The Arizona Insurance Exchange (Marketplace) is the Federally-Facilitated Marketplace.
The Federally-facilitated Marketplace is administered by the federal government, under the Department of Health and Human Services (HHS).
General information about the Federally-facilitated Marketplace can be found at: https://www.healthcare.gov/marketplace/individual/#state=arizona.
PATIENTS
The Federally-facilitated Marketplace is essentially a marketplace for individuals to shop for health insurance if they do not already have insurance coverage from another source. If individuals have insurance from another source such as employment, retirement benefits, or spousal benefits, they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the Federally-facilitated Marketplace.
This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.
As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discrimination policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Arizona Department of Insurance
2910 N. 44th Street, Ste. 210 (2nd Floor)
Phoenix, AZ 85018-7269
800-325-2548
www.azinsurance.gov/
Complaints: www.azinsurance.gov/consumerassistance.html
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Federally-facilitated Marketplace.
Arizona has established State of AZ Self-Insured Plan (Administered by United Healthcare) as the “benchmark” plan.
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.
Aetna
Plan Website: http://www.aetna.com/individuals-families/health-insurance-exchange.html
Provider Enrollment: http://www.aetna.com/healthcare-professionals/join-aetna-network/join-provider-network.html
Plan types offered: Individual
Assurant Health
Plan Website: http://www.assuranthealth.com/corp/ah/AHHome.htm
Provider Enrollment: http://www.assuranthealth.com/corp/ah/Providers/health-care-provider.htm
Plan types offered: Individual
Blue Cross Blue Shield of Arizona, Inc.
Plan Website: https://www.azblue.com/shop-plans/individuals
Provider Enrollment: https://www.azblue.com/healthcareprofessionals/contract-with-blue/contracting
Plan types offered: Individual, SHOP
Cigna Health and Life Insurance Company
Plan Website: http://www.cigna.com/individuals-families/arizona
Provider Enrollment: http://www.cigna.com/healthcare-professionals/join-our-network
Plan types offered: Individual
Cigna Healthcare
Plan Website: http://www.cigna.com/
Provider Enrollment: http://www.cigna.com/healthcare-professionals/
Plan types offered: Individual
Health Choice Insurance Company
Plan Website: http://www.healthchoiceaz.com/members/
Provider Enrollment: http://www.healthchoiceaz.com/providers/
Plan types offered: Individual
Health Net
Plan Website: https://www.healthnet.com/
Provider Enrollment: https://www.healthnet.com/portal/provider/content/iwc/provider/unprotected/dashboard/content/speak_to_an_agent.action
Plan types offered: Individual
Health Net Life Insurance Company
Plan Website: https://www.healthnet.com/portal/home.ndo
Provider Enrollment: https://www.healthnet.com/portal/broker/formsBrochures.action?group=brk_ifp
Plan types offered: Individual, SHOP
Health Net of Arizona
Plan Website: https://www.healthnet.com/portal/member/content.do?mainResourceFile=/content/general/unprotected/html/az/plans/ifp/az_ifp_plan_desc_main.html
Provider Enrollment: https://www.healthnet.com/portal/provider/content/iwc/provider/unprotected/working_with_HN/content/features.action
Plan types offered: Individual, SHOP
Humana Health Plan, Inc.
Plan Website: https://www.humana.com/individual-and-family/products-and-services/medical-plans/
Provider Enrollment: https://www.humana.com/provider/medical-providers/network/
Plan types offered: Individual
Humana, Inc.
Plan Website: https://www.humana.com/
Provider Enrollment: https://www.humana.com/provider/
Plan types offered: Individual
Meritus
Plan Website: http://www.meritusaz.com/
Provider Enrollment: http://www.meritusaz.com/node/18
Plan types offered: Individual
Meritus Health Partners
Plan Website: http://www.meritusaz.com/
Provider Enrollment: http://www.meritusaz.com/node/18
Plan types offered: SHOP
Meritus Mutual Health Partners
Plan Website: http://www.meritusaz.com/
Provider Enrollment: http://www.meritusaz.com/node/18
Plan types offered: Individual, SHOP
Phoenix Health Plans, Inc.
Plan Website: https://www.phoenixhealthplan.com/
Provider Enrollment: https://www.phoenixhealthplan.com/providers
Plan types offered: Individual
UnitedHealthcare
Plan Website: http://www.uhc.com/health_reform_guide.htm
Provider Enrollment: http://www.uhc.com/physicians/join_our_network.htm
Plan types offered: Individual
University Healthcare Marketplace (UHM)
Plan Website: https://www.uamarketplace.com/
Provider Enrollment: https://www.uamarketplace.com/ProvidersJoinUs.aspx
Plan types offered: Individual
University of Arizona Health Plans – University Healthcare Marketplace
Plan Website: http://www.universityhealthcaregroup.com/Default.aspx
Provider Enrollment: http://www.universityhealthcaregroup.com/ProvidersJoinUs.aspx
Plan types offered: Individual