Frequently Asked Questions

General Questions
High Deductible Plan
Prosano Health Care Centers

Before July 1, you can call our Pre‑Enrollment Service Team at 844‑817‑4117 for any questions or support.

After July 1, please contact our Customer Service Team at 1‑855‑776‑7266 for assistance with your plan and benefits.
All plan information and rates can be found by logging into SUSD Homeroom > Departments > Benefits > Benefit Resources. This is where you’ll access everything you need to complete your enrollment. If you need assistance you can call the SUSD Benefits Department at 480-484-6104 or email benefits@susd.org.
This is the amount you pay for healthcare services before your health insurance begins to pay. You don’t need to pay a deductible for covered preventive care services if they are received in-network.
This is a fixed amount you pay for a healthcare service, usually when you receive the service. The amount can vary by the type of service.

Your AZ Blue member ID card will list your deductible and copays for some types of visits. You can also compare plans at azblue.com/susd/health-plans before enrolling, or log in to your member portal after you've enrolled to view your copay.
The percentage you pay for the cost of covered health expenses after meeting your deductible. For example, you pay 20% of the cost of a covered service and your health plan would pay the other 80%.
The plan year runs from July 1 through June 30 each year. This means that every July 1, your deductible and out‑of‑pocket maximum reset for the new plan year.
No. You have the freedom to use any doctor or hospital without being required to choose a primary care physician (PCP) or get referrals. Choosing a Prosano Health provider for your primary care means you get $0 or low-cost regular visits and care coordination with any specialists you need to see.
Yes, adult children are eligible for coverage under the plan up to age 26.
Yes, you can see any doctor you want. You are encouraged to use healthcare providers in the network because they’ve agreed to charge lower prices. For example, when you use a network doctor, you’ll usually pay less compared to one who is not in the network.
Your out‑of‑pocket maximum is the most you will pay in a plan year for covered medical services. Once you reach that amount through deductibles, copays, and coinsurance, your health plan pays 100% of covered costs for the rest of the year. It’s a financial safety cap that protects you from very high medical expenses.
You have access to in-network providers nationwide and emergency coverage worldwide. Contact us at 855-776-7266 for details on coverage levels.

The HDHP was specifically created to give employees more control over their healthcare dollars as well as a plan option with lower premiums.

This HDHP is designed to deliver key benefits while offering:
- Lower Monthly Premiums
- Health Savings Account (HSA)
- HSA Tax Advantages
  - Pre-tax contributions
  - Tax-free interest earnings
  - Tax-free withdrawals on qualified expenses*
With an HDHP you’ll see lower monthly premiums but will have a higher annual deductible. A deductible is the portion you pay out of pocket before your insurance benefits kick in. To offset that higher deductible, you can open a tax-exempt health savings account (HSA) that is funded by you and your employer. Think of it like a 401(k) for your health. You have the option to then use those tax-free dollars on qualified expenses like doctor visits, vision and dental services, MRIs, and prescriptions. All qualified expenses go toward helping you meet your deductible. You can also use your HSA for unqualified expenses. However, those transactions are taxed and carry a withdrawal penalty.
With an HDHP, you’ll need to meet your annual deductible before the coinsurance benefit kicks-in. After your deductible is met the plan pays 80% of eligible expenses; you pay 20%. This means when you receive services, your cost-share will be more until your deductible has been met. The HSA account is designed to help you offset those costs. All eligible healthcare expense—from doctor visits, urgent care visits, hospitalizations and prescriptions accumulate towards your deductible and out-of-pocket maximum.
Having an HSA, like the one available with your plan, can not only help you prepare for current and future health expenses, it can also help you save on taxes in three ways: The account can be funded through pre-tax contributions by you and your employer, which can help bring down your yearly tax burden. Any interest you earn in your HSA grows tax-free. And withdrawals for qualified expenses such as doctor visits, vision and dental services, MRIs, and prescriptions are also tax-exempt.

Unlike other health accounts, there is no “use it or lose it” with an HSA. The balance of your HSA rolls over year after year, allowing you to build reserves that can help with future healthcare needs or even be used in retirement. The funds in your HSA are yours to use even if you switch jobs or retire.

Although doing so is not recommended, HSAs can be used for unqualified expenses. If you do make any unqualified withdrawals, they are subject to applicable taxes and penalties.
An HSA is designed to pay for all kinds of healthcare needs—everything from regular doctor visits, vision and dental services, diabetes medication and prescriptions to specialty care and even acupuncture. Your HSA can be used tax-free to pay for out-of-pocket qualified medical expenses—even if they’re not covered by your HDHP. This includes expenses for you, your spouse, and any dependents you claim on your tax returns. You can find a detailed list of qualified medical expenses at www.irs.gov.
It depends. The rule states that if you claim a family member as a dependent, then you can use your HSA for their qualified medical expenses.
No. When you use network providers you will pay the discounted amount of services (we call this “Allowed Amount”) until you reach your deductible. You can use your HSA to help pay for services, or you can save those funds to use later.
To deposit money into an HSA, you must be enrolled in an HSA-eligible health plan. You are eligible if:
- You are covered under an eligible high-deductible health plan (HDHP)
- You are covered by no other health coverage, unless it is permissible coverage
- You are not enrolled in Medicare
- You cannot be claimed as a dependent on someone else’s tax return
- Some other restrictions apply
Please talk to a tax, benefits, or financial advisor if you have more questions.
No. All of the money in your healthcare FSA must be spent before you can open an HSA. This rule does not apply to Limited FSA accounts. Please consult with your Human Resources contact regarding any questions about Limited FSA eligibility and options.
Yes. If a spouse will be or is already covered by Medicare, you can sign up for this plan and open and contribute to an HSA. If you file taxes jointly with your spouse, you can use your HSA to help pay for your spouse’s qualified expenses, such as Medicare Advantage premiums. However, you cannot use HSA funds to pay for Medicare Supplement premiums.
Examples of expenses that do not qualify include cosmetic surgery, health club memberships, teeth whitening, and over-the-counter medicines purchased without a prescription. If you use an HSA to pay for an expense that is not qualified, you will have to pay taxes on the expense and may also have to pay a 20% penalty on the amount spent.
Yes. The IRS limits how much you (and others) can put into an HSA each year. The 2026 limits are:
- $4,400 for individual coverage
- $8,550 for family coverage
If you are 55 or older, you can deposit an extra $1,000 during the year. This is called a catch-up contribution. Any contributions above these limits are subject to income taxes and a penalty.
The money in your HSA is yours to keep. If you leave your company, change health plans, or retire, you take your HSA with you. If you switch to a health plan that makes you ineligible to continue depositing money in an HSA, you may continue to use the money in your account for qualified medical expenses, but you can no longer make deposits.
Yes. But the IRS says the two of you together can only contribute up to the family limit. Both of you can contribute to just one of your HSAs, or you can contribute to both HSAs as long as the total amount doesn’t go above the annual family limit.
Log in to your member account at azblue.com/member, click Find Care, and use the Costs for Procedures tool to get estimates on various treatments such as eye exams, mental health services, and more.
If you receive a bill from your doctor or if you are paying for a prescription, you can pay from your HSA using your HSA debit card provided by HealthEquity^®.
Yes, as long as the service is a qualified expense. You can take money out of your HSA to pay yourself back with no penalty.
After you turn 65 or start receiving Medicare benefits, you may withdraw money from your HSA for medical and non-medical purposes without penalty. When your Medicare coverage starts, you can use your HSA to pay your Medicare Advantage premiums, deductibles, and copayments.
If your domestic partner meets the IRS qualifications of a tax dependent, you can use your HSA to help pay their qualified expenses. If your partner is not a tax dependent, you can still cover your partner under your plan. However, your partner would need to open and fund their own HSA to pay for the expenses.
No. If you are enrolled in a healthcare FSA, the IRS will not allow you to open an HSA. But the law does permit you to enroll in a limited-purpose FSA if it is offered to you. A limited-purpose FSA can only be used to pay for eligible dental and vision expenses.
No. All of the money in your healthcare FSA must be spent before you can open an HSA.

It’s coverage with care built in—simple as that. Members can experience more health for less money with Prosano Health plans by AZ Blue. These plans include exclusive access to Prosano Health Care Centers—which includes primary care, sick care, short-term counseling, support for chronic conditions and more under one roof. You’ll also have access to a broader network for even more choice.* With Prosano Health Care Centers, you can expect longer appointments when you need more time, same-day care when you need it fast, and doctors who take the time to get to know you. It’s care that feels more personal—and it’s working: members who get their care at Prosano Health Care Centers have fewer ER, specialist, and inpatient visits.**

* Please review your Summary of Benefits and Coverage and Benefit Book to determine what costs apply.

** 2024 Prosano outcomes vs. risk-adjusted non-Prosano cohort
Exclusive access to Prosano Health Care Centers, online scheduling, the choice and flexibility of in-person or virtual visits, same-day care when you need it fast, longer visits when you need more time, chronic condition support, short-term counseling, on-site labs, on-site Rx at some locations, and after-hours triage calls.
No, members don’t have to go to Prosano Care Centers. Typically, when members get care at Prosano Care Centers, they receive the best value from their plan. If members want to see doctors outside of Prosano, they can through the plan’s broader network with standard cost sharing.
No. You can continue seeing your current primary care or family provider and still use Prosano Health. Prosano Health is available to you as an additional option whenever you need it.
No. Prosano Health is designed to supplement your existing provider relationships, not replace them. You can use Prosano Health when your primary care provider isn’t available, or you can choose to make Prosano Health your primary care or family provider. The choice is completely yours.
Prosano Health provides primary care for individuals ages 5 and older, and sick care for all ages, giving families flexibility while ensuring access to high quality care.
There are 10 convenient locations in Maricopa County and Tucson. To find one near you, visit: prosanohealth.com/our-locations.
- Preventive and wellness for patients 5 and up: Routine wellness exams, health screenings and consultations, well woman exams, immunizations.
- Sick care for all ages: Examples include cough, cold, and flu, stomach pain, and rashes.
- Behavioral health: We can provide short-term counseling to help you get through difficult times like grief and bereavement.
- Chronic health conditions: Care for diabetes, asthma, high blood pressure, high cholesterol, and weight management.
While the Prosano Health team will not offer specialty services, our Care Guides and Benefit Liaisons will be there to help you find and make appointments with in-network specialists, and understand costs based on your benefit plan.
Prosano Health providers can provide sick care for issues such as colds and flu, rashes, and stomach pain. For urgent care needs such as fractures and sprains, sign into your AZ Blue member portal at azblue.com/member to find an urgent care center near you. If you need help after hours, call us at 1-855-776-7266 for triage. In an emergency, call 911.
Prosano Health providers are licensed only in Arizona, so out‑of‑state dependents cannot be seen at Prosano locations. They can contact our Benefit Liaisons at 1-855-776-7266 for help reviewing their benefits, finding care in their area, using available programs, and getting cost estimates. Out‑of‑state dependents also have access to our National PPO network outside Arizona and can use Telehealth by AZ Blue for virtual care at 1‑844‑606‑1612.
You are responsible for the cost in accordance with your health plan. Please review your Summary of Benefits and Coverage and Benefit Book to determine what costs apply.
Prosano Health providers can provide nutritional recommendations and support weight loss goals.
The Prosano Health Center can provide preventive and wellness care for children 5 years and older, and sick care for all ages.
We can provide short-term counseling to help you get through difficult times. Our counselors can also help with emotional wellness strategies, and provide medication management for mild to moderate symptoms. If you need ongoing behavioral health concerns, our Care Guides and help you find and schedule an appointment with an in-network provider.
Yes, we can provide basic primary care lab tests on site at all Prosano Health Care Centers.
Lab results should post automatically to your Prosano Health Patient Portal as soon as the lab has processed them (usually 1-2 days after they have been taken).

The Prosano Health team will also message you about your results within 1-2 business days after lab results are received.
Lab tests performed at Prosano Health Care Centers must be ordered by a Prosano Health provider. If you need help finding a lab for tests ordered by another provider, our Care Guides can help you locate one in network.

^{Blue Cross, Blue Shield, and the Cross and Shield Symbols are registered service marks and BlueSignature is a service mark of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Prosano is a service mark and Prosano Health is a registered service mark of Prosano Health Solutions, Inc.}