Lauren Lewthwaite Last Updated On: August 11, 2023

What You Should Know About Health Insurance If You Live in Arizona

Whether you’re exploring the Grand Canyon or browsing your health insurance options, there are some things you should know if you call Arizona home.

Many types of health insurance are available: individual health insurance (on or off exchange sold in metallic tiers), ACA (marketplace), employer based, Medicaid, or Medicare. 

Even though there are many choices, you can expertly navigate your options by identifying what you need. For instance, if you live below the federal poverty line, Medicaid is a wise decision. On the other hand, if you’re self-employed and looking for health insurance, try individual health insurance through Part C or Medicare Advantage Plan sold through insurers.

Read on, and we’ll fill you in on Arizona’s health insurance need-to-knows—and the nice-to-knows too!

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Table of Contents

How Much Is Individual Health Insurance In Arizona?

The average cost of individual health insurance (silver tier) for a middle-aged male in the United States is $560, while in Arizona, it’s $569.

Here’s a more detailed breakdown of how much health insurance costs for a 40-year-old by tier:

Metal Tier

Monthly Cost










If you’re in the market for health insurance for your family, your rates will naturally increase. For example, the typical cost for a silver family insurance plan is:

Family Size

Monthly Premiums

Adult + Child




Couple + Child


Couple + 2 Children


Couple + 3 Children



*Adults are 40 years of age, while children are under 14.

Although average health insurance costs in Arizona are slightly above the national average, there are ways to find savings. Keep reading for more info on finding affordable health insurance in Arizona.

How Health Insurance Rates Are Calculated

The thing to remember about insurance rates is they’re not “universal,” the way buying a small Dunkin’ coffee is the same price no matter what (or it is 99% of the time)!  When purchasing health insurance, your rates are calculated based on:
  • Factors such as age that every insurer uses to set premiums
  • The state’s health insurance regulations
  • The plan you choose
  • Your unique factors, e.g., where you live
Here are the additional ways Arizona health insurance companies calculate your rates:
  • Age: The older you are, the more expensive your rates will be. For children 14 years old and under, it’s a flat rate, while for over 15, rates begin to climb.
  • Location: Health insurance premiums are subject to state regulation, so rates differ between states.
  • Smoking: Smokers will always pay more for health insurance; in some states, that number could reach 50% more than a non-smoker. 
  • How Many People Are Covered: If you’re only insuring yourself, you’ll pay less than a policyholder with a family.
Now that you know a little more about the cost of health insurance in Arizona, it’s time to explore finding the right plan for you and your healthcare needs.  But if you’re in a hurry, feel free to get access to health insurance quotes in Arizona here.

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Choosing the Right Individual Health Insurance Plan for You

If you’re ready to look into Arizona health insurance plans, there are five main coverage options to choose from. 
  • Catastrophic: This coverage is ideal for individuals under the age of 30 who are healthy or cannot afford to pay higher premiums. Here are some policy highlights:
    • Low monthly premiums
    • High deductibles
    • The policy covers less than 60% of your medical costs—you’ll cover the rest
    • It protects you from the essential health benefits (10 listed in ACA) and some preventative services
    • It covers you for three doctor visits a year
  • Bronze: The most affordable metal-tier health insurance is bronze coverage. With bronze health insurance, you’ll get these features:
    • Low monthly premiums
    • The policy will pay 60%, while you pay 40% for your medical treatment
    • High deductibles
    • High out-of-pocket expenses if you need medical treatment
    • A great choice for healthy individuals that need a small amount of coverage as they don’t require routine medical care
  • Silver: Silver policies offer mid-level protection. Silver is a good alternative if you cannot afford gold protection. 
    • Moderate monthly premiums
    • Lower deductibles than bronze plans
    • Eligible to apply for low-income subsidies or “cost-sharing” with silver plans for extra savings
    • Policies pay 70% of your medical treatment costs
  • Gold: Gold health insurance plans offer primo protection for your routine care. Gold plans are ideal for policyholders that require routine medical treatment.
    • Higher monthly premiums
    • Lower deductible amounts
    • Your plan will cover 80% of your medical costs
  • Platinum: If gold coverage isn’t enough to suit your needs, there’s platinum.
    • Highest monthly rates
    • Lowest deductible amount
    • The policy will cover 90% of your medical treatment costs
    • This plan is best suited to those who require regular medical care
The right individual health care plan for you will depend on your unique needs and budget. The right plan for you might be different than a friend or family member’s plan, and that’s A-OK.

When Is Open Enrollment?

When it comes to getting health insurance, every American is familiar with the term “open enrollment”—it’s that time of year when you shop for health insurance. 

For Arizona residents, open enrollment runs from November 1—January 15. Enrolling during open enrollment is key to ensuring you have the coverage you need when you need it.

Other Health Insurance Options

You have options when it comes to your health care. If the above plans don’t seem quite right, keep reading for even more options.  Medicaid If shopping for health insurance is stressful for you because it’s financially out of your reach, you should consider applying for Medicaid. This is health insurance for individuals living below the federal poverty line. They refer to Medicaid in Arizona as the Arizona Health Care Cost Containment System.  To be eligible for Medicaid in the great state of Arizona, these are the requirements:
  • A family income below the federal poverty line 
    • By 147%: with infants, birth to 1 year
    • By 141% with children 1-5 years
    • By 133% with children 6-18 years
  • Children ineligible for Medicaid, below FPL by 200%, can sign up with KidsCare (CHIP)
  • Pregnant women with a family income of 156% below the FPL
  • Parents with a family income of 138% below the FPL
  • Childless adults (not seniors) with a family income of 138% below the FPL
  • Certain applicable elderly or disabled applicants   
Medicaid covers these benefits:
  • In/outpatient hospital services
  • Doctor or nursing services, medical and surgical dental services
  • Family planning
  • Midwife services
  • Early and Periodic Screening, Diagnostic, and Treatment Services
  • Nursing facility services
  • Home health services
  • Rural health clinic services
  • Family planning 
  • Lab and X-rays
  • Certified pediatric and nurse practitioner services
  • Transportation to medical care
  • Counseling for pregnant women to quit smoking
  • And much more
For many, Medicaid means the difference between getting the health care they need and doing without any at all.

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Medicare is a federally-funded health insurance program for seniors or qualifying individuals. Unlike individual health insurance that’s sold in metal tiers, Medicare is sold in units called parts. 

Here’s a quick overview of the four main parts Medicare offers:

  • Part A: This plan covers hospital visits. Usually, visits are free unless you’re new to Medicare.
  • Part B: This covers medical services such as doctor’s visits.
  • Part C: Part C or “Medicare Advantage” is Part A, Part B + any additional supplemental coverage, like dental, eye care, or prescription medication. Independent insurance companies offer this product.
  • Part D: This plan is optional coverage for prescription medication.

You become automatically eligible for Medicare in Arizona at age 65 or earlier if you have a qualifying health condition or disability.

Final Thoughts on Finding Arizona Health Insurance Plans

Life happens. Sometimes we need to see a doctor or go to the hospital, and when that happens, health insurance is there to help cover the costs. The most challenging part is figuring out the best health insurance in Arizona for you. 

To determine the best Arizona health insurance plan, you’ll want to assess your needs. If you’re over 65, look into Medicare and explore which part you’d like to purchase, while those living below the federal poverty line should look into Medicaid or KidsCare (Arizona’s CHIP equivalent). 

Otherwise, if you’re investigating your individual health insurance options, it boils down to what you can comfortably afford. If money is an issue, catastrophic, bronze, and even silver are your best options; also remember silver plans are eligible for cost-sharing subsidies, which can make it more affordable than lower tiers. But if you think you’ll need extra medical coverage, the higher tiers (gold and platinum) will cover a higher share of the health care costs.

And if you’re ready to take control of your health insurance in AZ, get access to free quotes fast here.


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