Open Enrollment for Arizonans purchasing or changing their Affordable Care Act (ACA) individual health coverage for 2022 runs Monday, November 1st, 2021 through Saturday, January 15th, 2022.
As the ACA enrollment season begins, Arizonans should now be thinking about Health Coverage for 2022. It is recommended that those interested in purchasing or switching their individual health plans speak to a licensed insurance agent or broker to thoroughly research all coverage options to determine the best plans for themselves and their families, as many plans and plan specifics may have changed.
What Will Be Your Effective Date?
If you are purchasing or switching your health insurance plan and would like your coverage effective date to begin January 1st, 2022, then you would need to ensure all changes are submitted between November 1st, 2021 and December 15th, 2021.
If you submit applications or make changes between December 15th, 2021 and January 15th, 2022 then your effective date for your insurance plan would begin on February 1st, 2022. It is important to make sure you have your coverage start when you need it, so beware of these deadlines as it could result in a temporary lapse in coverage.
ACA Enrollment Options: What’s New in AZ?
If you have a current Marketplace or ACA plan, then you may be aware of some of the previous carriers and plan options available for Arizona. Next year, Arizona will be unveiling a couple of PPO plans and new carriers to the individual ACA Marketplace. This comes after years without Marketplace PPO options in Arizona. This is exciting news in the Insurance world! If you would like more information on what PPO plans will be offered for 2022 in Arizona, it is a wonderful idea to speak to a licensed insurance broker, as they will be able to guide you through all the plan options available and assist you in choosing the right plan to suit the needs of yourself and your family.
What Is a PPO Plan?
PPO is an acronym for “preferred provider organization”. A PPO is a type of managed care health coverage. Insurance companies created PPO plans to mirror the cost-saving features of other managed care coverage like HMO’s while giving members more flexibility than a typical HMO (Health Maintenance Organization) offers. This combination of low costs and more care options is why PPO plans are wildly popular.
The “preferred provider” in PPO refers to doctors and other healthcare providers who are “in-network”. Like HMO plans, PPO plans feature a network of hospitals and doctors that agree to accept lower payments in exchange for participating in the network and thus gaining access to the patients in the insurer’s network.
You receive maximum benefits and generally lower out-of-pocket costs when you seek treatment from or visit an in-network provider. You can still see out-of-network providers in a PPO, but it will cost you more.
In a PPO, you can typically visit any provider without the need for a referral from your primary care physician, or PCP. This is one of the biggest differences between PPO plans and HMO plans, as HMO’s generally require referrals from your PCP. This is why HMO plans are commonly referred to as “gatekeeper” plans, as your primary physician generally has to refer you, in order for you to see a specialist. Members of HMO plans must go to in-network providers to get their medical care and services.
Subsidy Increases For Marketplace Plans
Thanks to the American Rescues Act, you may be able to get more savings and lower costs on Marketplace health insurance. Under the new law:
- More people than ever before qualify for assistance for paying for health coverage, even those who weren’t eligible in the past.
- Most people currently enrolled in a Marketplace plan may qualify for more tax credits
- Health insurance premiums after these savings will go down, and for some people, significantly decrease.
When you apply for Marketplace coverage, you will find out if you qualify for a premium tax credit that lowers your monthly premium. The amount of your premium tax credit depends on the estimated household income for 2021 that you put on your Marketplace application.
Would You Like More Information on PPO Plans IN AZ?
As you know, healthcare is complicated. PPO’s and HMOs are just two of many options available when looking for health insurance coverage for you and your family.
If you are about to start the process of looking for coverage, Group Plans Inc is able to help. We have been in the business since 1977 helping Arizona residents and independent contractors with their health plans. As a locally-owned, family business that’s been running for decades, it is our priority to ensure your satisfaction when it comes to choosing plans. We are committed to answering your questions, addressing any concerns, and providing the best solutions suited to your needs and individual priorities.
Starting November 1st, 2021, for a free consultation that includes a plan review and a free quote, please reach out to us at Group Plans Inc by calling (623) 889-7600.