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 rather than premiums alone, and check which Tucson systems each network includes — Banner – University Medical Center, TMC HealthCare, Carondelet and Northwest do not all appear in every plan, and the academic referral hospital is the one you want in network for anything serious.
Via employerWho: YouFirst 30 days of employment
3
Otherwise enrol through HealthCare.gov
Arizona uses the federal marketplace rather than running its own exchange, so the federal calendar applies: 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
Pima County recorded 125 heat-related deaths in 2025 and 146 in 2024. Heat exhaustion — heavy sweating, nausea, cramps, dizziness — becomes heat stroke, a medical emergency, once sweating stops and confusion begins. Pima County and the City of Tucson run a network of cooling centres each summer with published locations, and they are for anyone who needs them, not only the unhoused.
In personWho: You
5
Know what valley fever is before you get a persistent cough
Coccidioidomycosis is a fungal infection caused by inhaling spores from disturbed desert soil, and southern Arizona is its global epicentre. It usually presents as a lingering flu or pneumonia that antibiotics do not touch. Newcomers and dogs are most at risk because long-term residents have often been exposed already. If a cough lasts more than a week, ask 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, and expect new-patient waits — southern Arizona is a designated shortage area for primary care in several ZIP codes, and a federally qualified health centre is the fallback if you cannot find a practice taking patients.
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

Southern Arizona is the world centre of valley fever, and doctors elsewhere will miss it.

Coccidioidomycosis comes from inhaling fungal spores in disturbed desert soil, and Arizona accounts for the large majority of US cases with Pima County among the highest-incidence areas in the state. It presents as a persistent flu or pneumonia that antibiotics do not touch and can take weeks to months to resolve. Newcomers are disproportionately affected because residents often carry immunity. If you travel and fall ill after leaving, say you have lived in southern 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 counted.

The Pima County Office of the Medical Examiner recorded 125 heat-related deaths in 2025 and 146 in 2024. The critical distinction is that heat exhaustion still sweats and heat stroke stops — confusion, hot dry skin and no sweat mean 911, not shade and water. Pima County and the city publish a cooling centre map each summer and visits ran to tens of thousands in 2025, so the capacity exists; the failure is usually not knowing it is there.

Source: Pima County — cooling centres

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 anything. Someone arriving from the UK, Canada or India reads 'I have insurance' as 'I am covered', then receives a four-figure bill for a scan. Read the deductible and the annual out-of-pocket maximum before the premium — that is where 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 Tumamoc, Sabino Canyon or the Catalinas mid-morning in summer.
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.