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Health Insurance in Glendale and Phoenix, AZ

Many people get health insurance through their employers, but that isn’t the only option for coverage. If you don’t currently participate in your employer’s health plan or they don’t offer coverage, you could explore an individual health insurance policy. Obtaining individual health insurance is a good method for ensuring that you and your family will be financially protected from very high costs in the event of a medical emergency.

Individual health insurance is health coverage purchased by an individual or a family that is not tied to a job or a group of policyholders.

Talking with an Ayala Insurance agent is a great first step in determining the right coverage for your needs and budget. We have a variety of coverage options and the expertise to guide your choices.

What Is Health Insurance?

Health insurance is a contract that helps pay for your health care costs in exchange for a premium payment. The details of your policy, such as how much the policyholder pays via copay, deductibles and coinsurance, will all vary with the policy itself. Without health insurance, health care costs can be insurmountable. You cannot purchase health insurance after medical needs arise, so be sure to be proactive and discuss your needs with an agent before opting out of coverage.

Why Is It Important To Have Health Insurance?

Health insurance is vital to have for many reasons. Without it, you may have to pay for the total costs of your health care, which can be costly. Not only can health insurance help you cover medical fees, but it can provide you with a network of participating doctors within your network that offer lower rates than going to practitioners outside of your network. Your provider also encourages you to get routine check-ups typically covered by your health plan.

What each policy covers is unique. It’s important to check with your insurer before making a decision about coverage to receive the care that’s best for you.

How Can I Get Health Insurance?

There are also other ways to seek individual health insurance, including those listed below.

Join Someone Else’s Plan

If your spouse or domestic partner has an employer-sponsored plan that is open to participants’ family members, consider joining and enrolling your children as well.

Additionally, the ACA extends coverage eligibility for young adults up to age 26 on plans offering dependent coverage, regardless of their marital or student status.

Obtain Insurance in the Individual Market

The Health Insurance Marketplaces (also known as Exchanges) are some of the most common places to buy health insurance and apply for Medicaid. Created by the Affordable Care Act (ACA), the Marketplaces are designed to help you easily find health insurance that fits your budget. Different states may have different Marketplaces and available options—there is also a federal Marketplace, HealthCare.gov.

Qualified health plans in the Marketplaces are sold and run by private companies. Every plan covers a core set of 10 essential health benefits, including emergency, prescription drug and mental health services. Additionally, all plans offered in the Marketplace must provide free preventive care, with 100% of the costs paid for by insurance companies.

Use Medicaid or Other State Programs, As Applicable

Medicaid provides health coverage for some low-income individuals, including families and children, pregnant women, the elderly and people with disabilities. People who do not qualify for full Medicaid benefits may still be eligible for breast cancer and cervical cancer screenings or for assistance with specific treatments.

The rules for Medicaid enrollment differ slightly from state to state. You can visit www.medicaid.gov or use your state’s Marketplace to determine whether you are eligible for Medicaid coverage in your state. You can also consult your local health department to see any public coverage options available in your area.

Seek Insurance Through COBRA and State-sponsored Programs

The Consolidated Omnibus Budget Reconciliation Act (COBRA) provides certain former employees, retirees, spouses, former spouses and dependent children the right to a temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events, such as having work hours reduced and subsequently losing employer-based coverage.

COBRA coverage is usually more expensive than health coverage for active employees, so individuals may wish to consider other options, such as Exchanges, if they ever lose their employer-sponsored coverage.

Gain Insurance Through Protections Under HIPAA

Under the Health Insurance Portability and Accountability Act (HIPAA), at least one private insurer must sell you a policy if you meet all of the following conditions:

  • You previously had 18 months of coverage without a break for more than 63 days.
  • The last day of your coverage was through your former or current employer.
  • You do not have a COBRA or mini-COBRA option available.

Contact Us Today

With all the different health plans available, it can be challenging to select the plan that best meets your and your family’s needs and, ultimately, your budget. While it can be tempting to pick the plan with the lowest premium, you don’t want to be surprised by high out-of-pocket costs or network restrictions when seeking medical care.

Speak with Ayala Insurance for assistance in determining your best available health insurance options.

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