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Your Rights under Arizona Health Insurance Law
(Copyright 2005 All Rights Reserved)
Arizona Health Insurance
Individuals, families, self employed and small business owners are having an increasingly difficult time finding health insurance.
Those with pre-existing medical conditions have even more difficulty. There are a multitude of companies offering health insurance in most states and people without serious pre-existing health conditions should be able to find a health insurance plan to suit their needs and budget.
Arizona Individual Health Insurance:
Arizona Group Health Insurance is for businesses with 2 or more employees, which can include the owner of the business.
Group health insurance is regulated by both the state and federal government. The HIPAA act of 1997 determines eligibility in some cases and provides rules for individuals leaving a group plan. The group plans usually have more benefits than an individual plan because of federal requirements established by ERISA and HIPAA laws.
As long as an employer meets the criteria required by the
Arizona Health Insurance Company, they cannot be turned down for insurance nor can any of the employees be turned down.
Insurance companies can impose a pre-existing medical condition waiting period if the employee was without insurance for more than 63 days prior to enrolling or if the employee did not have insurance for an 18 month period prior to enrolling.
In Arizona, your access to individual health insurance may depend on your health status, but once you have health insurance, it cannot be canceled because you or anyone in your family becomes sick. Individual health insurance is guaranteed renewable, unless the insurance carrier cancels the plan.
Low or moderate household incomes may be eligible for free or subsidized health insurance coverage for all members of the family through a Arizona sponsored Individual health insurance program. If your children are 18 years old or younger and are considered low income based on Arizona guidelines, you may be able to purchase individual health insurance through the Arizona sponsored health insurance plan or receive assistance paying for private health insurance. All states take part in the federally sponsored program that provides health insurance for children or expectant mothers and are considered low income.
If you enroll in the Arizona Comprehensive Health Insurance Plan and are not HIPAA eligible, you will face a pre-existing condition removal period.
If you move away from Arizona, you may not be able to buy individual health insurance in another Arizona unless you are HIPAA eligible.
Under Arizona law, newborns and adopted children are automatically covered under the health plan of the parents and are fully insured for the first 31 days, if the plan covers dependents.
If you have had difficulty obtaining affordable individual health insurance because of your health condition, you may also be eligible for a Arizona sponsored Health Insurance Plan.
Eligibility for Medicaid in Arizona is based on your household income. People with high medical expenses may also qualify for Medicaid.
To find out more visit the Arizona Department of Insurance website is HTTP://WWW.STATE.AZ.US
Arizona Group Health Insurance:
When an insurance carrier advertises that they have group like benefits, you should be very wary of the person presenting the plan.
Every plan may have some group like benefits such as doctor co-pays, however, individual plans seldom offer the benefits of a group plan. There are some important questions you should ask when purchasing
Arizona Health Insurance for yourself, family or as a self employed individual.
You can see a list of these questions by clicking here.
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Companies can decline to insure you for individual health insurance in
Arizona if you have pre-existing medical conditions and are
not HIPAA eligible. There are state sponsored plans available to cover those who are declined. To help you find the best health insurance company check out the complaint ratio. Click here for the instruction sheet on
"How to find an insurance company complaint ratio".
Coverage under your group health plan cannot be denied or limited, nor can you be required to pay more, because of your health status. All group health plans in Arizona must limit refusal due to pre-existing conditions.
If you have to take leave from your job due to illness, the birth or adoption of a child, or to care for a seriously ill family member, you may be able to keep your Arizona group health insurance coverage for a limited time, of up to 12 weeks. Your employer must continue your health benefits. However, you will have to continue paying your share of the premium.
Arizona group health insurance plans cannot apply a pre-existing condition refusal period for pregnancy, newborns, or newly adopted children, children placed for adoption, or genetic information. Increased premiums can be assessed on new groups if employees enrolling have any of the above. Existing groups may have their premiums increased to offset any extraordinary medical expenses the group may incur.
With few exceptions, small employers cannot be turned down for group health insurance in Arizona. They can also require you to contribute a minimum percentage of your workers premiums.
If you are self-employed and buy your own self-employed health insurance in Arizona, you are eligible to deduct 100% of the cost of your premium from your federal income tax.
If you lose your Arizona group health insurance and meet other qualifications, you will be HIPAA eligible. You can buy an Arizona individual health insurance policy.
If you have a legal dependent or disabled child, that dependent or child may remain covered under your fully insured Arizona group health plan after he or she reaches the age at which dependent coverage is usually terminated for as long as the person remains dependent.
To help you find the best health
insurance company check out the complaint ratio. Click here for the instruction
sheet on
"
How to find an insurance company complaint ratio".
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