Health Insurance for Individuals

by | Mar 25, 2019 | Blog Posts, Individual Insurance

Individual Health Insurance in Phoenix, Arizona

When it comes to health insurance for individuals we know it can be pretty confusing. In fact, with all the changes that have occurred and continue to occur, we want to be able to make the process as easy as possible and educate you on why making the best decision is important.

At Hershenberg Stone-Walsh Insurance we are leading experts in Individual Health Insurance in Arizona and have been helping our local community for over 20 years. We are FFM (Federally-Facilitated Marketplace) Certified since the inception of the Affordable Care Act, garnering the Circle of Champions recognition issued by the Marketplace and continue to stay up-to-date on all regulatory and carrier changes.

As an individual, your health insurance options are to either enroll in an Affordable Care Act qualified plan (AKA Marketplace plans) or with a Short-Term Medical plan. It can be very complicated to figure out which is the best options for you.  We believe our role is to educate our clients on the plans, provider networks, and coverage options and available to them and be able to answer all their questions, allowing them to make the best decision for them and their family.

Affordable Care Act in Arizona

A.C.A. qualified plans are available during the annual open enrollment period (November 1st thru December 15th) or throughout the year with a Qualifying Life Event (Special Election Period).

Advantages of an A.C.A. Plan:

  • Guaranteed Coverage (no medical questions asked)
  • Pre-existing conditions are covered
  • Potential premium savings based on household income
  • Prescription coverage

Disadvantages of an A.C.A. Plan:

  • HMO networks (no out of network coverage)
  • Premiums could be high based on household income
  • Limited annual enrollment period (must apply between Nov. 1st– Dec. 15th or have a qualifying life event)
  • There are 4 basic types of qualifying life events: loss of health coverage, household changes, residence changes, and other qualifying events, like income changes that may affect your coverage options.
  • See the full list of all qualifying life events. (this link will redirect you to www.healthcare.gov)

Currently, the A.C.A. qualified plan options through the Marketplace in Arizona are as follows:

  • If you reside in Maricopa County you will have health insurance plan choices through:
  • Ambetter
  • Bright Health
  • Oscar
  • Cigna

If you reside in Pima County you will have health insurance plan choices through:

  • Ambetter
  • Bright Health

If you reside outside of Maricopa and Pima County your health insurance plan choices are with Blue Cross

Short Term Plans in Arizona

If you are outside of annual open enrollment and are not experiencing a qualifying event, you may want to consider a Short-Term Medical plan to ensure you have coverage against a catastrophic health event.

Advantages of a Short-Term Medical Plan:

  • Lower Premium
  • Enroll any time of the year
  • PPO provider network

Disadvantages of an A.C.A. Plan:

  • Answers to medical questions are used to determine your qualification to enroll
  • No Prescription coverage
  • No pre-existing conditions are covered
  • Policy lengths are for a maximum of 6 months

We represent many of the nation’s top short-term medical insurance companies including:

  • National General (uses the Aetna Open Choice PPO Network)
  • United Healthcare
  • IHC

Short-Term Medical plans have some restrictions and limitations, so let’s discuss your needs and if this plan is right for you.

About Hershenberg & Stone-Walsh Insurance Services

Our company is based on a “client first” philosophy and at Hershenberg & Stone-Walsh Insurance Services we recognize that insurance can be difficult to understand and we vow to take as much time as needed to explain the coverage and limitations to the policies that we present to our clients. We also review our client’s current policies and request quotes from our other carrier partners to ensure competitive rates. We will strive to return our clients calls/emails within 24 hours and handle all service requests promptly. To learn more about how we can help you, CONTACT US TODAY!