Frequently Asked Questions - State of Arizona Employees

Frequently Asked Questions

As Far as We’re Concerned, Every Question Is Top-Tier

The Triple Choice Plan, called BluePreferred® Care, was created by Blue Cross® Blue Shield® of Arizona (BCBSAZ) specifically for employees of the State of Arizona. This three-tier plan delivers three unique benefits:

  • Helps you easily find doctors, hospitals, and other healthcare providers that offer high-quality, cost-effective care
  • Gives you a wide choice of providers
  • Provides you with more control over your healthcare spending

This plan gives you the freedom to choose from any healthcare professional in the BCBSAZ national network without a referral through a primary care provider (PCP). The plan offers you three different provider tiers to choose from. You will save the most money when you choose a Tier 1 provider.

Tier 1 In‑Network Providers Choose doctors and facilities from Tier 1 to get the highest level of benefits.
Tier 2 In-Network Providers You receive in-network benefits for using participating network care providers. For some services, you’ll pay a higher out-of-pocket cost with a Tier 2 provider than you would with a Tier 1 provider.
Tier 3 Out‑of‑Network Providers You will pay the highest cost for using out-of-network providers, and may be responsible for paying the full provider billed charges.

The Triple Choice Plan is made up of three tiers. If your provider is not in Tier 1, but is part of the BCBSAZ national network (Tier 2), you will still enjoy in-network benefits. However, you will pay more out of pocket for certain services.

If your provider is not in the BCBSAZ national network (called an out-of-network provider), you will pay the highest out-of-pocket costs. In many cases, this will be the entire cost of the service or procedure.

Remember, if your doctor is not in Tier 1, it doesn’t mean they provide a lower standard of care. All doctors who contract with the BCBSAZ national network must meet our credentialing requirements.

To search for BCBSAZ in-network providers, visit azblue.com/stateofaz. You’ll see the Tier 1 Ribbon icon next to all Tier 1 provider listings. Listings that do not feature the ribbon icon are Tier 2 providers.

Tier 1 and Tier 2 deductible and out-of-pocket maximums cross-apply. With Tier 3 providers, applicable costs go toward only your Tier 3 deductible and out-of-pocket maximum.

You have access to in-network providers nationwide and emergency coverage worldwide. Contact us for coverage level details.

Yes, the BluePreferred Triple Choice Plan gives you the freedom to choose from any healthcare professional, whether they’re part of our network or not. Just remember that when you use Tier 1 providers, you will enjoy the lowest deductible and overall cost than with either of the other tiers.

Yes, doctors and healthcare facilities can verify your eligibility and benefits either by looking for the Tier 1 Ribbon icon on your BCBSAZ ID card, going online to azblue.com/stateofaz, using the Electronic Data Interchange (EDI), or by calling us.

This is the amount you pay for healthcare services before your health insurance begins to pay. You don’t need to pay a deductible for covered preventive care services if they are received in-network.

How it works: Your Tier 1 individual deductible is $200. You’ll pay 100% of eligible healthcare expenses until the bills total $200. After that, you share the cost with your plan by paying copayments.

This is a fixed amount you pay for a healthcare service, usually when you receive the service. The amount can vary by the type of service.

How it works: The plan determines what your copay is for different types of services, and when you have one. Remember, you have to satisfy your deductible before your copays apply. You will pay the lowest deductible when using Tier 1 providers.

Your BCBSAZ member ID card will list your deductible and copays for some types of visits. You can also compare tiers on our portal, azblue.com/stateofaz, before enrolling or log in to your member account after you’ve enrolled, or call us at 1-866-287-1980. You can also look up your copay amounts through your member account on our website or by using our mobile app.

This is your share of the cost of healthcare services. It’s usually figured as a percentage of the amount allowed to be charged for services, and primarily applies when you use Tier 3 (Out-of-Network Providers). You start paying coinsurance after you’ve met your Tier 3 deductible.

How it works: Imagine you’ve paid $5,000 in healthcare expenses, meeting your Tier 3 deductible. The next time you go to your doctor, instead of paying all costs, you and the plan share the cost: The plan will cover 50% of the cost, and you’ll pay the remaining 50%—your coinsurance. That 50% is your coinsurance. Remember, your cost will be much less if you use Tier 1 or Tier 2 providers.

The HDHP is not tiered in the same way as the Triple Choice Plan. If you enroll in the State of Arizona HDHP (retirees are not eligible for this plan), you can choose from a vast list of in-network providers in Arizona and around the country. With this plan, you can also see out-of-network providers, but your out-of-pocket costs will be higher (usually that means you’ll have to pay the provider’s billed charges in full). For more answers, reference the HDHP FAQs.

No. You have the freedom to use any doctor or hospital without being required to choose a primary care physician (PCP) or get referrals.

The Blue Cross® Blue Shield® of Arizona (BCBSAZ) HDHP was specifically created to give State of Arizona employees more control over their healthcare dollars as well as a plan option with lower premiums.

This High-Deductible Health Plan is designed to deliver key benefits while offering:

  • Lower Monthly Premiums
  • Health Savings Account (HSA)
  • HSA Tax Advantages
    • Pre-tax contributions
    • Tax-free interest earnings
    • Tax-free withdrawals on qualified expenses*

With an HDHP you’ll see lower monthly premiums but will have a higher annual deductible. A deductible is the portion you pay out of pocket before your insurance benefits kick in. To offset that higher deductible, you can open a tax-exempt health savings account (HSA) that is funded by you and your employer. Think of it like a 401(k) for your health. You have the option to then use those tax-free dollars on qualified expenses like doctor visits, vision and dental services, MRIs, and prescriptions. All qualified expenses go toward helping you meet your deductible. You can also use your HSA for unqualified expenses. However, those transactions are taxed and carry a withdrawal penalty.

The difference between the plans is the yearly deductible. The HDHP has lower monthly premiums but a higher yearly deductible. The BluePreferred® Care plan has higher premiums and copays but a lower deductible. Another key difference is that with an HDHP you can elect to open a tax-advantaged HSA to help cover your qualified medical costs and pay down your deductible.

BluePreferred® Care Plan HDHP
Low deductible, higher monthly premiums High deductible, lower monthly premiums

Can open a tax-advantaged HSA to cover healthcare expenses

Yes; both plans provide access to all Blue Cross Blue Shield providers in Arizona and around the country. If you select the Triple Choice Plan you will pay less if you use Tier 1 in-network providers. These providers are clearly marked with the Tier 1 icon.

  • Lower Monthly Premiums
  • Health Savings Account (HSA)
  • HSA Tax Advantages

With an HDHP, you’ll need to meet your annual deductible before the coinsurance benefit kicks-in. After your deductible is met the plan pays 90% of eligible expenses; you pay 10%. This means when you receive services, your cost-share will be more until your deductible has been met. The HSA account is designed to help you offset those costs. All eligible healthcare expense—from doctor visits, urgent care visits, hospitalizations and prescriptions accumulate towards your deductible and out-of-pocket maximum.

HDHP option
In-network
Deductible
(Single/Family) Type of Deductible 		$1,600/$3,200
Combined Medical/Rx
deductible
OOP Maximums
(Single/Family) (includes deductible and coinsurance) 		$8,050/$16,100
Combined Medical/Rx
OOP Max

Having an HSA, like the one available with your plan, can not only help you prepare for current and future health expenses, it can also help you save on taxes in three ways: The account can be funded through pre-tax contributions by you and your employer, which can help bring down your yearly tax burden. Any interest you earn in your HSA grows tax free. And withdrawals for qualified expenses such as doctor visits, vision and dental services, MRIs, and prescriptions are also tax exempt.

Unlike other health accounts, there is no “use it or lose it” with an HSA. The balance of your HSA rolls over year after year, allowing you to build reserves that can help with future healthcare needs or even be used in retirement. The funds in your HSA are yours to use even if you switch jobs or retire.

Although doing so is not recommended, HSAs can be used for unqualified expenses. If you do make any unqualified withdrawals, they are subject to applicable taxes and penalties.

An HSA is designed to pay for all kinds of healthcare needs—everything from regular doctor visits, vision and dental services, diabetes medication and prescriptions to specialty care and even acupuncture. Your HSA can be used tax free to pay for out-of-pocket qualified medical expenses—even if they’re not covered by your HDHP. This includes expenses for you, your spouse, and any dependents you claim on your tax returns. You can find a detailed list of qualified medical expenses at www.irs.gov.

It depends. The rule states that if you claim a family member as a dependent, then you can use your HSA for their qualified medical expenses.

A deductible is the amount you have to pay for covered healthcare services before your health plan starts to pay. You don’t need to pay a deductible for covered preventive care services if they are received in the network.

No. When you use network providers you will pay the discounted amount of services (we call this “Allowed Amount”) until you reach your deductible. You can use your HSA to help pay for services, or you can save those funds to use later.

After you’ve paid your deductible, you only pay a percentage of the cost for each covered service, called coinsurance (e.g., your plan pays 90% and you pay 10%).

The out-of-pocket limit is the most you have to pay for covered services in a plan year. If your deductible and coinsurance payments reach the out-of-pocket limit, your plan will pay 100% of covered services for the rest of the year.

Yes, you can see any doctor you want. You are encouraged to use healthcare providers in the network because they’ve agreed to charge lower prices. For example, when you use a network doctor, you’ll usually pay less compared to one who is not in the network.

No. You have the freedom to use any doctor or hospital without being required to choose a primary care physician (PCP) or get referrals.

Yes, emergency room and urgent care services are covered after you meet the deductible.

Yes, adult children are eligible for coverage under the plan up to age 26.

To deposit money into an HSA, you must be enrolled in an HSA-eligible health plan. You are eligible if:

  • You are covered under an eligible high-deductible health plan (HDHP)
  • You are covered by no other health coverage, unless it is permissible coverage
  • You are not enrolled in Medicare
  • You cannot be claimed as a dependent on someone else’s tax return
  • Some other restrictions apply
Please talk to a tax, benefits, or financial advisor if you have more questions.

No. All of the money in your healthcare FSA must be spent before you can open an HSA. This rule does not apply to Limited FSA accounts. Please consult with your ADOA Human Resource contact on any questions about Limited FSA eligibility and options.

Yes. If a spouse will be or is already covered by Medicare, you can sign up for this plan and open and contribute to an HSA. If you file taxes jointly with your spouse, you can use your HSA to help pay for your spouse’s qualified expenses, such as Medicare premiums.

Examples of expenses that do not qualify include cosmetic surgery, health club memberships, teeth whitening, and over-the-counter medicines purchased without a prescription. If you use an HSA to pay for an expense that is not qualified, you will have to pay taxes on the expense and may also have to pay a 20% penalty on the amount spent.

Yes. The IRS limits how much you (and others) can put into an HSA each year. The 2024 limits are:

  • $4,150 for individual coverage
  • $8,300 for family coverage
If you are 55 or older, you can deposit an extra $1,000 during the year. This is called a catch-up contribution. Any contributions above these limits are subject to income taxes and a penalty.

Yes, anyone can contribute to your HSA.

The money in your HSA is yours to keep. If you leave your company, change health plans, or retire, you take your HSA with you. If you switch to a health plan that makes you ineligible to continue depositing money in an HSA, you may continue to use the money in your account for qualified medical expenses, but you can no longer make deposits.

Yes. But the IRS says the two of you together can only contribute up to the family limit. Both of you can contribute to just one of your HSAs, or you can contribute to both HSAs as long as the total amount doesn’t go above the annual family limit.

After you enroll, you will have tools on azblue.com that can help you estimate the cost of treatments and other procedures based on your health plan, a specific doctor or hospital, and your ZIP Code.

If you receive a bill from your doctor or if you are paying for a prescription, you can pay from your HSA using your HSA debit card or checks provided by Optum Bank®.

Yes, as long as the service is a qualified expense. You can take money out of your HSA to pay yourself back with no penalty.

After you turn 65 or start receiving Medicare benefits, you may withdraw money from your HSA for medical and non-medical purposes without penalty. When your Medicare coverage starts, you can use your HSA to pay your Medicare premiums, deductibles, and copayments.

If your domestic partner meets the IRS qualifications of a tax dependent, you can use your HSA to help pay their qualified expenses. If your partner is not a tax dependent, you can still cover your partner under your plan. However, your partner would need to open and fund their own HSA to pay for the expenses.

No. If you are enrolled in a healthcare FSA, the IRS will not allow you to open an HSA. But the law does permit you to enroll in a limited-purpose FSA if it is offered to you. A limited-purpose FSA can only be used to pay for eligible dental and vision expenses.

No. All of the money in your healthcare FSA must be spent before you can open an HSA.

Have more questions?

Call 1-866-287-1980