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Antidote Health Plans in Arizona
2026 ACA individual and family HMO coverage for Maricopa, Pima and Pinal counties. Unlimited $0 telehealth on every Complete and Elite plan, with a focused in-person hospital network.
What Antidote Health is
Antidote Health Plan of Arizona, Inc. is a licensed HMO carrier offering ACA individual and family coverage on the federal marketplace and directly off exchange. Because the plans are ACA-compliant and on exchange, premium tax credits and cost-sharing reductions apply if you qualify based on income.
The model is virtual-first. Every Complete and Elite plan includes unlimited $0 visits with Antidote's own board-certified clinicians, available day or night, and you use a contracted in-person network of doctors, hospitals and facilities for anything a video visit cannot handle. In exchange for a narrower hospital network than the big Arizona carriers, the premiums tend to come in lower. Whether that trade works for you comes down to which hospitals and doctors you actually use, which is why the network table is on this page.
Plan suites and metal levels
Antidote sells four plan suites. Complete, Elite and Standard each come in Bronze, Silver and Gold metal levels. Bronze pays roughly 60 percent of covered costs, Silver roughly 70 percent and Gold roughly 80 percent. If you qualify for extra savings through cost-sharing reductions, those only attach to Silver plans.
Complete
- Unlimited $0 virtual visits with Antidote clinicians
- Four $0 primary care visits per plan year at designated Tier-1 primary care providers
- $0 CoreRx drug list when prescribed by an Antidote virtual provider
- Discounted primary care and specialist copays when referred by an Antidote clinician
Elite
- Everything in Complete
- $0 AdvancedRx drug list, covering 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 rather than applying to your deductible
Standard
- Government-standardized benefit design, which makes it simple to compare against other carriers' Standard plans side by side
- Same low copay whether you see an Antidote virtual provider or an in-network provider, regardless of tier
- Predictable cost sharing across services
Catastrophic
- Low monthly premium with a high deductible
- Three $0 primary care visits per plan year, including Antidote virtual provider visits
- Protection against major unexpected medical bills
- For 2026, eligibility expanded. Adults over 30 who cannot get premium tax credits because their income falls below 100 percent or above 400 percent of the federal poverty level may qualify through a hardship exemption
What every Antidote plan includes
Core coverage
- All 10 ACA essential health benefits, including hospital care, prescriptions, maternity and mental health
- $0 in-network preventive care, including annual check-ups, flu shots and screenings
- Mental health and substance use coverage on every plan
- Emergency balance billing waived at out-of-network facilities
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
- Doctor's notes and prescription services handled in the same place
Chronic condition programs
- Diabetes care
- Hypertension care
- Mental health support inside a primary care setting, including medication management and referrals
- Weight loss program
Pharmacy, dental and vision access
- Pharmacy benefits administered by Navitus, with 24/7 customer care at 844.268.9789 and a published exception-to-coverage process
- Pediatric vision through the VSP directory
- In-network dentists through the HRI Dental directory
- Member portal and app with digital ID card, claims and scheduling
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.
| 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 three-county 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 your own hospital and doctors in Antidote's live provider directory before you enroll.
The honest network trade-off
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
This is not a reason to rule Antidote out. It is a reason to check your own hospital first. Plenty of people in Phoenix and Tucson live closer to an Abrazo or Carondelet campus than anything else, and for them the lower premium is close to free money. If your doctor admits at Banner, it is not.
Who Antidote is best for
Strong fit
- People in Maricopa, Pima or Pinal county who are comfortable starting care on their phone
- Anyone currently uninsured because the premium was the obstacle
- Healthy adults and families whose care is mostly preventive, routine and urgent-care shaped
- Self-employed people, gig workers and early retirees under 65 shopping on the marketplace
- People managing diabetes, hypertension or mental health who want those programs included rather than billed separately
- Anyone whose regular hospital is an Abrazo or Carondelet campus
- Anyone with a maintenance prescription that sits on the CoreRx or AdvancedRx $0 drug list
Poor fit
- Anyone whose hospital or specialist is at Banner, Dignity, Mayo, Phoenix Children's or HonorHealth's north-valley campuses
- People in the middle of active treatment or with an established specialist relationship they will not change
- Families whose children are treated at Phoenix Children's
- Anyone living outside Maricopa, Pima or Pinal county
- People who split their year between Arizona and another state and need in-network care in both
- Anyone who wants a broad national PPO and freedom to self-refer anywhere
How to keep your costs lowest
On a plan like this, the referral path is the whole ballgame. Care that starts with an Antidote virtual clinician is the cheapest route. 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, which your in-network doctor arranges.
Two practical habits cover most of it. Start with the app before you book anywhere else, and confirm tier designation in the provider directory before your first visit with any new doctor.
Enrolling in an Antidote plan
Antidote plans are available on the federal marketplace, where premium tax credits apply, and off exchange. Enrollment is limited to the annual open enrollment period unless you have a qualifying life event such as losing job-based coverage, moving, marriage, divorce or a new baby, which opens a special enrollment period.
We will run your subsidy, compare Antidote against the other Arizona marketplace carriers, and check your specific doctors and hospital against the network before you commit. There is no cost to you for using an agent.
See if Antidote works for your doctors
A licensed Arizona agent will check your hospital, your doctors and your subsidy, at no cost to you.
☎ 855.847.7020Compare 2026 Plans →Have an Agent Call MeSources and last review. Plan suite benefits, metal level definitions, catastrophic eligibility and service area from Antidote Health plan overview, Antidote Health provider search and Antidote Health transparency in coverage. 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.
Related: All Arizona individual carriers · Arizona HSA plans · Antidote group plans for employers