Arizona Medicaid (AHCCCS) Benefits

AHCCCS is Arizona’s Medicaid Program. It provides health coverage to low-income residents, including children, pregnant women, parents, seniors, and individuals with disabilities.

Medicaid is sometimes referred to by state-specific names. Regardless of the various names, the programs are still Medicaid and are governed by federal Medicaid law and regulations.

Eligibility Requirements

To be eligible for this benefit program, you must be a resident of Arizona, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:*

• Pregnant
• Be responsible for a child 17 years of age or younger
• Have a disability or a family member in your household with a disability

* ACA Medicaid expansion covers eligible low-income adults.

Annual Household Income Limits (before taxes)

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Additional Services for Children Under Age 21

Additional Services for Recipients of Long-Term Care

Copayments

Copays are amounts members pay directly to a provider for each item or service they receive at the time of service. Copays can be mandatory (also known as required) or optional (also known as nominal) as explained below. Certain services and populations are exempt from any copays which means that no mandatory or optional copays will be charged.

Copays are not charged for the following services:

• Family planning services and supplies
• Pregnancy-related health care including tobacco cessation treatment for pregnant women
• Emergency services
• Services paid on a fee-for-service basis
• Preventive services, such as well visits, immunizations, pap smears, colonoscopies, and mammograms
• Provider preventable services

Copays are not charged to the following groups:

• Children under age 19
• People determined to be Seriously Mentally Ill (SMI) by ADHS
• People enrolled in the Arizona Long Term Care System
• People enrolled in the Children’s Rehabilitative Services program
• People eligible as Qualified Medicare Beneficiaries
• People who are acute care members residing in nursing homes or residential facilities
• People who receive hospice care
• People enrolled in the Breast and Cervical Cancer program
• People who are pregnant and throughout the postpartum period following the pregnancy
• American Indian members of the Indian Health Service
• People receiving Title IV-E Adoption Subsidy or Foster Care Assistance
• People receiving Title IV-B Child Welfare Services