Medical

COVID-19 No-Cost Coverages Ending July 19

As the COVID-19 vaccine becomes widely available, services that were provided for no-cost will be returning to standard coverage starting July 20. See the coverage chart.

  • Telehealth/Virtual Visits - For service providers such as Doctor on Demand, Teladoc, AmWell, BlueCare Anywhere and the UnitedHealthcare app, charges are as follows:
    • Triple Choice Plan - copay after deductible, HDHP - coinsurance after deductible.
    • For virtual visits from your primary care physician, or specialist, you will pay the billed charge before deductible and the copay or coinsurance after deductible.
    • This applies to all telehealth services, including mental health.
  • COVID-19 Treatment - ER, office visit, inpatient and outpatient care will be charged as per standard coverage. Testing and vaccines remain free.
  • Prescription Drugs - “Refill too soon” restrictions will resume, so prescriptions will be refilled on the standard schedule.

COVID-19 Vaccines and Tests Remain Free and Widely Available

  • Safe, effective, and free vaccines are widely available at doctor’s offices, pharmacies, and numerous other locations around the state. Arizonans age 12 and older are eligible to receive the vaccine. You can find a vaccine site at azdhs.gov.
  • COVID-19 testing is also widely available, please visit azdhs.gov.  Please help prevent the spread of COVID-19 by getting tested if you have symptoms and isolating if you test positive.

MEDICAL PLANS


CARRIERS

The State of Arizona offers medical coverage through two carriers. The plan is identical with each carrier. The difference is the provider networks. Both carriers offer coverage nationwide. When choosing a plan, check with your medical providers (doctors, therapists, etc.) to confirm that they accept the plan. Use the links provided here. Do not use the main carrier websites. 

MEDICAL ID CARDS

When you enroll in medical and dental benefits you will receive a medical ID card within a few weeks. You can also access your ID card via the insurance company’s website or app.  If you need assistance before you can retrieve your card information, contact your carrier. See the information below.

SUMMARY OF BENEFITS AND COVERAGE | SBC

A Summary of Benefits and Coverage (SBC) is an easy-to-understand overview of a health plan's benefits and coverage. The documents listed here apply to both medical plans, regardless of the provider network (carriers).

2021

Resources

SUMMARY PLAN DESCRIPTION | SPD

The documents listed here apply to both medical plans, regardless of the provider network (carriers).

  • The Summary Plan Description (SPD) is a detailed description of what the plan provides and how it operates. 
  • The Summary of Material Modifications (SMM) informs participants and beneficiaries of changes to the SPD during the plan year.

2021

2020

  • EPO SPD - applies to all carriers  | 2020
  • PPO SPD - applies to all carriers  | 2020
  • HDHP with HSA SPD - applies to Aetna only | 2020
  • HSA Information - common questions, and information from PayFlex, the HSA account administration company.
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    PREMIUMS & COPAYS

    2021

    See pg. 11 | Active Enrollment Guide 2021

     

    Medical premiums per pay period
     Triple Choice Plan (TCP)High Deductible Health Plan + HSA (HDHP)
     EmployeeStateEmployeeStateAgency HSA Contribution
    Employee only $26.17$279.46$10.15$181.87$27.69
    Employee + Spouse$71.49$576.74$30.46$376.95$55.38
    Employee + 1 Child$57.30$376.83$25.89$246.41$55.38
    Family $121.61$638.55$56.35$419.97$55.38

    CONTACT