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Do you qualify for free or low-cost health insurance?

Posted at 7:10 AM, Nov 01, 2019
and last updated 2019-11-01 10:10:09-04

Do you qualify for free health insurance? More than 300,000 Arizonans do, according to one study, but haven't applied.

Or maybe you qualify for low cost insurance through the Healthcare Marketplace? Enrollment for that starts Friday. But you may think you make too much.

Allen Gjersvig is with the Arizona Alliance for Community Health Centers .

He says too many people don't think they qualify for either program, but actually do.

If you don't have employer insurance, you should start with AHCCCS .

It's the Arizona Healthcare Cost Containment System. It's Arizona's Medicaid and it's basically free.

Gjersvig says there may be small copays, but no premiums, no deductibles and no out-of-pocket maximum to pay.

You qualify by income.

For a single person, you must make $17,236 or less. For a family of four, it's $35,535.

If you make more, pay a small premium and kids could still be covered.

You choose from a number of companies, with different doctors and hospitals.

You must go through a primary care physician to see any specialist.

If you earn a little too much for that, try the Healthcare Marketplace.

Big name companies offer many different plans.

The lower your income, the more financial help you get.

I used their calculator and put in $60,000 for a family of four.

This example shows that would allow me to get $1,683 a month to cover insurance premiums.

In fact, with two of the 24 plans available in this example, you wouldn't pay any monthly premium, but they have large deductibles.

These may be best for families with few medical needs.

The higher premium you pay here, the lower the deductible.

If you make more than $103,000, you won't get financial help, but you may still want to buy through Healthcare.gov.

These plans don't limit what they pay in a year or over a lifetime.

Also, they have to meet 10 requirements including providing outpatient ambulatory services and mental health/substance use disorder services.

And Gjersvig says if you shopped a while ago and didn't find anything, plans have changed.

Healthcare marketplace enrollment starts Friday and ends December 15th.

And Friday on ABC15 mornings at 6 a.m., we'll look at where you can go for help with your insurance questions throughout the state.