Health and Medicare insurance in Scottsdale.

Scottsdale's problem is not choice, it is the subsidy cliff

Above 400 percent of poverty the credit is zero, and Scottsdale has more households in that position than almost anywhere in Arizona.

Scottsdale skews toward business owners, professionals, consultants, and early retirees. That is a demographic where a large share of households earn above 400 percent of the federal poverty level, and above that line the premium tax credit is zero, with no taper. The enhanced credits that softened the edge from 2021 through 2025 expired at the end of 2025, so the cliff is back at full height.

About 83 percent of Arizona Marketplace enrollees receive a credit. The unsubsidized minority pays the full premium, and in Arizona that full premium is not small: the cheapest available plan for a 40-year-old in the Phoenix rating area runs several hundred dollars a month before anyone has been to a doctor.

Here is the Arizona-specific part that matters. About 6.2 percent of Arizona Marketplace enrollees are above the cliff, against roughly 1.9 percent in Texas. Unsubsidized Arizonans have not abandoned the exchange the way unsubsidized Texans have, which tells you the full-price exchange plan is still frequently the right answer here. It should be priced, not assumed away. That is a different conclusion from the one we reach in Texas, and it is why we price both.

Every plan is an HMO, and Scottsdale is where that bites hardest

All 199 Arizona Marketplace plans are HMOs. If you have Mayo or a specific specialist, check the network before the premium.

Every medical plan on the Arizona Marketplace for 2026 is an HMO. All 199 of them, across all seven carriers. There is not a single PPO available. Blue Cross Blue Shield of Arizona did not renew its PPOs and Aetna left the individual market entirely.

An HMO means a defined network, a referral to see a specialist, and generally no out-of-network coverage outside emergencies. In Scottsdale this lands harder than it does elsewhere in the Valley, because a lot of households here have established relationships with specific physicians and systems, including Mayo Clinic Arizona and the HonorHealth Scottsdale hospitals, and they assume that access travels with them. It does not travel automatically.

This is the strongest argument for looking at private coverage alongside the exchange in Scottsdale. Some private plans run on national PPO networks and can preserve out-of-network access that no Arizona Marketplace plan offers. They are also medically underwritten, are not ACA-compliant comprehensive coverage, and can exclude pre-existing conditions, so they are the right answer for some households and the wrong one for others. We will tell you which you are.

Cigna is leaving Arizona for 2027

Cigna sells in Maricopa today and is absent from the 2027 filings.

Cigna HealthCare of Arizona sells individual coverage in Maricopa County for 2026 and is absent from the 2027 individual-market filings. It is part of a wider Cigna exit from the individual marketplace across eleven states. Your 2026 coverage is unaffected.

If you do nothing, the Marketplace re-enrolls you into a similar plan from another company. Similar means a comparable metal level, not the same network, drug list, deductible, or price, and nothing in that process checks whether your doctors are included. In Arizona, where every Marketplace plan is an HMO and out-of-network care is generally not covered at all, an automatic reassignment can quietly cost you the specialist you have seen for years.

Business owners and the self-employed

Scottsdale runs on small business, and the tax treatment of premiums changes which option actually wins.

Scottsdale has one of the higher concentrations of self-employed people and small business owners in Arizona: consultants, real estate, professional practices, and owner-operators. Two things follow that most comparison sites never mention.

First, if you are self-employed, health premiums may be deductible above the line, which changes the real after-tax cost of every option on the table. A plan that looks more expensive on the sticker can be cheaper after tax. Second, once you have even a couple of employees, a small group plan becomes worth pricing against individual coverage, and the answer is genuinely situational. See self-employed coverage and small business plans.

If your income varies year to year, which it does for most owners, the projection you give the Marketplace is the single most important number in the process, because your credit is calculated from the projection and reconciled at tax time.

What working with us looks like

Independent, multi-carrier, licensed in Arizona, and free to you.

We are independent rather than captive to one carrier, so we compare across the companies we are appointed with and tell you what fits. Our help costs you nothing, because the carrier builds the same commission into the premium whether you use an agent or not.

For Scottsdale households specifically, the useful version of that is this: we will price the exchange at full cost, price private coverage beside it, model the tax treatment if you are self-employed, and tell you plainly which one wins. Sometimes the answer is the exchange plan even at full price. We are based in the Phoenix North Valley and work by phone, video, and email rather than from a Scottsdale office.