If you do not have any serious pre-existing medical conditions and you do not qualify for a tax credit under the Affordable Care Act (aka Obamacare), there are health insurance options currently available for you that are likely MUCH cheaper than an Obamacare plan. If you make more than $51,040 for a household of one person, you will not qualify for the tax credit.

Currently you can get one of these alternative health plans and it can last for up to three years. You’ll save thousands of dollars on premiums and on medical care. After the inauguration of President-elect Joe Biden, politicians may try to lower the maximum length you can get one of these plans to around 90 days. If you don’t have your plan already in force before they push that through, it will be too late and there will be nothing you can do except get an Obamacare plan that much fewer Arizona doctors accept and costs a lot more in monthly premiums. If you need to enroll in a health plan, act now before your time runs out. Once you’ve got a contract for a three year plan in place with a health insurance company, your plan will be grandfathered in and you will be able to keep it until it expires.

Some of these three year plans give you doctor visits for a $30 copayment, generic drugs for $10, and you get urgent care visits for $60.

Many of the plans available outside of Obamacare have certain limitations, so they are not for everyone. For example, they do not cover pre-existing conditions and they are not required to cover preventive care at 100%. But many Arizona residents can save thousands of dollars a year by enrolling in a plan outside of the Obamacare exchange.

Here is a real-life example using an Arizona family of 5. This is a client of ours who lives in Scottsdale. Their family has no pre-existing health conditions and makes too much money to qualify for a tax credit under Obamacare. The cost for the family to enroll in one of the most popular Obamacare plans from Ambetter or Blue Cross Blue Shield ranges from about $1400-$1500 a month. The cost for a non-Obamacare plan that we recommend ranges from about $500-$800 a month.

Aside from cost, Another reason to consider a non-Obamacare plan is the limited network options that the Obamacare plans offer. Every Obamacare plan currently offered to AZ residents uses a limited HMO network, and many of the plans require you to get a referral from your primary physician before seeing a specialist. If you travel outside the network, you will only be covered for an emergency. Some of the non-Obamacare plans use much larger PPO networks, offering you the ability to visit a lot more doctors and hospitals, including the top-ranked Mayo Clinic– which is not included in the network for any AZ Obamacare plans.

There are certain groups of people who benefit from the Affordable Care Act (Obamacare). Two of those groups are:

– People with serious pre-existing health conditions.
– People who qualify for a large tax credit, based on income, that substantially reduces the cost of their monthly premium on Obamacare plans.

If you have had a serious health condition such as diabetes, cancer, a heart attack or stroke, HIV, emphysema, or Crohn’s disease, then Obamacare is likely your best option for getting coverage in the individual market. Obamacare plans are not allowed to turn you down  for coverage due to pre-existing conditions. Other plans available on the individual market outside of Obamacare can deny you coverage based on your past health history. Other reasons they may decline you for coverage include reasons such as: you are an expectant parent (man or woman), you have an unresolved health issue, or because you have lived outside the United States in the last 12 months. If you are affected by any of these issues, Obamacare is currently your best option for getting health insurance coverage in Arizona.

The second group that benefits from Obamacare is the people who qualify for a large tax credit based on their household income. If your income is above the level to qualify for AHCCCS, Arizona’s Medicaid program ($17,609 for a one person household), you may qualify for a tax credit. You also may qualify for a “cost sharing reduction,” which lowers the cost of your medical expenses including your deductible, copays, and max out of pocket. Even if you don’t have pre-existing conditions, the low cost of a plan makes Obamacare an attractive option if you have a low income, but make too much money to  qualify for Medicaid.

Need help deciding which plan is best for you and your family? Fill out our online form today or give us a call at 1-800-600-9663. We’ll help you determine which plans you qualify for, and what is your smartest option to take based on your particular situation.

Author: Tony Lehrman
Founded by Tony Lehrman in 1988, Lehrman Group serves the health insurance needs of individuals and families, small and large businesses, franchises, governments, municipalities and institutional clients throughout Arizona. Lehrman Group maintains leadership positions in the Arizona health insurance marketplace.