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AHCCCS Health Insurance Frequently Asked Questions

What if I need help with the application process?

If you need assistance, please contact DES.

You can also contact Community Assistors which help people complete and submit their Medical Assistance application.  They will also help you understand eligibility rules and what may be required of you to participate in the program.  Once your application is submitted, the Community Assistor may also help you get and submit verification documents (for example: pay stubs, proof of citizenship or legal resident status, etc.).  Some Assistors will be available to guide you through the entire process, and others will provide you with access to computers, scanners, telephones, copy machines and/or fax machines that you can use for free.

You can find a Community Assistor in your ZIP Code on the Get Help screen of Health-e-Arizona Plus. Also, many SNAP Community Partners are also Community Assistors that can help you apply for Medical Assistance.

It is recommended that you call the Assistor/Partner before visiting to make sure they offer the service you need and to make an appointment, if needed.

Are there any costs or fees that I need to pay for Medical Assistance?

There are no fees for applying for medical assistance. 

Some medical assistance programs may require the participant to make a co-payment when receiving medical services. Some co-payments are mandatory; the medical provider may not provide service if the mandatory co-payment is not paid. However, if you do not have mandatory co-payments the provider may ask for the co-payment, but cannot deny service when you are unable to pay.  You will receive a letter indicating whether you have mandatory co-payments. The letter also includes the services which require co-payment and amount of the co-payment. The co-payment may be waived by the medical provider.

The KidsCare program requires payment of monthly premiums. If you need to pay a premium, AHCCCS will send a letter to you before your first premium is due.

When does my Medical Assistance coverage start?

Coverage for Medical Assistance in most cases begins the first day of the month that you are found eligible.  The 'start date' will show on the Medical Assistance decision letter for each person who applied.

What kind of medical expenses are covered under my AHCCCS health plan?

You can find the information on AHCCCS Covered Medical Services.

Where do I find information about health plans?

Go to AHCCCS Available Health Plans to find information about health plans, to pre-enroll, or to change enrollment in your anniversary month.  You can also call (855) 432-7587 if you need health plan enrollment information.

Once eligible, AHCCCS will send an AHCCCS ID Card with health plan information for each eligible person in your household.

What if I already have medical bills?

If you have medical bills from up to 3 months before you applied for Medical Assistance, indicate this on your application and/or contact AHCCCS as soon as possible to discuss Prior Quarter Coverage.  Medical bills prior to 3 months before you apply cannot be used.

What if my earnings increase?

When families are eligible for AHCCCS Health Insurance and an increase in their earnings cause them to no longer be eligible for family coverage, they may be eligible for AHCCCS Health Insurance under Transitional Medical Assistance. Do not voluntarily withdraw from AHCCCS Health Insurance just because your earnings increase.  Medical coverage may continue for up to 12 months when: 

  • Your family received AHCCCS Health Insurance benefits in Arizona in three of the last six months; AND
  • The person working is the parent or other relative caring for a minor child in the home. Please note that you must let DES know if your earnings increase by reporting a change. This will allow your eligibility for continued medical assistance to be decided under Transitional Medical Assistance.

Your family's eligibility for Transitional Medical Assistance coverage must be reviewed every six months. You must keep proof of your income and child care expenses over the six-month period and give it to DES at your review. Contact your local DES office for more information.

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