Antidote Individual & Family Health Insurance: New in Arizona

Key Takeaways

• Antidote is a virtual-first health maintenance organization (HMO), where members can get affordable healthcare when they use providers that are covered within the network. 
• Because Antidote is not a preferred provider organization, if you choose to see a physician outside of the HMO network, you’ll have to pay for costs out-of-pocket. This means, if you have a preferred provider, you should check to see if they’re covered by Antidote before signing up for this health insurer. 
• With Antidote, you’re assigned a virtual primary care provider and can get 24/7 virtual care for free. You can typically see a provider in as few as 20 minutes through the Antidote app.
  

How Does Antidote Work?

Antidote may be a good health insurance option for individuals and families who want the convenience of healthcare in their smartphone or computer, and who don’t mind being limited to physicians who are covered within the Antidote network. Some of the benefits of having an Antidote individual or family health insurance plan include:

• Get 24/7 access to a virtual primary care provider, for $0 cost. With the Antidote app, you can see a healthcare provider virtually within about 20 minutes, any time of day. There’s never any cost to seeing your virtual primary care provider. If that exact person isn’t available, another doctor will help you. 
• Get free in-person primary care provider visits. It’s also no cost to see a primary care provider in person. When your primary care provider refers you to a specialist, you’ll get a discounted rate, or potentially no-cost care.
• Virtual primary care providers can diagnose, treat and prescribe for diverse medical conditions. Virtual primary care providers can offer primary and urgent care, mental health services and chronic health services. Some conditions Antidote virtual care providers can help with include coughs, sore throats, urinary tract infections, muscle sprains, nausea, flu-like symptoms, skin infections, major depressive disorders, diabetes and hypertension. 
• Get affordable medications. Antidote provides $0 copay options for select prescriptions and low-cost options for other medications. 

For Arizona residents, you can expect Antidote coverage for urgent care, emergency response and employed doctors in the Arizona Care Network (ACN), which includes Dignity Health, Abrazo Health and Phoenix Children’s Care Network, as well as with HonorHealth networks. If your preferred provider is in-network with Antidote, you can continue to see them at in-network prices. If they’re not, you won’t be covered.

Considerations for Antidote

A major consideration with Antidote health insurance plans in Arizona is that you’ll be limited to their network of providers if you want healthcare coverage, since they’re an HMO. If you have doctors you know you want to continue seeing, check that they’re covered in-network with Antidote, first.

Also, because Antidote is so new to the health insurance space (with an investment from National Basketball Association star Giannis Antetokounmpo to boost it!), you should also consider how long you plan on being an Arizona resident for in the year you have coverage. If you move to any other state other than Ohio, you’ll have to find a new health insurer. Moving does typically qualify you for a special enrollment period, in which you can sign up for a new health insurer, but it’s worth considering for the potential inconvenience.

How to Sign Up for Antidote on the ACA Marketplace

When you’re ready to sign up for Antidote on the ACA Marketplace, use our free form. Open enrollment begins November 1 and lasts through December 15 for coverage beginning January 1. If you sign up between December 16 and January 15, your coverage will begin February 1. 

If you experience a qualifying event for a special enrollment period, you’ll typically have 60 days before or after the event to sign up, as well. Qualifying events include having a child or adopting a child, moving, losing health insurance through work, getting divorced, and having household income fall below a certain amount.

To sign up for Antidote or compare all your ACA Marketplace options, use our form now. If you have questions about health insurance in Arizona in general, you can call 602.617.4107, contact us online or email quotes@azhealthinsuracebrokers.com.