Before you start

Arizona residence
Income information for AHCCCS or subsidy eligibility
An SSN or ITIN for marketplace applications
A qualifying life event, if enrolling outside the annual window

Step-by-step

1
Check AHCCCS eligibility before buying anything
Arizona expanded Medicaid, so adults up to 138% of the federal poverty level qualify with no premium, and KidsCare covers children at higher household incomes. A newcomer on a modest or part-year income frequently qualifies, and people who assume otherwise buy marketplace coverage they did not need.
OnlineWho: YouWeek 1–2
2
Enrol in your employer's plan inside the new-hire window
Typically 30 days from your start date. Compare deductibles and out-of-pocket maximums between offers rather than premiums alone, and check which of the Valley's hospital systems each network includes — Banner, HonorHealth, Dignity and Mayo do not all appear in every plan.
Via employerWho: YouFirst 30 days of employment
3
Otherwise enrol through HealthCare.gov
Arizona uses the federal marketplace rather than running its own exchange. Open enrolment starts 1 November each year; outside it you need a qualifying life event such as moving to Arizona, losing coverage, marriage or a new child.
OnlineWho: You
4
Learn the signs of heat illness in your first week, not your first crisis
Maricopa County records hundreds of heat-associated deaths each summer, and newcomers are over-represented because they misjudge exposure. Heat exhaustion — heavy sweating, nausea, cramps, dizziness — becomes heat stroke, which is a medical emergency, once sweating stops and confusion begins. Hike before sunrise, carry more water than feels necessary, and know that the county publishes cooling centre locations every summer.
In personWho: You
5
Know what valley fever is before you get a persistent cough
Coccidioidomycosis is a fungal infection caused by inhaling soil spores, endemic to the Sonoran Desert and concentrated in Arizona. It usually presents as a lingering flu or pneumonia that does not respond to antibiotics. Newcomers are most at risk because long-term residents have often been exposed already. If you have a cough lasting more than a week, ask your doctor specifically about valley fever — outside the endemic states it is routinely missed.
In personWho: You
6
Register with a primary care physician while you are well
Your PCP gates specialist access on most plans. Confirm network status with the practice itself rather than the insurer's directory, which is frequently out of date. The Valley's growth means new patient waits have lengthened considerably.
OnlineWho: You

Documents you’ll need

Proof of Arizona residence
Income documentation for AHCCCS or marketplace subsidies
SSN or ITIN
Immigration documents for Medicaid and marketplace eligibility categories
Evidence of losing prior coverage, if using a special enrolment period

Things most newcomers don’t know

Valley fever is an Arizona-specific diagnosis that doctors elsewhere will miss.

Coccidioidomycosis comes from inhaling fungal spores in disturbed desert soil, and Arizona accounts for the large majority of US cases. It presents as a persistent flu or pneumonia that antibiotics do not touch, and it can take weeks to months to resolve. Newcomers are disproportionately affected because residents often carry immunity from prior exposure. If you travel and fall ill after leaving, tell the doctor you have lived in Arizona — that sentence is what triggers the test.

Source: Arizona Department of Health Services — valley fever

Heat is a clinical emergency here, and the deaths are concentrated among people who misjudge it.

Maricopa County has recorded several hundred heat-associated deaths in each recent summer, a large share of them outdoors and preventable. The critical distinction is that heat exhaustion still sweats and heat stroke stops — confusion, hot dry skin and a lack of sweat mean 911, not shade and water. Trails are legally closed during extreme heat warnings for this reason and the closures are enforced.

Source: Maricopa County Department of Public Health

Arizona expanded Medicaid, so there is no coverage gap below the subsidy floor.

AHCCCS covers adults up to 138% of the federal poverty level with no premium, and KidsCare extends to children in higher-income households. That is the opposite of Texas and Tennessee, where a working-age adult below the subsidy floor may qualify for nothing at all. Anyone arriving mid-year on a part-year income should apply before assuming they must buy a marketplace plan.

Source: AHCCCS — eligibility

The deductible is what actually shocks people from national health systems.

US plans commonly require you to pay the first several thousand dollars of care each year before the insurer contributes. Someone arriving from the UK, Canada or India reads 'I have insurance' as 'I am covered', then receives a $2,800 bill for a scan. Read the deductible and the annual out-of-pocket maximum before the premium — that is where the plans genuinely differ.

Source: community-reported

Common mistakes to avoid

Ignoring a cough that lasts weeks and never mentioning valley fever to a doctor.
Hiking Camelback or Piestewa mid-morning in summer, which is how the rescue helicopter earns its keep.
Buying a marketplace plan without first checking AHCCCS eligibility.
Missing the 30-day new-hire enrolment window at a new employer.
Choosing a plan on premium alone and meeting a five-figure out-of-pocket maximum.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.