Catastrophic
coverage in Arizona
1.
The Affordable Care Act catastrophic plans. The Affordable Care Act
(ACA) designates specific plans as "catastrophic." These are available
only to applicants 30 years old or younger. The idea was to offer
insurance to the "invincibles" who are very healthy, who rarely go to
doctors, and who need a basic plan to protect against a catastrophic
event such as a car accident.
2. High Deductible All Inclusive The next level of plans are high deductible plans for which most services (usually everything but preventative) are subject to the main deductible. The Health Savings Account - HSA qualified plans are an example of this type. The Health Savings Account offers additional tax benefits in addition to the premium savings of the high deductible insurance plan. You can find more information on the Health Savings Account.
3. High Deductible with Office Visits/Prescription The next level of plans typically have a high deductible but offer some sort of immediate benefits for office visits and prescription, for which you don't have to meet the deductible.
The monthly premiums for Arizona health insurance plans have
increased significantly of late. As this trend continues, catastrophic
coverage may make more and more sense---especially the Health Savings
Account option---for families who are relatively healthy, who want to
keep their monthly premium costs to a minimum---and who could meet a
high deductible if need be in an emergency.
Catastrophic coverage plans work very well for anyone in the 40's, 50's
or 60's who are facing an increase of premiums with age. It also tends
to work well with families who can afford to meet the high deductible
Again, the annualized premium savings vs potential out of pocket is the
key comparison to make (read below).
Since the insured person is both paying the premium and receiving the benefits, it usually makes sense to look at a low cost, high deductible PPO plan that is comprehensive. Compare the annual savings in premium versus the Maximum out of Pocket liability if you ever have to meet. If your savings in premium accounts for a sizable amount the potential out of Pocket maximum, then it might be a good decision. In a bad year (health wise), it's a wash. In a good to average year, you stand to save the annual premium difference. We would be happy to help with this health insurance comparison.
Arizona heath plans should cover emergency care, even if you do not go to a hospital in your plan's network. Any emergency room must treat you until you are well enough to be moved to a hospital in your health plan's network. Your plan must also cover emergency care when you travel outside of your plan's service area.
There is usually a substantial charge on top of whatever bill you might incur if you got to an emergency room and you're not admitted to the hospital itself for further treatment. A better option might be an urgent care center unless the necessity for immediate treatment demands going to the hospital.
The law says that it is an emergency if you reasonably believe that it is an emergency. It is an emergency if waiting to get care could be dangerous to your life or a part of your body. A bad injury or a sudden serious illness can be an emergency. Severe pain and active labor are also emergencies. Your Arizona health plan must cover emergency care no matter where you are and what hospital you go to. However, you may be moved to a hospital in your health plan's network when you are stable enough to be moved.
Urgent care is care you need within 24 to 48 hours. Your health plan must cover urgent care when you travel outside your plan's service area. If you are within your plan's service area, you must use doctors in the network for urgent care.
Ask your primary care doctor what to do if you or your child needs urgent care.
Ask your primary care doctor or call your health plan to find out where you can go for urgent care or other after-hours care. You can also find out about urgent care in your Evidence of Coverage.
Tips:
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| 4 People | $24k - $95k |
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