not have the protections available to purchasers of licensed insurance plans. These “plans” can deny any claim and there are no protections for provider balance/surprise billing.
Supplemental Plans: Limited benefit plans cover a limited number of visits or only pay a limited dollar amount per service; they do not provide full medical coverage. In many cases these plans exclude pre-existing conditions, etc. There are also short-term benefit plans. Then there are specific condition/disease policies, such as Hospital only, Cancer only, or Accidental Death and Dismemberment policies, etc. These only provide coverage as stated in the name and with a limited dollar amount. And finally, there are ancillary plans that cover only dental or vision coverage.
Health insurance shopping resources to help you comparison shop wisely: