Individual health coverage · Arizona · 2026
Health coverage options in Arizona —
ACA plans, Health Shares, DPC, and more.
Arizona uses the federal HealthCare.gov exchange for ACA enrollment. The 2026 benchmark premium for a 40-year-old is $532/month — but the state’s weighted average rate increase hit 36.1% in 2026, among the largest in the country. Arizona has expanded Medicaid (AHCCCS), which covers residents below 138% FPL. Aetna exited the market and BCBSAZ dropped all PPO plans, leaving seven carriers offering HMO plans only. This page covers what each coverage type costs in Arizona, who qualifies for subsidies, and where the real trade-offs are.
+36.1%
Arizona weighted avg rate increase in 2026 — among the highest nationally
83%
of Arizona ACA enrollees qualified for subsidies in 2026, saving avg $555/month — but subsidy-eligible enrollees dropped sharply
ACA plans in Arizona
What ACA plans cost in Arizona in 2026
Arizona uses the federal exchange at HealthCare.gov — there is no state-run marketplace. For 2026, seven insurers participate in the Arizona marketplace through HealthCare.gov. Aetna/Banner exited (55,553 enrollees displaced). BCBSAZ dropped all PPO plans — only HMOs remain on-exchange in Arizona. This is a significant limitation for anyone who wants provider flexibility or out-of-network access.
The 2026 benchmark silver premium for a 40-year-old in Arizona is $532/month — but Arizona’s weighted average rate increase of 36.1% was among the largest in the country. For households below the 400% FPL subsidy cliff ($62,600 for a single adult), subsidies can significantly reduce this cost — subsidy-eligible enrollees paid just $133/month on average in 2026. Above the cliff, you pay the full benchmark.
| Annual income | % of FPL (single) | Full benchmark | Estimated subsidy | Your est. monthly cost |
|---|---|---|---|---|
| $20,000 | 128% FPL | $532/mo | ~$628/mo | ~$33/mo |
| $30,000 | 192% FPL | $661/mo | ~$511/mo | ~$150/mo |
| $40,000 | 256% FPL | $661/mo | ~$395/mo | ~$266/mo |
| $50,000 | 320% FPL | $661/mo | ~$286/mo | ~$375/mo |
| $62,600 | 400% FPL | $661/mo | ~$141/mo | ~$520/mo |
| $63,000+ | Above cliff | $661/mo | $0 | $661/mo |
Estimates for a single adult, age 40. Subsidy calculated using IRS Rev. Proc. 2025-25 applicable percentage table and 2025 HHS poverty guidelines. Actual subsidy depends on exact income, household size, and county. Source: KFF.org · IRS Rev. Proc. 2025-25. Use the comparison tool for your specific ZIP, age, and income.
Arizona has expanded Medicaid — AHCCCS
Arizona has expanded Medicaid through AHCCCS (Arizona Health Care Cost Containment System). Adults earning below 138% FPL — approximately $22,590 for a single adult or $46,800 for a family of four in 2026 — may qualify for AHCCCS coverage at little or no cost. If your income is below 138% FPL, check eligibility at azahcccs.gov before purchasing any marketplace or alternative coverage.
Arizona ACA marketplace — key 2026 facts
Arizona enrolls through HealthCare.gov only — no state exchange. Seven insurers for 2026. Aetna/Banner exited (55,553 enrollees displaced); BCBSAZ dropped all PPO plans — HMO plans only on-exchange. Weighted average rate increase: 36.1%. Open enrollment: November 1 – January 15. Sources: healthinsurance.org Arizona · ACA Signups — Arizona 2026 rate changes · Arizona DIFI 2026 open enrollment.
2026 Arizona benchmark — key numbers
Benchmark premium — age 40, Arizona
$532/mo
Premium increase vs 2025
+36.1%
Subsidy cliff — single adult
$62,600/yr
No-subsidy-zone below 100% FPL
$15,650/yr
Medicaid expanded (AHCCCS) — residents up to 138% FPL ($19,937/yr single adult) may qualify. Source: KFF.org 2026
Subsidy cliff — Arizona
A single adult in Arizona earning just below the 400% FPL cliff receives a subsidy — at $63,000 the subsidy drops to $0 and the full $532/mo applies for a 40-year-old. All Arizona marketplace plans are HMO only — residents above the cliff who want any-provider flexibility have no on-exchange option. Use the comparison tool for your specific numbers.
Alternatives to ACA plans in Arizona
How Health Shares, DPC, and STM compare in Arizona
| Coverage type | Typical monthly cost | What it covers | Key limitation | Enrollment |
|---|---|---|---|---|
| ACA plan (unsubsidized) | $532/mo (age 40) | Full ACA coverage — pre-existing, mental health, maternity | No PPO on-exchange · HMO/EPO only · high deductibles | Nov 1–Jan 15 |
| Health Share | $150–$350/mo est. | Major medical after Annual Unshared Amount | Not insurance · pre-existing often excluded · voluntary sharing | Year-round |
| DPC + Health Share | $230–$480/mo est. | Unlimited primary care (DPC) + major medical (Health Share) | Pre-existing often excluded · not regulated as insurance | Year-round |
| Direct primary care only | ~$92/mo avg | Unlimited primary care — no major medical | Must pair with other coverage for hospitalizations | Year-round |
| Short-term medical | $95–$165/mo est. | Major medical for temporary gap — 3–4 month terms | Pre-existing excluded · not MEC · terms limited | Year-round |
Why Health Shares and DPC are relevant in Arizona
Arizona has a large self-employed, remote worker, and early retiree population — particularly in the Phoenix metro, Tucson, and Scottsdale. Arizona’s $532 benchmark is lower than most Southern states, but the 36.1% rate increase in 2026 combined with the loss of all PPO plans makes alternatives worth evaluating. For Arizonans above the subsidy cliff who also want any-provider flexibility (which no on-exchange AZ plan offers), a Health Share with no network restrictions is a meaningful contrast. The DPC + Health Share combination typically runs $230–$480/month — well below the unsubsidized $532/month benchmark for a 40-year-old.
Short-term medical in Arizona
Yes. Short-term medical insurance is available in Arizona. Arizona state law (§20-1384) allows STM plans and the Arizona Department of Insurance clarified in late 2025 that insurers no longer need to follow the 2024 federal 4-month cap. As of early 2026, at least 6 insurers offer STM in Arizona with total durations up to 36 months available. Arizona is among the most permissive states for STM access. STM excludes pre-existing conditions and does not count as ACA minimum essential coverage. Source: healthinsurance.org Arizona STM tracker.
Initial term allowed
up to 364 days
Maximum total duration
up to 36 months total including renewals
ACA marketplace — 2026 carrier & plan guide
Arizona marketplace carriers, plans, and pricing
The table below shows every carrier offering ACA marketplace plans in Arizona for 2026, what metal tiers they offer, their network type, and estimated starting premium for a 40-year-old before subsidy. Availability varies by county — verify at healthcare.gov for your specific ZIP code.
Carriers — 2025
8
marketplace insurers
Carriers — 2026
7
▼ 1 fewer than 2025
National average
9.0
insurers per state 2026
2026 notable changes: Aetna exited. BCBSAZ ended all PPO individual plans — HMO only on-exchange. 7 carriers. Cigna ⚠ exiting after 2026. Source: KFF — Insurer Participation 2026.
Premiums are estimates for a 40-year-old non-smoker before any subsidy. ⚠ carriers are participating in 2026 but have announced exit after the 2026 plan year — 2027 coverage will need to be selected from remaining carriers. Carrier count and county availability vary. Always verify at healthcare.gov for your ZIP code.
See your exact costs for Arizona — enter your income and ZIP
The comparison tool calculates your ACA subsidy, benchmark premium, and how alternatives compare — for your specific age, income, and Texas ZIP code.
Arizona health coverage — common questions
Individual health coverage in Arizona — questions people ask most
Does Arizona have its own health insurance marketplace?
No. Arizona uses the federal exchange at HealthCare.gov — there is no state-run marketplace. The Arizona Department of Insurance and Financial Institutions (DIFI) regulates carrier rates. Seven insurers participate in the Arizona marketplace for 2026. Aetna/Banner exited, displacing 55,553 enrollees. BCBSAZ dropped all PPO plans — only HMO plans are available on-exchange in Arizona. For residents who want any-provider or out-of-network flexibility, no on-exchange plan provides it.
What is the 2026 ACA benchmark premium in Arizona?
The 2026 benchmark silver premium for a 40-year-old in Arizona is $532/month — but Arizona’s weighted average rate increase of 36.1% was one of the largest in the country. Subsidy-eligible enrollees paid just $133/month on average, but that figure reflects the significant subsidies available below 400% FPL. Above the cliff, the full $532/month applies for a 40-year-old. Premiums are age-rated: younger adults pay less, older adults pay more. For a 60-year-old, the benchmark premium is significantly higher. If your household income is between $15,650 and $62,600 (100%–400% FPL for a single adult), you likely qualify for a premium tax credit that reduces this cost. Use the comparison tool to calculate your specific subsidy. Source: KFF.org 2026.
Does Arizona have Medicaid expansion?
Yes. Arizona has expanded Medicaid through AHCCCS. Adults earning below 138% FPL — approximately $22,590 for a single adult in 2026 — may qualify for AHCCCS at little or no cost. Arizona also has Medicaid for children through KidsCare. If your income is below 138% FPL, check eligibility at azahcccs.gov before purchasing any marketplace or alternative coverage.
Are Health Shares available in Arizona?
Yes. Health Shares are available to Arizona residents year-round with no open enrollment requirement. For Arizonans above the subsidy cliff who also want any-provider flexibility — which no on-exchange Arizona plan currently offers — a Health Share with no network restrictions is a meaningful alternative. Health Shares are not insurance and are not regulated by the Arizona Department of Insurance. Pre-existing conditions are typically excluded or subject to waiting periods. See the Health Shares guide for a full explanation.
What are the best health coverage options for self-employed Arizonans?
It depends on your income. If your MAGI is between $22,590 (138% FPL — the AHCCCS threshold) and $62,600 (400% FPL cliff), an ACA plan with a subsidy is almost always the most cost-effective option. If your income exceeds $62,600, you pay the full $532/month benchmark for a 40-year-old — and all Arizona plans are HMO only, with no out-of-network coverage. At that income level, a Health Share with no network restrictions paired with a DPC membership typically runs $230–$480/month and offers provider flexibility that no Arizona marketplace plan currently provides. Consult a CPA for health insurance deduction specifics.
Is short-term health insurance available in Arizona?
Arizona state law (§20-1384) allows STM plans and the Arizona DOI clarified in late 2025 that insurers no longer need to follow the 2024 federal 4-month cap. At least 6 insurers offer STM in Arizona with total durations up to 36 months available. STM excludes pre-existing conditions, does not satisfy ACA minimum essential coverage, and losing it does not trigger an ACA SEP. Arizona is among the most permissive states for STM access. See the short-term medical guide.