Change Report for Nutrition, Cash, and Medical Assistance Benefits
Reporting certain changes is required when you are eligible for benefits from the following programs:
- Nutrition Assistance (NA)
- Cash Assistance (CA)
- Medical Assistance (MA)
You can report changes in the following ways:
- On-line at Health-e-Arizona Plus (HEAplus) for Medical Assistance
- On-line at MyFamilyBenefits for Nutrition and Cash Assistance
- By calling 1-855-432-7587 or 1-855-HEAplus
- By completing the Change Report form and mailing, faxing, or submitting it to your local DES office:
- Change Report - English (FAA-0412A)
- Change Report - Spanish (FAA-0412A-S)
When do changes need to be reported?
For Nutrition Assistance (NA) and Cash Assistance (CA) (except the Two-Parent Employment Program (TPEP)), you must report the change by the 10th calendar day of the month following the month the change occurred. For Medical Assistance (MA) and TPEP, changes must be reported within 10 calendar days from the date you know about the change. Unanticipated changes must be reported within 10 days of the date the change occurred.
What changes need to be reported?
Nutrition Assistance (NA) and Cash Assistance (CA) (except TPEP) are subject to Simplified Reporting. Medical Assistance (MA) and (TPEP) are assigned to Standard Reporting. Check your approval letter to determine which one you have been assigned.
The following charts can help you remember some of the changes for each program you must report.
| Cash Assistance (CA) (except TPEP) | Nutrition Assistance (NA) |
Medical Assistance (MA) Two Parent Employment Program (TPEP) |
|---|---|---|
|
You need to report changes when: Your total gross income of all persons getting Cash Assistance in your household totals more than 36% of the 1992 Federal Poverty Level, which is anything over the CA payment that you are eligible to receive. When a dependent child moves out of the household or is removed by a government agency. |
You need to report changes when: The total gross income of all persons getting Nutrition Assistance in your household totals more than 130% of the current Federal Poverty Level. All lottery and gambling winnings of $4,500 or more in a single game. (Casinos, Lottery, Bingo, etc). An Able-Bodied Adult Without Dependents (ABAWD) is a person aged 18-54 who is fit for employment and does not have a child. ABAWD participants need to report when their work hours fall below 20 hours per week or less than 80 hours per month. |
Simplified Reporting does not apply to MA or TPEP. See Standard Reporting requirements. |
| Types of Changes to Report | CA, TPEP | MA |
|---|---|---|
| Address Change Moved or relocated to another address |
Yes | Yes |
| Changes in Household Member(s) Someone moved in or out of your household |
Yes | Yes |
| Changes in Marital Status Any member of your household |
No | Yes |
| School Attendance (Ages 6 to 15) | Yes | No |
| School Attendance (16 years and older) | No | Yes |
| Dependent Care Expense (Childcare) | No | No |
| Housing Expense When you have reported a change of address |
Yes | No |
| Income ** Earned income: Self-employment/work wages, etc. Unearned income: Child support, SSI, Retirement, Gift, etc. |
Yes | Yes |
| Resources Examples of resource types, but not limited to: Savings, retirement account, 401K |
Yes | No |
Please note that it helps you to report a change to your mailing address to ensure that you receive information about your renewal.