Frequently Asked Questions (FAQs)

GENERAL QUESTIONS

How do I enroll in a plan?

To view the health plans available on the Health Insurance Marketplace and enroll in a plan that best fits you, visit healthcare.gov.

What should I consider when buying a plan?

When purchasing health insurance on the Health Insurance Marketplace, consider the following:

• Does the plan cover your preferred physicians and facilities?
• What level of coverage do you need?
• Do you qualify for subsidies that will reduce your premiums?

What plans are available in my area?

We will have up to five different plans available, depending on where you live, including our Everyday Health, Portfolio and Simple Health plans. To view the health plans available on the Health Insurance Marketplace and enroll in a plan that best fits you, visit healthcare.gov.

Where are plans available?

BCBSAZ plans are available in all Arizona counties with the exception of Maricopa County. We decided to offer plans in areas that would have few or no options if we did not participate in this year’s open enrollment. BCBSAZ is the sole insurance company in 13 of Arizona’s 15 counties.

What happens if I don’t enroll in a plan?

In most cases, those who choose not to buy a health insurance plan will face a penalty called the individual shared responsibility payment. You can incur a fee for any month you, your spouse or your tax dependents don’t have qualifying health coverage, and this fee will need to be paid when you file your federal tax return. The penalty is calculated as either a percentage of household income, or a set amount for each person in your household. You pay whichever amount is higher.

 What is the difference between on-exchange and off-exchange plans?

"Off exchange" refers to buying health coverage directly through an insurance company or through a broker. Premium subsidies are typically not available. The term "on exchange" refers to buying health coverage through the online marketplace at healthcare.gov.

How can I find out if I qualify for subsidies?

To find out if you qualify for a subsidy or cost-share savings, go to healthcare.gov.

What are the 2017 Affordable Care Act Open Enrollment deadlines?

Open Enrollment for individuals and families who want to purchase an Affordable Care Act plan will begin on Nov. 1, 2016, and end on Jan. 31, 2017.

How can I ensure I have coverage on Jan. 1, 2017?

To have coverage on Jan. 1, 2017, you must enroll by Dec. 15, 2016.

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BCBSAZ SPECIFIC QUESTIONS

How many plans do you anticipate offering?

We will have up to five different plans available, depending on where you live, including our Everyday Health, Portfolio and Simple Health plans.

How do I find out if my preferred doctor and hospital are in my plan’s network?

To ensure that your preferred doctor or hospital is covered by your plan, please visit the BCBSAZ provider directory.

Why are rates increasing?

There are many reasons why healthcare costs are going up, including hospital consolidation, costly technology advancements, overpriced prescription drugs, an aging population and increase in chronic conditions.

Most recently with ACA plans, the volume of healthcare services used have far surpassed premiums collected, causing rates to go up. In fact, a recent study by the Blue Cross Blue Shield Association shows that newly enrolled members’ medical expenses are significantly higher today than prior to the ACA. Those enrolling in ACA plans tend to have higher rates of diabetes, depression and high blood pressure, among other conditions, and visit the emergency room more frequently.

What changes to the plans can I expect?

This year we added new, coordinated care features to ensure our members get the most efficient care possible, avoid out-of-network charges and get more consistent advice. Members will be required to select a primary care provider and seek referrals before seeing a specialist.

If I can no longer afford coverage, what other options do I have?

Of Arizonans who bought ACA plans in 2015, 75 percent qualified for subsidies. The level of subsidies available will be greater than last year. In some cases, people could get a plan for as low as $0 per month, with a subsidy. To find out if you qualify for a subsidy and cost-savings, visit healthcare.gov.

Is there anything I can do to lower my out-of-pocket medical costs?

Here are some things you can do to help control how much you spend on healthcare:

1. It is required that you see your primary care provider first, rather than a specialist.
2. When filling prescriptions, request generic drugs. These are just as effective, and are often more affordable.
3. Shop around, comparing the cost of procedures by contacting several providers to determine the best value.
4. If it’s not a true emergency, consider an urgent care center. You could pay as little as one-tenth of the cost of the ER. Some urgent care centers are open 24-hours and on holidays, making them not only cost-effective, but also convenient.
5. Request itemized hospital bills. As many as 80 percent of bills may have errors.[1]
6. Take advantage of your preventive care benefits, as these often cost nothing out-of-pocket.
7. Eat healthy and stay active to help prevent chronic disease.

_{[1] ABC News, 2013. Accessed November 2015.}

What if I have questions?

If you have any questions, visit healthcare.gov or a see a broker.