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DDD Health Plans Information

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DDD Health Plans

The Division of Developmental Disabilities, through a contract with the Arizona Health Care Cost Containment System (AHCCCS), offers health care coverage to members who are eligible for the Arizona Long Term Care System (ALTCS). This coverage includes physical health services, behavioral health services, Children’s Rehabilitative Services (CRS) and limited Long Term Services and Supports (LTSS). Mercy Care and UnitedHealthcare Community Plan (UHCCP) provide the DDD Health Plans effective October 1, 2019.

Mercy Care and UHCCP can provide services to members statewide.

All LTSS are provided by DDD contracted qualified vendors and specialty contractors except nursing facilities, augmentative and alternative communication (AAC) devices, emergency alert system services and habilitative physical therapy for members age twenty-one (21) and over. These LTSS will be provided by the member's DDD Health Plan.

Learn About DDD Eligibility

Changing DDD Health Plans

Newly enrolled members can change their assigned DDD Health Plan within 30 days of enrollment. Current members can change DDD Health Plans every 12 months during their birth month. You will receive a notification from DDD 60 days before your annual enrollment choice date. You can request to change your DDD Health Plan anytime, but you will not be transferred to the new DDD Health Plan until the first day of your birth month. Members interested in changing their DDD Health Plan should contact their Support Coordinator or DDD Member Services at 1-844-770-9500 ext. 7.

DDD Health Plan contact details are as follows.

Mercy Care Contacts and Resources

Toll Free: 1 (800) 624-3879 (TTY/TDD 711)

Mercy Care Website

Address: 4750 S 44th Place, Suite 150, Phoenix, AZ 85040

24-Hour Nurse Line: 1 (800) 624-3879 (TTY/TDD 711) or (602) 263-3000 option 2

Children's Services Liaison:

Tribal Liaison

Tribal Relations Administrator

Member Liaison

Behavioral Health Coordinator

Resources

UnitedHealthcare Community Plan Contacts and Resources

Toll Free: 1 (800) 348-4058 (TTY/TDD 711)

UnitedHealthcare Community Plan Website

Address: 1 East Washington, Suite 900, Phoenix, AZ 85004

24-Hour Nurse Line: 1 (877) 440-0255 (TTY/TDD 711)

UHCCP DDD Liaisons General Email

Children's Services Liaison:

Indigenous Relations Liaison

Clinical Tribal Coordinator

Care Management Referrals

Member Liaisons

Behavioral Health Coordinator

Resources

DDD Tribal Health Program (THP) Contacts and Resources

Toll Free: 1 (844) 770-9500 option 7 (TTY/TDD 711)

DDD Tribal Health Program

The DDD Tribal Health Program is a fee-for-service program that allows eligible members to receive services at any AHCCCS registered fee-for-service provider in Arizona that sees fee-for-service THP members.

Address: 1789 W Jefferson, Phoenix, AZ 85042

24-Hour Nurse Line: (480) 267-7267

Tribal Health Services Coordinator

Tribal Nurse Liaison

Resources

Other Information

AHCCCS Drug List Effective April 1, 2026

Physical Health Care Services

Individuals eligible for the Arizona Long Term Care System (ALTCS) can receive physical health services through their DDD Health Plan or the Tribal Health Program. Available services include:

Service Title 19 Service Available to Members Under Age 21 Title 19 Service Available to Members Age 21 & Over
Audiology Yes Yes
Breast Reconstruction after Mastectomy Yes Yes
Chiropractic Services Yes Yes
Cochlear Implants Yes No
Diagnostic Testing Yes Yes
Emergency Dental Services Yes Yes
Preventive & Therapeutic Dental Services Yes Yes
Limited Medical and Surgical Services by a Dentist No Yes
Dialysis Yes Yes
Emergency Services-Medical Yes Yes
Emergency Eye Exam Yes Yes
Vision Exam/Prescriptive Lenses Yes Yes
Lens Post Cataract Surgery Yes Yes
Treatment for Medical Conditions of the Eye Yes Yes
Health Risk Assessment & Screening Tests No Yes
Preventive Examinations in the Absence of any Known Disease or Symptom Yes Yes
HIV/AIDS Antiretroviral Therapy Yes Yes
Home Health Services Yes Yes
Hospice Yes Yes
Hospital Inpatient Medical Yes Yes
Hospital Observation Yes Yes
Hospital Outpatient Medical Yes Yes
Hysterectomy (medically necessary) Yes Yes
Immunizations Yes Yes
Laboratory Yes Yes
Maternity Care Services Yes Yes
Family Planning Services and Supplies Yes Yes
Early and Periodic Screening, Diagnosis and Treatment (Health Services) Yes No
Other Early and Periodic Screening, Diagnosis and Treatment Services Covered by Title XIX Yes No
Medical Foods Yes Yes
Medical Equipment and Appliances Yes Yes
Medical Supplies Yes Yes
Prosthetic Yes Yes
Orthotic Devices Yes Yes
Negative Pressure Wound Therapy Yes Yes
Nursing Facilities (up to 90 days) Yes Yes
Non-Physician First Surgical Assistant Yes Yes
Physician Services Yes Yes
Foot and Ankle Services* Yes Yes
Prescription Drugs Yes Yes
Primary Care Provider Services Yes Yes
Private Duty Nursing Yes Yes
Radiology and Medical Imaging Yes Yes
Occupational Therapy – Inpatient Yes Yes
Occupational Therapy – Outpatient Yes Yes
Physical Therapy – Inpatient Yes Yes
Physical Therapy – Outpatient (See policy regarding visit limitations) Yes Yes
Sleep Studies (Polysomnography) Yes Yes
Speech Therapy – Inpatient Yes Yes
Speech Therapy – Outpatient Yes Yes
Respiratory Therapy Yes Yes
Total Outpatient Parenteral Nutrition Yes Yes
Non-Experimental transplants approved for Title XIX Reimbursement (See policy regarding specific Transplant Coverage) Yes Yes
Transplant Related Immunosuppressant Drugs Yes Yes
Transportation – Emergency Yes Yes
Transportation – Non-emergency Yes Yes
Triage Yes Yes
Women’s Preventive Care Services Yes Yes

Behavioral Health Care Services

Individuals eligible for the Arizona Long Term Care System (ALTCS) can receive behavioral health services through their DDD Health Plan or the Tribal Health Program. Available services include:

  • Adult Behavioral Health Therapeutic Homes
  • Behavior Analysis Services
  • Behavior Management (personal care, family support/home care training, peer support)
  • Behavioral Health Case Management Services (with limitations)
  • Behavioral Health Residential Facility
  • Crisis Intervention Services
  • Emergency Behavioral Health Care
  • Emergency and Non-Emergency Transportation
  • Evaluation and Assessment
  • Individual, Group and Family Therapy, and Counseling
  • Inpatient Hospital Services
  • Intensive Outpatient and Behavioral Health Day Programs
  • Non-Hospital Inpatient Psychiatric Facilities
  • Laboratory and Radiology Services for Psychotropic Medication Regulation and Diagnosis
  • Opioid Agonist Treatment
  • Partial Care (supervised day program, therapeutic day program, and medical day program)
  • Permanent Supportive Housing
  • Psychotropic Medication Adjustment and Monitoring
  • Rehabilitation Services (living skills training; health promotion; supported employment services)
  • Respite Care (with limitations)
  • Rural Substance Abuse Transitional Agency Services
  • Screening
  • Therapeutic Foster Care

Behavioral Health Residential Facility Medical Necessity Criteria

If a member has a diagnosed behavioral health condition that reflects the symptoms and behaviors necessary for a request for residential treatment level of care, the behavioral health condition causing the significant functional and/or psychosocial impairment shall be evidenced in the assessment by the following:

  1. At least one area of significant risk of harm within the past three months as a result of:
    • Thoughts or behaviors of suicide, homicide, or harm to self or others,
    • Impulsivity with poor judgment/insight,
    • Maladaptive physical or sexual behavior,
    • Inability to remain safe within environment despite environmental supports (i.e. informal supports), AND
  2. At least one area of serious functional impairment as evidenced by:
    • Inability to complete developmentally appropriate self-care or self-regulation due to member’s behavioral health condition(s);
    • Neglect or disruption of ability to attend to majority of basic needs, such as personal safety, hygiene, nutrition or medical care;
    • Frequent inpatient psychiatric admissions, or legal involvement due to lack of insight or judgment associated with psychotic or affective/mood symptoms or major psychiatric disorders,
    • Frequent withdrawal management services, which can include but are not limited to, detox facilities, MAT, and ambulatory detox;
    • Inability to independently self-administer medically necessary psychotropic medications despite interventions such as education, regimen simplification, daily outpatient dispensing, and long-acting injectable medications; or
    • Impairments persisting in the absence of situational stressors that delay recovery from the presenting problem.
  3. A behavioral health need for 24-hour supervision to develop adequate and effective coping skills that will allow the member to live safely in the community,
  4. Anticipated stabilization cannot be achieved in a less restrictive setting;
  5. Evidence that behavioral health treatment in a less restrictive level of care (e.g., Intensive Outpatient Program (IOP), partial hospitalization program, etc.) has not been successful, is not clinically appropriate, or is not available, therefore warranting a higher level of care.
  6. Member or Guardian agrees to participate in treatment. In the case of those who have a Health Care Decision Maker (HCDM), including minors, the HCDM also agrees to, and participates as part of, the treatment team;
  7. Agreement to participate in treatment is not a requirement for individuals who are court-ordered to a secured BHRF,
  8. Member’s outpatient treatment team, shall be part of the pre-admission assessment and treatment plan formulation, including when the documentation is created by another qualified provider. Exception to this requirement exists when the member is evaluated by the Crisis provider, Emergency Department, or Behavioral Health Inpatient Facility,
  9. The BHRF shall notify the member’s outpatient treatment team, including the TRBHA for members assigned to a TRBHA for their behavioral health enrollment, of admission prior to creation of the BHRF treatment plan.

Behavioral Health Crisis Services

Suicide and Crisis Hotlines

See all behavioral crisis lines including national, county, and TRBHA contacts on the AHCCCS website.

Additional Crisis Services

Mobile teams staffed by behavioral health professionals who travel to the individual experiencing a crisis and provide assessment, stabilization and may triage the individual to a higher level of care, as appropriate are available 24/7.

Facility-based crisis stabilization centers are also available that offer crisis stabilization and observation, including access to Medication Assisted Treatment (MAT) and drug detoxification.

Visit your DDD Health Plan’s website or call their Member Services unit to locate a provider near you.

Prior Authorization

DDD provides health care coverage to members who are eligible for the Arizona Long Term Care System (ALTCS) through a contract with the Arizona Health Care Cost Containment System (AHCCCS).

Members can receive physical and behavioral health services as well as Children’s Rehabilitative Services (CRS) from their DDD Health Plan. Certain long-term services and supports are also provided by the DD Health Plan. Currently, these DD Health Plans are Mercy Care or UnitedHealthcare Community Plan.

Members receiving services from Mercy Care or UnitedHealthcare Community Plan can learn more about the prior authorization requirements for each health plan online or by calling the Health Plan’s member services.

Mercy Care Prior Authorization Requirements

UnitedHealthcare Prior Authorization Requirements

In addition, American Indian/Alaska Natives have the option to receive services through the DDD Tribal Health Program. Prior Authorization requirements for members using the Tribal Health Program are available on the AHCCCS website.

Need for the following services are driven by the planning process, identifying goals, outcomes, exhausting natural and community supports and funding availability. The amount of service is individually determined by the planning process and based on need. This document is not intended to reflect an individual’s service level minimum and/or maximum.

Learn more about the following services in the DES/DDD Arizona Long Term Care System (ALTCS) Member Handbook.

You may also contact your assigned DDD Support Coordinator or the DDD Customer Service Center for more information.

Prior Authorization Requests Data

DDD Health Plan Data

Most health plans require a doctor to ask if certain things will be paid for before providing certain care. A person’s doctor decides if they need a specific service. Then, the doctor sends a request and the person’s medical records to the health plan. The health plan reviews the records to see if the service is truly needed or medically necessary. Based on that review, the health plan says "yes" or "no" to approving the request. This is called prior authorization.

DDD handles home and community based services (HCBS) authorizations differently from how most doctors get permission. DDD uses a "person-centered" approach. This means DDD members and their planning teams get to make choices about their lives. These choices help members reach their goals and stay active in the world. Every member works with a DDD Support Coordinator and has a planning team. Members and their families choose who is on the planning team. They can invite friends, caregivers or other family members.

The Support Coordinator leads the Person Centered Service Plan meeting, which the planning team attends. At the meeting, everyone shares information. The Support Coordinator assesses which medically necessary HCBS the member needs and creates or updates the service plan. The authorized services are agreed upon during the meeting. Once the plan is completed, the Support Coordinator authorizes the services. A Notice of Adverse Benefit Determination (NOA) is sent to the member and/or health care decision maker when a service is denied. This will explain why a service was denied and how they can appeal the decision.

As a result of the Person Centered Planning meeting process, DDD's data may look different from that of other health plans.

Division Home and Community Based Services (HCBS) Prior Authorization Request Data
Determination How Many times this happened Out of total requests Percentage
Request approved 234,120 234,263 99.939%
Request denied (Notice of Adverse Benefit Determination [NOA] issued) 143 234,263 0.061%
Request approved only after appeal 15 36 41.67%
Request approved only after time for review was extended 26 234,263 0.08%
Request for expedited prior authorization that was approved 0 0 0.00%
Request for expedited prior authorization that was denied 0 0 0.00%
DDD HCBS time between receiving a prior authorization request and a determination
Request Type Mean (Average) Time Median (Middle) Time
Standard (non-urgent) Prior Authorization Requests (response due to provider within 7 calendar days)  0.022 days 0.00 days
Expedited (urgent) Prior Authorization Requests (response due to provider within 72 hours) 0 days 0 days

DDD Home and Community Based Services Requiring Prior Authorization

  • Attendant Care
  • Habilitation
  • Day Treatment & Training Adults
  • Day Treatment & Training Children
  • Habilitation Related Services
  • Habilitation, Communication
  • Housekeeping
  • Respite
  • Employment Related Services
  • Non-emergent Transportation
  • Long-term Out of Home Placements (Adult and Child)
  • Therapy (speech, occupational, physical)

Augmentative and Alternative Communication (AAC)

Understanding DDD's AAC Program

The Division of Developmental Disabilities (DDD) works with the Arizona Health Care Cost Containment System (AHCCCS). They help people who are part of the Arizona Long Term Care System (ALTCS) by giving them healthcare coverage. This includes special services, tools, and extras for Augmentative and Alternative Communication (AAC).

These DDD Health Plans Cover AAC Supplies and Services

  1. Mercy Care Plan (MCP)
  2. United Health Care Community Plan (UHCCP)
  3. AHCCCS DFSM for enrolled Tribal Health Plan Members

What is AAC?

AAC Systems are special methods used when regular talking isn't enough for everyday chatting and needs. There are two main types:

  • Augmentative: This is when you can still talk but use AAC to help.
  • Alternative: This is when you can't talk at all, and AAC replaces speech.

Types of AAC

  1. Unaided AAC: This doesn't need any tools or gadgets. It's things like gestures or sign language. You need to be able to move your body to use it.
  2. Aided AAC: This type needs tools or technology.
    1. Non-technology: These are simple things like boards or books with pictures. You point to these pictures to show what you mean.
    2. Technology-based: These are more advanced and use special devices or software. They can show messages on a screen or even speak out loud. There are two main kinds:
    3. Speech-Generating Devices (SGDs): These special machines talk for you. You can choose what to say using buttons or a screen. SGDs can either use recorded messages or create new words on their own.
    4. Mobile AAC Technologies: These apps or programs let computers or tablets speak for you.

Getting AAC Through DDD

Who Can Get It: The DDD offers AAC tools to people of all ages if they're needed for their health.

How It Works: Sometimes, there are limits to how much, or what kind, of AAC you can get. But if it's needed to make your health better or stop it from getting worse, these limits might not apply, especially for people under age 21.

How to Start the AAC Process?

  1. Get a Prescription: Get a prescription for an AAC evaluation from your primary doctor. It will be valid for one year.
  2. Find a Speech Language Pathologist (SLP): Not all SLPs can do AAC evaluations. You can find an SLP that does evaluations by:
    1. Asking your DDD Support Coordinator, UHCCP’s member services, or UHCCP DD liaisons for help finding a licensed SLP. For Mercy Care, you can contact member services for this information. Or, you can use UHCCP’s or Mercy Care’s website to find one yourself.
    2. Contact AHCCCS DFSM member services for this information. Or, you can use AHCCC DFSM’s website to find one yourself.
  3. Schedule an Evaluation: After picking an SLP, call them to set up your evaluation.
  4. Get Approval: The SLP needs to get permission (Prior-Authorization) from your health plan. The SLP will send your information to the health plan for you.
  5. Appointment Time: You should get your evaluation within 45 days of asking for it.
  6. Approval Wait Time: The health plan should decide on your evaluation within 14 days.
  7. If Approved: The SLP will call you to schedule the evaluation.
  8. If Not Approved, you'll receive a Notice of Adverse Benefit Determination (NOA) explaining the decision and detailing your appeal rights..

What Happens During the AAC Evaluation?

  1. Choosing Devices: Before your visit, the SLP picks out some AAC devices for you to try.
  2. Trying Devices: Up to three devices can be tried during the evaluation. Other therapists, like occupational therapists or physical therapists, may be present and make a recommendation based on their skill area.
  3. Device Trial: You can choose a device to try at home for 30 days. The SLP will help make sure it works for you.
  4. Final Decision: If a device works well, the SLP sends a report to your doctor for their signature.

What Happens After the AAC Evaluation?

  1. Doctor’s Approval: After your doctor signs off on the device and training sessions, the SLP will ask your health plan for permission to get it for you. This will happen within 20 days of your evaluation.
  2. Submitting for Approval: They will send all the important information and a list of things you need with the device.
  3. Approval Wait Time: The health plan will make a decision within 14 days.
  4. If Approved: If yes, your device, training, and accessories will be ordered.
  5. If Not Approved: You'll receive a Notice of Adverse Benefit Determination (NOA), explaining the decision and your appeal rights.

How Will You Receive the Device?

Delivery and Training: The device is delivered to your home. The SLP who completed your AAC device evaluation will contact you to plan your training sessions once you receive the AAC device. These sessions are for setting up the device and making any changes so it works best for you. They will be scheduled within 90 days after approval. You can contact the SLP for assistance if needed.

What Accessories May Come with an AAC System?

  1. Selection Devices: Things like optical head pointers, joysticks, and scanning devices to choose letters, words, or symbols.
  2. Switches and Buttons: For members who have trouble moving their arms or head.
  3. Head Control Devices: Laser or infrared pointers for those who can't use their hands but can move their head.
  4. Software: Special programs for the AAC device.
  5. Device Case: To protect the AAC device.
  6. Batteries and Charger: To power the device.
  7. Power Supplies and Cables: For connecting and powering the device.
  8. Sensors and Moisture Guard: To keep the device safe and working.
  9. Adapters: For electrical connections.
  10. Memory: Enough storage for at least three years.
  11. Mounting Systems: To attach the AAC device to a wheelchair or table if needed.
  12. Warranty: An extended warranty from the manufacturer.

What is Not Included with the AAC System?

  1. Computers, PDAs, or non-dedicated AAC devices.
  2. Items not needed for the AAC system, like printers or internet routers.

What if the AAC System Needs a Repair?

  1. Approval Needed: Your health plan needs to approve all repairs.
  2. One Repair Per Year: All health plans for DDD members cover one repair yearly unless the device is under warranty.
  3. Warranty Check: You can ask your DDD Support Coordinator or the DDD Health Plan who gave you the device if it’s under warranty.
  4. Warranty Assistance: If under warranty, the health plan helps you return the device.
  5. No Coverage for Lost Information: Your health plan won’t cover lost or deleted applications if you forget your username and password.

What if You Need an AAC Replacement?

  1. Life Expectancy: The device and accessories should last up to 36 months.
  2. Replacement Conditions: You might get a new one if:
    1. It’s lost or damaged beyond repair.
    2. It’s been three years, and the device doesn’t work anymore.
    3. Your medical needs change.
    4. The device isn’t helping you, even after training.
    5. The manufacturer says it can’t be fixed.
    6. The original accessories are damaged or worn.
    7. If lost or stolen, you need a police report or a "Find My iPad" report (for iPads).
  3. Who to Contact: You can ask your DDD Support Coordinator or contact the DDD Health Plan for any questions about the replacement process.

What if You Need a Re-Evaluation or Changes to the Device?

Re-evaluation may be necessary if your communication needs change, the device doesn't effectively support your communication, or the device isn’t meeting your needs. Approval may be required. Contact your original SLP or DDD Support Coordinator for guidance.

  • Conditions for Re-Evaluation:
    • After three months of training.
    • If your medical condition changes.
    • If the device isn’t meeting your needs.
  • Getting Approval: You might need approval for a re-evaluation. Contact your original SLP or ask your DDD Support Coordinator for help.

For more information about AAC, please contact your DDD Health Plan.

  • Mercy Care - 1-800-624-3879
  • UnitedHealthcare Community Plan - 1-800-348-4058
  • DDD Tribal Health Program AHCCCS Healthcare Coordinator - 602-417-4994

Substance Use Disorder/Medication Assisted Treatment (OUD/MAT)

You do not need a referral from your PCP to begin substance use services. Any behavioral health provider can assist with substance use disorders and provide opioid information. Visit your DDD Health Plan’s website or call their Member Services unit to locate a provider near you. You can also contact the National Substance Use and Disorder Issues Referral and Treatment Hotline: 1-800-662-HELP (4357).

Mercy Care

UnitedHealthcare Community Plan

DDD Tribal Health Program (THP)

Additional Resources

Health & Wellness

Monthly Member Emails

Read bi-annual newsletters and monthly Office of Individual & Family Affairs (OIFA) updates.

Health Information Exchange (HIE)

In 2019, the Arizona Legislature passed two bills, SB1321 and SB1352, that impact personal health information (PHI).

A Health Information Exchange (HIE) connects provider electronic health record (EHR) systems allowing them to securely share patient information and better coordinate care. Contexture, Arizona’s HIE, connects organizations, including first responders, hospitals, labs, and behavioral health, physical health, post-acute care and hospice providers.

The HIE makes patients’ health information available to participants electronically. State and federal law give patients certain rights and protections concerning this information. Your DDD Health Plan will send you a Notice of Health Information Practices if they participate in the HIE. Members can choose to opt out of having their personal health information made available on the HIE. If you opt out, your healthcare providers will not be able to access your personal health information through the HIE.

Contact your DDD Health Plan or provider for more information about your personal health information, the HIE and your ability to opt out.

Health Plan Enrollment Verification

AHCCCS considers DDD as your health plan. AHCCCS will get your picture from the Arizona Department of Transportation/Motor Vehicle Division (MVD) if you have an Arizona driver’s license or state-issued ID. When your health care providers check to see if you are eligible with AHCCCS, they will see your picture (if available) with your coverage. This will help us to know that no one else is using your ID card or benefits. Your health insurance card and ID number are for your use only. It is your responsibility to protect your ID card. Selling, loaning, or letting someone else use your card is fraud. You could lose your services and benefits. Legal action could also be taken against you. It is very important to always keep your card and not discard it.

To find out which DDD Health Plan you have, please call DDD Health Care Services at 1 (844) 770-9500 ext. 7.

Oversight of Health Plans - Operational Reviews (OR)

Mercy Care

UnitedHealthcare Community Plan

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