Frequently Asked Questions (FAQs) About Health Insurance

Here’s a peek at some of the questions people often ask when shopping for a health plan. Click on the ones that interest you for helpful answers:

Why do I need health insurance?
Can I get help paying for an Affordable Care Act (ACA) plan?
How can I find out if I qualify for financial help?
What if I don’t qualify for financial help?
What are the advantages of a short-term medical (STM) plan?
What are the disadvantages of a short-term medical (STM) plan?
Will I have to pay a penalty if I go with a short-term medical (STM) plan?
How can I apply for a short-term medical (STM) plan?
How can I enroll in an Affordable Care Act (ACA) plan?
What if I need additional coverage?


Why do I need health insurance?
By law, most people are required to have health insurance. No one ever plans on getting a serious illness or having an accident. But life happens. And when it does, people with medical problems can often need major treatment. Surgeries, hospitalization and follow-up care can cost hundreds of thousands of dollars. Health insurance can help protect you in these situations.

Can I get help paying for an Affordable Care Act (ACA) plan?  
Find out if you can get financial help—called subsidies—that are available from the federal government. You may qualify for a Premium Tax Credit which helps you pay for all or part of your monthly bill or a Cost-Share Reduction which helps pay your share of the costs for medical care, such as copays, deductibles and coinsurance.


How can I find out if I qualify for financial help?
Go to HealthCare.gov/see-plans and answer a few simple questions. In less than a minute, you’ll see if you’re likely to qualify for financial help and if so, how much. It depends on your income and the number of family members in your household, as shown in this chart:

2018 Qualifying Income Levels table
2018 QUALIFYING INCOME LEVELS
Number of people in your household
1
2
3
4
5
6
$12,060
$16,240
$20,420
$24,600
$28,780
$32,960


The poverty guidelines may be formally referenced as "the poverty guidelines" updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2).


What if I don’t qualify for financial help?
If you don’t qualify for financial help and you can’t afford an Affordable Care Act (ACA) plan, consider short-term medical (STM) coverage**. STM is temporary medical insurance that keeps you protected if you don’t have insurance or are between plans. Keep in mind that STM isn’t the same as having an annual health insurance plan under the ACA. For example, it doesn’t provide the same benefits and will not excuse you from tax penalties for being uninsured. However, it will offer you protection against unforeseen medical expenses like accidents or hospitalizations that are not related to a pre-existing medical condition. For more information visit azblue.com/short-term.



What are the advantages of a short-term medical (STM) plan?
For starters, it’s flexible. You can buy coverage from 30 to 90 days, depending on your needs. You can get a quote and apply in just minutes and coverage can begin as soon as the next day. There’s also no enrollment deadline, so you can sign up any time during the year, even outside of the annual Affordable Care Act (ACA) open enrollment period. You have a choice of deductible and coinsurance options and plans start as low as $95 per month.*** For more information visit azblue.com/short-term.



What are the disadvantages of a short-term medical (STM) plan?
STM is not guaranteed issue, meaning you may not be accepted. It’s not ACA-compliant meaning it doesn’t cover pre-existing medical conditions treated or diagnosed within the last 5 years. It also doesn’t cover pregnancy or childbirth, or wellness and preventive care. Your insurance certificate or policy will include a full listing of what’s not covered. For more information visit azblue.com/short-term.



Will I have to pay a penalty if I go with a short-term medical (STM) plan?
STM plans will not excuse you from the federal tax penalty for being uninsured under the Affordable Care Act (ACA). However, in most Arizona counties, residents may not be subject to a federal tax penalty if the cost of a Bronze ACA plan is more than 8.13% of their household income. Consult your tax advisor for more information.



How can I apply for a short-term medical (STM) plan?
You can get a quote and apply online at azblue.com/Appy4STM. Decide how long you’ll need coverage, from 30 to 90 days. Choose your deductible, coinsurance and out-of-pocket amounts from the options shown. Then, answer eight simple qualifying questions. Once your online application is approved, you can access your ID cards and welcome kit electronically, and coverage may begin as soon as the next day.



How can I enroll in an Affordable Care Act (ACA) plan?
To get a quote, find out if you qualify for a subsidy, and apply for an ACA plan visit HealthCare.gov. If you have questions the Marketplace help center is available 24/7 to answer your questions (except holidays) at 1 (800) 318-2596. If you need in-person help, there are trained brokers, agents and navigators in your community who can help you fill out an application. Visit localhelp.healthcare.gov to find support near you. Learn more about how to enroll on the marketplace.



What if I need additional coverage to supplement my medical?
For generations, Arizonans have turned to Blue Cross Blue Shield of Arizona for the security and stability they want for themselves and their families. Today, you have even more choices for reliable, affordable coverage and care. Visit azblue.com/specialtyplans for information about additional coverage options or add-ons such as Dental, Telemedicine, Metal Gap 2 or an Rx Pay Card that may be available.


Looking for ACA coverage?

Looking for short-term medical coverage?