Need affordable health coverage in Arizona? Here’s how to sign up through the Marketplace.

By: Tom Grote, Banner|Aetna CEO

Open Enrollment for obtaining health insurance in 2023 is open until January 15! The Affordable Care Act (ACA) health insurance Marketplace gives Americans who don’t qualify for Medicaid, Medicare or employer-provided insurance access to affordable health coverage in Arizona. Before the ACA, many individuals and their families in our community faced sky-high insurance costs or didn’t have access to coverage at all. Now, health insurance is available to Arizonans who are:

• Freelance, consultant and gig workers
• Unemployed
• Part-time employees without access to coverage through their employer
• Business owners without employees
• Retired but don’t yet qualify for Medicare

Even some households that are eligible for employer health coverage may have new opportunities to save through the Marketplace this year. Now is the perfect time to explore ACA plan options to see if they could be right for you.

All the essentials are covered

When comparing Marketplace insurance, you can rest assured your coverage includes 10 essential health benefits no matter what plan you choose. That’s because all Marketplace plans are required to provide benefits including prescription drug coverage, pregnancy and newborn care, pediatric services (including dental and vision), mental health, as well as lab tests, ER and hospital services. Preventive and wellness services are also fully covered, meaning with an ACA plan you won’t have any out-of-pocket costs for these important benefits.

Choosing the right plan level

If you qualify for coverage, it’s helpful to start the selection process by first understanding the different plan options. Insurance plans have levels which are distinguished by “metals”—including Gold, Silver and Bronze. While all plans are required to cover the essentials, these levels indicate how the insurer splits costs with you for other care and services. Cost sharing includes fees like deductibles, coinsurance and copays. Gold plans require the lowest cost share from you for many services, while Bronze plans have the highest cost share.

Premium costs refer to the bills you pay every month for health coverage and are also an important factor when comparing plan options. Plans with a lower cost share will have higher premiums. For example, Gold plans have lower deductibles, coinsurance and copays, but the highest monthly premiums. Bronze plans have higher deductibles, coinsurance and copays, but the lowest monthly premiums.

Qualifying for a premium tax credit

This year, more people are eligible for affordable health coverage as well as bigger subsidies, or premium tax credits, which lower the monthly cost of insurance coverage. In 2022, 89% of people enrolled in a Marketplace plan received premium subsidies. These discounts are based on household size and income level, so individuals with lower incomes will get larger credits to help cover the cost of insurance. Yet many people don’t realize that they qualify for subsidies. If you want a quick and easy way to check if you’re eligible to receive a credit that can dramatically reduce the cost of health care—before you complete an application—use this helpful calculator.

Income limits for the premium tax credit

Premium tax credits are available to those whose income is at least as high as the federal poverty level. Some of those who earn more than the income limits based on household size may still qualify for the premium tax credit thanks to a law that removes the income cap of 400% of the federal poverty level. Subsidies are usually available if the cost of the benchmark plan is more than 8.5% of your household income.

Additional assistance paying for out-of-pocket costs

In addition to a premium tax credit, some individuals and families may also qualify for extra savings known as cost-sharing reductions which lower out-of-pocket costs for medical services. However, this is only available to individuals who select a Silver plan, which is just one affordable health coverage option through the Marketplace.

Other factors to consider

The metal plan level isn’t the only choice you have when selecting your ACA plan. In many Arizona counties, you can choose from many health insurance companies which may offer different value-added programs and services. While all Marketplace plans provide the 10 essential health benefits, Banner|Aetna plans also include innovative benefits like no cost virtual primary care. You may also have different preferences depending on each plan’s network, which includes all the doctors, hospitals and other providers contracted to provide care.

For example, Banner|Aetna, the fastest-growing health insurer in Arizona, offers ACA health insurance plans to individuals and families across Coconino, Cochise, Maricopa, Pinal, Pima and Yuma counties in 2023. And its network includes far more than just Banner Health doctors and hospitals. With a Banner|Aetna plan you can get care from other large organizations like Honor Health, Innovation Care Partners, Arizona Community Partners, Northern Arizona Healthcare, Yuma Regional Medical Center, Canyon Vista Medical Center and many others.

How to enroll

Many people compare and enroll in ACA plans through the Health Insurance Marketplace. The healthcare.gov website is run by the federal government, but coverage is provided through private health insurance companies. 

Some insurers also allow you to enroll directly from their own website—including Banner|Aetna. You can choose your Banner|Aetna plan and sign up directly from the plan information page. You can also enlist the help of a qualified health insurance broker, who can help you choose an ACA plan and enroll.

Get covered for 2023

There are a variety of factors to consider when you’re deciding if an ACA plan is right for you, or which plan best meets your needs for affordable health coverage. To learn more about the ACA and how to enroll, visit this helpful page, and remember that open enrollment ends January 15 for 2023 coverage. With so many affordable plan options and new plans available through insurers like Banner|Aetna, now is the time to make sure you have health insurance for 2023.