Medicaid / AHCCCS

The Arizona Health Care Cost Containment System (AHCCCS) is Arizona's version of Medicaid. This government health insurance program helps certain people get health care services at a lower cost. This includes people who are older, blind, or living with a disability.

What does Arizona AHCCCS / Medicaid cover?

AHCCCS / Medicaid pays for routine and acute health care services such as:

• Visits to health care providers (including physicians and nurse practitioners)

• Inpatient and outpatient hospital services

• Prescription drug coverage (only available in certain cases)

• Lab tests

• X-rays

• Medical transportation

• Nursing home care

• Home health services

• Family planning services

Most states also cover optional services such as:

• Physical, respiratory, and occupational therapy

• Home- and community-based care

• Case management

• Prescription drugs

• Dental and vision care

• Hearing services

• Podiatry services

• Hospice care

Since the program serves those with limited income and resources, people with AHCCCS pay few to no out-of-pocket costs for their benefits. To get coverage once you are enrolled, you must go to health care providers that take part in the AHCCCS program.

How do I know if I qualify for AHCCCS / Medicaid?

You can get help from the AHCCCS program if your income and resources fall below a certain amount. Some resources may not be counted when determining whether you meet the program guidelines. These include your home, car, and certain portions of life insurance and burial accounts.

If you are a U.S. citizen and meet the other AHCCCS guidelines, you may get help from this program. Some people who are not U.S. citizens may also take part in the program. You should contact your local office for more information about AHCCCS citizenship rules.

What are the different AHCCCS / Medicaid programs in Arizona?

You may be able to get AHCCCS health coverage if you fall into one of the following categories.:

Arizona Long-Term Care System (ALTCS)

The Arizona Long-Term Care System (ALTCS) provides health care and support services in a nursing home or other medical institution. In addition to room and board, ALTCS may cover:

• Nursing care

• Rehabilitation services

• Social services

• Medical equipment and supplies

• Prescription medications

• Personal care items such as hair care and clothing

You may be able to get this coverage if you have limited income and resources. You must also have a medical condition that requires the skills of a licensed nurse on a regular basis.

Health Insurance for Working Individuals with a Disability (AHCCCS Freedom to Work)

If you have a disability and are working, the Health Insurance for Working Individuals with a Disability (AHCCCS Freedom to Work) program may provide you with health care benefits. In some situations, working and earning money could prevent you from getting public benefit programs such as Medicaid. AHCCCS Freedom to Work lets you work, keep money in savings, and still get health care coverage. You may have to pay a monthly premium.

How do Medicare and AHCCCS work together?

If you get Medicare, you may also be able to get help from AHCCCS. AHCCCS pays for some services not covered by Medicare such as eyeglasses, hearing aids, and dental care. It also pays for some Medicare co-payments and deductibles.

Also, if you enroll in both Medicare and AHCCCS, you will be signed up for the Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with low income pay for their medicines.

If you have Medicare and AHCCCS, you can get your coverage through a Medicare Advantage Special Needs Plan (SNP). This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from original Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.

Note: SNPs are not available in every community. To find out if there is an SNP in your area, visit the Medicare website or call 1-800-633-4227 or 1-877-486-2048 (TTY)

How do I prepare to apply for AHCCCS / Medicaid in Arizona?

When you apply for AHCCCS, you’ll be asked for important information to help determine if you qualify for benefits.

Before you start, gather some basic information to make your application process easier:

• A document that shows your age, such as your birth certificate or driver’s license

• Your Social Security card

• Pay stubs for anyone in your household who has earned income

• Documentation that shows any other form of income, such as letters from Veterans Affairs (VA) or the Social Security Administration (SSA)

• Information about your financial assets, such as bank account or investment account statements

How do I apply for AHCCCS / Medicaid in Arizona?

There are a few different ways you can apply for AHCCCS. Read below to learn more about which option might be right for you.

Apply Online

The quickest and easiest way to apply for AHCCCS is online through the Health-e- Arizona Plus website. All your personal information is kept 100% confidential and protected by special security technology.

Apply through Health-e- Arizona Plus

Apply by Phone, Mail, or in Person

• To apply by phone, call DES at 1-855-432-7587 or contact a Community Assistor near you.

• To apply by mail, print and fill out the application form and mail it to your local DES office.

• You can also visit your local DES office in person. Find your local office here.

How can I get help with my AHCCCS / Medicaid application?

There are a few ways to get help filling out your AHCCCS application:

• Contact your local DES office.

• Call DES Customer Service at 1-855-432-7587.

• Find a Community Assistor near you.

• Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.

NCOA also has a HelpLine you can call to get free support. To get started today, call [1-800-794-6559](tel:1-800-794-6559).