Understanding Ahcccs Income Adjustments For Private Insurance Holders

AHCCCS, or the Arizona Health Care Cost Containment System, offers health insurance to Arizona residents who meet certain income and eligibility requirements. While having private insurance does not automatically disqualify someone from AHCCCS, their income must still be below certain limits.

AHCCCS is available to US citizens and qualified immigrants who are under 65 years old, not eligible for Medicare, and have income below certain limits. If someone qualifies for AHCCCS, it is usually their best option, even if they have employer-sponsored health insurance. This is because AHCCCS typically has lower copayments and may cover more services than private insurance.

However, if someone's income is too high to qualify for AHCCCS, they may still be able to receive assistance in paying for a private insurance plan through HealthCare.gov.

AHCCCS offers health insurance for adults and children meeting income and eligibility requirements

AHCCCS, the Arizona Health Care Cost Containment System, offers health insurance to Arizona residents who meet certain income and eligibility requirements.

Health Insurance for Adults

AHCCCS offers health insurance for adults aged 19 to 64 who do not qualify for AHCCCS Medical Assistance (MA) in other programs, such as SSI-MAO and Young Adult Transitional Insurance (YATI). There are no monthly premiums for those who qualify. To be eligible, applicants must:

• Be an Arizona resident
• Not qualify for Medicare
• Be a US citizen or a qualified immigrant
• Have a Social Security number or apply for one
• Have income below certain limits

Health Insurance for Children

AHCCCS also provides health insurance for eligible children under the age of 19. There are no monthly premiums for those who qualify. To be eligible, applicants must:

• Be an Arizona resident
• Be a US citizen or a qualified immigrant (non-citizen children may still be eligible for emergency services)
• Have a Social Security number or apply for one
• Have income under certain limits

Health Insurance for Caretaker Relatives

Additionally, AHCCCS offers health insurance for adult relatives who are living with and caring for a child under the age of 19 and who meet the income and eligibility requirements. There are no monthly premiums for those who qualify. To be eligible, applicants must meet the same requirements as those for Health Insurance for Children, as well as cooperate with the Division of Child Support Services if needed.

Income Requirements

The income requirements for AHCCCS health insurance are based on the Federal Poverty Guidelines (FPG). For 2024, the income limit is $20,783 for an individual and $43,056 for a family of four. The income limit is 138% of FPG, although it is sometimes listed as 133% of FPG. AHCCCS knocks 5% of FPL off the income if an individual makes more than 133% of FPL, which is why the limit is listed as 138% of FPG.

Private Insurance

If an individual's job offers health insurance, they can still sign up for AHCCCS if their income is low enough to qualify. However, if the job offers affordable insurance, they cannot receive subsidies for purchasing an individual health plan through HealthCare.gov.

Applicants must be Arizona residents, US citizens, or qualified immigrants

To qualify for AHCCCS health insurance, applicants must be Arizona residents, US citizens, or qualified immigrants.

Who is eligible for AHCCCS?

AHCCCS offers health insurance for adults aged 19 to 64, who do not qualify for AHCCCS Medical Assistance (MA) in any of the following programs:

• SSI-MAO (aged 65 or older; blind or have a disability)
• Young Adult Transitional Insurance (YATI)

For those who qualify, there are no monthly premiums.

Who can receive services?

The applicant may qualify for this program if they meet the following criteria:

• Are an Arizona resident
• Do not qualify for Medicare
• Are a US citizen or a qualified immigrant
• Have a Social Security number or apply for one
• Apply for potential income that may be available, such as unemployment, pensions, and Social Security
• When the individual is the primary caretaker of a child, the child must have insurance coverage
• Are under the income limit
• Are not eligible for any other group

The income limit depends on the number of people in the household. For each additional person, the limit increases by approximately $597.

If the applicant is under 26 and was in foster care, they may qualify for AHCCCS Health Insurance regardless of how much money they make.

Undocumented immigrants do not qualify for full AHCCCS coverage but may qualify for coverage for emergency services. Immigrants who have been legal residents for less than five years do not qualify for full AHCCCS coverage but may qualify for private coverage subsidised by the government. Immigrants who have been legal residents for five years or longer qualify for the same programs as citizens.

Applicants must have a Social Security number or apply for one

To apply for a Social Security number, you must be a U.S. citizen or a qualified immigrant. You can apply for a Social Security number online and then visit a local Social Security office to provide your documentation.

If you are a noncitizen, you may be able to request a number if you work or attend school, or if you have a valid nonwork reason. If you are an international student, foreign worker, citizen child, Deferred Action for Childhood Arrivals applicant, or domestic violence survivor, you may need a new Social Security number.

When applying for a Social Security number, you must present original documents or copies certified by the issuing agency. Photocopies or notarized copies are not accepted. All documents must be current and not expired.

If you are a U.S. citizen, you must provide proof of citizenship. This can include a U.S. birth certificate, U.S. passport, Certificate of Naturalization, or Certificate of Citizenship.

If you are a noncitizen, you must provide proof of your immigration status and work authorization. This can include a Permanent Resident Card, Arrival/Departure Record, or Employment Authorization Document.

If you are applying for a Social Security number for the first time and are 12 years of age or older, you must submit the following documents:

• Application for a Social Security Card (Form SS-5)
• Original birth certificate
• Original Consular Report of Birth Abroad (if applicable)
• Valid U.S. passport (duly signed)
• Letter addressed to the Social Security Administration explaining why you did not apply for an SSN at an earlier age
• Original supporting documents for each year you have lived abroad (if applicable), such as school records, employment records, medical/dental records, tax declarations, rental leases, bank accounts, utility bills, old ID cards issued abroad, etc.

In addition to the above documents, you must provide a photocopy of each document to be enclosed with the Application for a Social Security Card.

There is no fee for applying for a Social Security number, and you will receive your Social Security card by mail within 14 days of your application being approved.

Applicants must apply for potential income, e.g., unemployment, pensions, and Social Security

When applying for AHCCCS health insurance, applicants must apply for potential income sources, including unemployment benefits, pensions, and Social Security. This means that applicants need to explore and pursue all possible avenues of financial support before being deemed eligible for AHCCCS coverage.

Unemployment benefits are available for workers who have lost their jobs through no fault of their own, such as layoffs or terminations without a specific cause. Each state has its own unemployment insurance program with varying eligibility criteria, but common requirements include being a citizen or permanent resident, having a qualifying work history, and demonstrating unemployment status. It's important to note that unemployment benefits are not considered wages under Social Security's annual earnings limit, so receiving them won't reduce your Social Security benefits.

Regarding pensions, retirement payments or 401(k) distributions may impact your eligibility for unemployment benefits as they are considered a form of income. However, they generally do not affect your Social Security benefits.

When it comes to Social Security, individuals can apply for retirement benefits if they are at least 62 years old or disabled. Social Security benefits are funded through payroll withholding taxes, and eligibility depends on factors such as citizenship, residency, and work history. Importantly, Social Security benefits are not considered income for unemployment reporting in most states, so receiving them won't affect your unemployment benefits.

While it is possible to receive both unemployment and Social Security benefits simultaneously, it's crucial to understand the specific rules and requirements of each program, as well as how they interact with each other. Additionally, applicants should be aware of potential factors that could impact their income and taxes when receiving both types of benefits.

AHCCCS eligibility is based on income below certain limits, with no resource limit

AHCCCS, the Arizona Health Care Cost Containment System, is jointly funded by the federal and state governments. It provides health insurance for adults aged 19 to 64 and families with children who meet certain income and eligibility requirements. Importantly, there is no resource limit for AHCCCS eligibility.

To be eligible for AHCCCS, individuals must meet the following basic requirements:

• Be under 65 years old (unless you are the parent or caretaker of a child).
• Not be eligible for Medicare (exceptions apply if you are pregnant or a parent/caretaker).
• Be a U.S. citizen or meet specific noncitizen requirements.
• Have income below certain limits.

The income limit for AHCCCS eligibility is generally set at 138% of the Federal Poverty Guidelines (FPG). For 2024, this equates to an annual income of $20,783 for an individual and $43,056 for a family of four. It's important to note that AHCCCS counts most types of earned and unearned income, but some income is not counted, such as Supplemental Security Income (SSI) benefits.

For families with children, AHCCCS offers health insurance to adult relatives caring for a child under 19 who meet the income and eligibility requirements. There are no monthly premiums for those who qualify. Additionally, if the child was previously in foster care, they may qualify for AHCCCS Health Insurance regardless of their income.

In summary, while AHCCCS eligibility is based on having an income below certain limits, there is no resource limit associated with AHCCCS.

Frequently asked questions