Antidote Health Group Plans in Arizona

A virtual-first HMO built for small Arizona employers in Maricopa and Pima counties. Unlimited $0 telehealth, a focused Tier-1 hospital network, and setup in under two weeks.

Plan typeVirtual-first HMO

Group size2 to 50 employees

Group service areaMaricopa & Pima

Plan year2026

What Antidote Health is

Antidote Health Plan of Arizona, Inc. is a licensed HMO carrier writing small group coverage for Arizona employers with 2 to 50 employees, plus ICHRA and individual ACA plans. The model is virtual-first: every plan includes unlimited $0 visits with Antidote's own board-certified clinicians, day or night, and members use an in-person network of contracted doctors, hospitals and facilities for everything telehealth cannot handle.

This is a genuinely different design from a Blue Cross or UnitedHealthcare group plan. The network is deliberately narrow and the telehealth benefit is deliberately rich. For the right employer that trade produces a meaningfully lower premium. For the wrong employer it produces disruption. The hospital table further down this page is the fastest way to tell which one you are.

Plan suites available

Antidote sells four plan suites. Complete, Elite and Standard each come in Bronze, Silver and Gold metal levels.

Complete

Unlimited $0 virtual visits with Antidote clinicians
Four $0 primary care visits per plan year at designated Tier-1 PCPs
$0 CoreRx drug list when prescribed by an Antidote virtual provider
Discounted PCP and specialist copays when referred by an Antidote clinician

Richest benefits

Elite

Everything in Complete
$0 AdvancedRx drug list, which covers the CoreRx list plus additional medications regardless of who prescribes them
$0 labs when referred by an Antidote virtual provider
Physical, occupational and speech therapy paid by copay instead of applying to the deductible

Standardized

Standard

Government-standardized benefit design, so it lines up cleanly against other carriers' Standard plans
Same low copay for Antidote virtual providers and in-network providers, regardless of provider tier
Predictable cost sharing across services

Individual only

Catastrophic

Low premium, high deductible safety net
Three $0 primary care visits per plan year, including Antidote virtual provider visits
For 2026, adults over 30 who are ineligible for premium tax credits may qualify through a hardship exemption
Not a small group option. Listed here for completeness

Value adds worth quoting on

Unlimited $0 telehealth

No visit cap and no copay for virtual visits with Antidote clinicians on Complete and Elite plans
Primary care, urgent care, mental health, prescriptions and refills
Appointments typically available within 60 minutes, though not guaranteed
For a workforce that currently skips care over a $40 copay, this is the benefit that moves utilization

Integrated chronic condition programs

Diabetes care
Hypertension care
Mental and behavioral health, including medication management and referrals
Weight loss program
Delivered inside the plan rather than as a bolt-on vendor, so there is no separate contract or fee

Pharmacy

$0 CoreRx drug list on Complete plans when prescribed by an Antidote clinician
$0 AdvancedRx drug list on Elite plans regardless of prescriber
Pharmacy benefit manager is Navitus, with 24/7 customer care and a published exception-to-coverage process

Employer administration

Setup in under two weeks
Simple online employee enrollment
ACA-compliant coverage that satisfies the employer offer
Member portal and app with digital ID cards, claims and scheduling
ICHRA available as an alternative if you would rather fund employee choice than sponsor a group plan

Antidote is the only Arizona carrier that covers Ozempic without prior authorization

We pulled all seven Arizona carriers' 2026 drug lists as filed with CMS and compared them drug by drug. Every carrier covers Ozempic. Six of the seven make your doctor get approval first. Antidote does not.

2026 Arizona carrier	Covers Ozempic	Prior authorization required
Antidote Health	Yes	No
Blue Cross Blue Shield of Arizona	Yes	Yes
Ambetter	Yes	Yes
Oscar Health	Yes	Yes
UnitedHealthcare	Yes	Yes
Cigna	Yes	Yes
Imperial	Yes	Yes

The same pattern holds across the whole class. Rybelsus, Mounjaro and Trulicity are all covered by Antidote with no prior authorization, while every other Arizona carrier requires it on all three.

The honest trade-off: Antidote applies step therapy instead. That means you may need to try a preferred alternative first and have it not work for you. You are swapping an approval process your doctor has to fight for a treatment sequence you have to follow. For many people that is the better deal, but it is not nothing, and it is worth knowing before you enrol rather than at the pharmacy counter.

Two more places Antidote comes out ahead in the filings: it is the only Arizona carrier listing insulin glargine with no prior authorization, no step therapy and no quantity limit, and the only one listing Eliquis with no quantity limit.

Source: each Arizona issuer's machine-readable formulary filed with CMS for plan year 2026, retrieved August 2026, across 1,010 individual medical plans. See the full comparison in our Arizona drug coverage guide.

Arizona hospitals in the Antidote network

The table below lists every hospital and acute facility filed in Antidote Health Plan of Arizona's machine-readable provider directory for the 2026 plan year. Every facility in the directory is filed at the Tier-1 network level. Facilities are grouped by county.

County	Facility	Address	City	Type
Maricopa	Abrazo Arizona Heart Hospital	1930 E Thomas Rd	Phoenix	Specialty hospital
Maricopa	Abrazo Arrowhead Campus	18701 N 67th Ave	Glendale	Acute care
Maricopa	Abrazo Arrowhead Campus	16815 W Bell Rd	Surprise	Acute care
Maricopa	Abrazo Central Campus	2000 W Bethany Home Rd	Phoenix	Acute care
Maricopa	Abrazo Scottsdale Campus	3929 E Bell Rd	Phoenix	Acute care
Maricopa	Abrazo West Campus	13677 W McDowell Rd	Goodyear	Acute care
Maricopa	Abrazo Peoria Emergency Center	26900 N Lake Pleasant Pkwy	Peoria	Freestanding ER
Maricopa	Arizona Specialty Hospital	750 N 40th St	Phoenix	Specialty hospital
Maricopa	Arizona Spine and Joint Hospital	4620 E Baseline Rd	Mesa	Specialty hospital
Maricopa	Wickenburg Community Hospital	520 Rose Ln	Wickenburg	Acute care
Pima	St. Mary's Hospital (Carondelet)	1601 W Saint Marys Rd	Tucson	Acute care
Pima	St. Mary's Hospital Inpatient Rehab	1601 W Saint Marys Rd	Tucson	Inpatient rehab
Pima	Bridges Geropsychiatric Program at St. Mary's Hospital	1601 W Saint Marys Rd	Tucson	Behavioral health
Pima	Carondelet Marana Hospital	5620 W Cortaro Farms Rd	Tucson	Acute care
Pima	Carondelet St. Joseph's Hospital and Behavioral Health	350 N Wilmot Rd	Tucson	Acute care
Pima	Carondelet St. Raphael's Emergency Center	7401 S Wilmot Rd	Tucson	Freestanding ER
Pima	Tucson Medical Center Rincon Hospital	5755 S Houghton Rd	Tucson	Acute care
Pima	La Frontera Psychiatric Health Facility	1601 E Apache Park Pl	Tucson	Behavioral health
Pinal	HonorHealth Florence Medical Center	4545 N Hunt Hwy	Florence	Acute care

Carondelet Holy Cross Hospital in Nogales, Santa Cruz county, is also in the network but sits outside the group service area. Hospital list compiled from Antidote Health Plan of Arizona's CMS-filed machine-readable provider directory for plan year 2026, retrieved August 2026. Networks change during the plan year. Always confirm a specific facility in Antidote's live provider directory before enrolling.

Read this before you quote it

Antidote's Arizona hospital network is essentially the Tenet Arizona system, meaning the Abrazo hospitals in metro Phoenix and the Carondelet hospitals in Tucson, plus Wickenburg Community Hospital, HonorHealth Florence Medical Center and Tucson Medical Center Rincon.

Banner Health hospitals are not in the directory
Dignity Health and CommonSpirit hospitals, including St. Joseph's Phoenix, Chandler Regional and Mercy Gilbert, are not in the directory
Mayo Clinic is not in the directory
Phoenix Children's is not in the directory
HonorHealth's Scottsdale, Deer Valley and John C. Lincoln campuses are not in the directory. Only the Florence Medical Center appears
Tucson Medical Center's main hospital is not in the directory. Only TMC Rincon appears
Valleywise Health Medical Center is not in the directory, though Valleywise clinics and behavioral health centers are

For a lot of Arizona employees, Banner is the default. If your census is concentrated around a Banner or Dignity campus, or anyone has an established specialist there, Antidote will create real disruption no matter how good the premium looks. We will run the disruption analysis against your actual census before you take this to your employees.

Who Antidote is best for

Strong fit

Small Arizona employers, roughly 2 to 50 lives, based in Maricopa or Pima county
Businesses currently offering nothing, where the alternative is no coverage rather than a richer plan
Young, healthy, largely well workforces whose care is routine, episodic and urgent-care shaped
Employers whose people already live on their phones, such as restaurants, retail, trades, logistics and remote teams
Companies where the budget is the binding constraint and premium is the deciding factor
Employers with chronic-condition exposure who want diabetes, hypertension and mental health programs built into the plan instead of purchased separately
Employees who use the Abrazo or Carondelet systems already

Poor fit

Any census concentrated around Banner, Dignity, Mayo or HonorHealth's north-valley campuses
Employees with ongoing specialist relationships or an active course of treatment
Families with children who use Phoenix Children's
Employers outside Maricopa and Pima county for group coverage
Groups over 50 employees
Executive or professional-services teams who expect a broad national PPO and will read a narrow HMO as a benefit cut
Anyone who travels heavily for work and needs out-of-area in-network access

How the tiers and referrals actually work

Antidote files its Arizona network at the Tier-1 level, and its plan documents describe Tier-1 and Tier-2 provider designations that drive copays. The practical rule for employees is that care routed through an Antidote virtual clinician is the cheapest path. A referral from an Antidote clinician can make a primary care visit $0 regardless of the provider's tier, while self-referring means the standard Tier-1 or Tier-2 copay applies. Specialist copays are discounted based on tier. Inpatient hospital care other than maternity requires prior authorization.

This matters for employee communications. A plan like this underperforms when nobody explains the referral path at open enrollment, and outperforms when they do. We build that into the enrollment materials.

Getting a quote

Antidote small group quotes run through the carrier's broker channel. Send us your census, the ZIP codes your employees actually live in, and your current plan and rates if you have them. We will come back with Antidote alongside the other Arizona small group carriers we represent, plus a disruption read on the hospital network against your specific census, so you are comparing more than a premium.

Should your Arizona business look at Antidote?

A licensed Arizona group specialist will tell you honestly whether the network works for your census, at no cost.

☎ 855.847.7020 Get Group Quotes →Have an Agent Call Me

Sources and last review. Plan suite benefits, service area and employer program details from Antidote Health plan overview and Antidote Health for employers. Hospital network compiled from Antidote Health Plan of Arizona's CMS-filed machine-readable provider directory for plan year 2026. Antidote member services 888.623.3195. Page last reviewed August 2026 by Arizona Health Agents. This page is a summary and does not replace the plan's Evidence of Coverage or Summary of Benefits and Coverage.