Paul Sanchez
Arizona offers various health insurance options, including free or low-cost coverage, to help its residents find the best plan for their needs and budget. The state's Medicaid program, Arizona Health Care Cost Containment System (AHCCCS), provides health care services to eligible residents who meet certain income and other requirements. To be eligible for AHCCCS, individuals must qualify both financially and medically. Arizona also has a long-term care system (ALTCS) that offers little to no-cost health care to residents with age-related or physical disabilities or developmental disabilities requiring skilled care. The application process for health insurance in Arizona can be done online, by phone, or with assistance from a community helper.
| Characteristics | Values |
|---|---|
| Name of the program | Arizona Health Care Cost Containment System (AHCCCS) |
| Type of program | Arizona's Medicaid agency |
| Who is eligible | Individuals who meet certain income and other requirements |
| Application process | Online at www.healthearizonaplus.gov or through Health-e-Arizona Plus |
| Required documentation | Proof of citizenship, Alien Registration Cards (for non-U.S. citizens), Social Security numbers, birth certificates, a statement verifying address and names of individuals living with the applicant |
| Additional support | Community Assistor |
| Contact | 1-855-432-7587 |
| Long-term care | Arizona Long Term Care System (ALTCS) |
| ALTCS eligibility | Financially and medically eligible Arizona residents with an age-related, physical, or developmental disability who require a skilled level of care |
| ALTCS financial eligibility | A single applicant cannot exceed $2901.00 per month in gross monthly income, and resources cannot exceed $2000.00 per month |
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What You'll Learn
Arizona Health Care Cost Containment System (AHCCCS)
To apply for AHCCCS Health Insurance, you can submit an application online, by mail, or by fax. The quickest way to apply is online at www.healthearizonaplus.gov. This works for anyone eligible for AHCCCS, including those who are also eligible for Medicare. You can also apply by printing and mailing the form available on the AHCCCS website. The application process is the same for individuals applying for Medicare Cost Sharing.
To be eligible for AHCCCS, you must meet certain financial and medical requirements. Financially, a single applicant cannot exceed $2,901 per month in gross monthly income, and resources cannot exceed $2,000 per month. You may be required to provide proof of income and resources. In addition, you may need to provide proof of citizenship, Social Security number, birth certificate, and a statement verifying your address and the names of everyone living with you. The statement must be made by a non-relative who doesn't live with you.
Medically, you must be in immediate need of a nursing home level of care or a care facility for individuals with intellectual disabilities. You must also require assistance with your activities of daily living, but you are not required to reside in a facility. If you are waiting for your application to be processed or are not eligible for AHCCCS medical assistance, you may qualify to receive drug, alcohol, and mental health treatment services through other funding sources administered by the Regional Behavioral Health Authority (RBHA).
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ALTCS eligibility
The Arizona Long Term Care System (ALTCS) is Arizona's long-term care Medicaid program. It provides long-term care services at little or no cost to financially and medically eligible Arizona residents who are disabled, elderly, or have a developmental disability diagnosed before the age of 18.
To be eligible for ALTCS, you must meet both financial and medical requirements. Financially, a single applicant cannot exceed $2,382 in gross monthly income, and resources cannot exceed $2,000 per month. The monthly income limit depends on whether you are married or single. A married couple can have a combined income of no more than $4,764 per month. Not all resources are considered countable; for example, your primary home and one car are not included when determining eligibility.
Medically, you must be in immediate need of a nursing home level of care or a care facility for individuals with intellectual disabilities, and require assistance with your activities of daily living (you are not required to reside in a facility).
The ALTCS application process can be complex, and it is not unusual to be rejected, especially if you do not meet the financial eligibility requirements. If you are deemed ineligible, you can apply to ALTCS more than once and reapply as soon as you become eligible.
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Income requirements
Arizona residents can check their eligibility for medical insurance through the Arizona Health Care Cost Containment System (AHCCCS) using the Quick Screener on the Health-e-Arizona Plus website. This site also houses the online application for medical, food/nutrition, and cash assistance programs, and it connects with the federal health insurance marketplace, HealthCare.gov.
The income requirements to qualify for AHCCCS differ based on the age and family situation of the applicant. For instance, a single Nursing Home Medicaid applicant in Arizona must meet the following criteria:
- Income under $2,901 per month
- Assets under $2,000
- Require a Nursing Home Level of Care
If an applicant is under 26 and was in foster care in the custody of the Department of Child Safety (DCS) or an Arizona Tribe when they turned 18, they may also qualify for AHCCCS Health Insurance.
For families, the income limit is $21,597 per year for an individual in 2025, and $44,367 for a family of four. Children aged 18 or younger can get AHCCCS KidsCare coverage if their family's income is 230% of the Federal Poverty Guidelines (FPG) or less ($73,945 per year or less for a family of four).
AHCCCS eligibility rules for people with disabilities are different from those for other applicants. For example, if an applicant's income is higher than the 138% of the Federal Poverty Level (FPL) limit, they may still qualify under disability rules because AHCCCS's eligibility rules for people with disabilities do not count all of their earned income. People with disabilities who work and have higher incomes may qualify through AHCCCS Freedom to Work.
Arizona also offers Qualified Income Trusts (QITs), which are a type of Special Treatment Trust (STT) that allows Medicaid Nursing Home and Medicaid Home and Community-Based Services (HCBS) applicants who are over the income limit to still become income-eligible. Applicants can deposit their "excess" income into the irreversible trust, and it will no longer count towards Medicaid's income limit.
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Application process
The application process for medical insurance in Arizona depends on the type of insurance and the specific requirements of the applicant. Here is a detailed outline of the application process for different types of medical insurance in Arizona:
Arizona Health Care Cost Containment System (AHCCCS)
AHCCCS is Arizona's Medicaid agency, providing healthcare programs to Arizona residents who meet certain income and other requirements. The application process for AHCCCS can be completed online through Health-e-Arizona Plus (HEAplus), which is available in both English and Spanish. The website allows individuals to apply for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance. Alternatively, applicants can choose to print and fill out the application form manually and submit it.
Arizona Long Term Care System (ALTCS)
ALTCS is a part of Arizona's Medicaid program and provides long-term care services at little or no cost to financially and medically eligible Arizona residents. To be eligible for ALTCS, an applicant must meet both financial and medical criteria. Financially, a single applicant cannot exceed $2,901 per month in gross monthly income, and resources cannot exceed $2,000 per month. Medically, the applicant must require a nursing home level of care or a care facility for individuals with intellectual disabilities and need assistance with daily activities (residence in a facility is not mandatory). The application for ALTCS can be registered online through Health-e-Arizona Plus by creating an HEAplus account, or by calling or faxing the specified numbers.
KidsCare
KidsCare is Arizona's version of the Children's Health Insurance Program (CHIP). The application process for KidsCare is not explicitly mentioned but likely follows a similar procedure to other medical insurance programs in Arizona, such as online application through Health-e-Arizona Plus.
Other Options
Arizona also offers other medical assistance programs, such as the Arizona Supplemental Nutrition Program for Women, Infants, and Children (WIC), which provides nutrition education, breastfeeding support, and supplemental nutritious foods. Additionally, individuals can apply for health insurance through HealthCare.gov, a federal government website that helps individuals find insurance that fits their needs and budget.
It is important to note that specific eligibility criteria and application processes may vary, and it is recommended to refer to the official websites and resources for the most up-to-date and accurate information.
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Open Enrollment period
The Open Enrollment Period is the annual period during which individuals can purchase health insurance through the Arizona Health Insurance Marketplace. The Open Enrollment Period for 2024 began on November 1, 2024, and will end on January 16, 2025. If you sign up for health insurance before January 1, your coverage will begin on January 1. If you sign up between January 1 and January 15, your coverage will typically start on February 1.
During the Open Enrollment Period, you can enroll in an Arizona Obamacare plan. Obamacare, formally known as the Affordable Care Act, is a federal program that helps individuals without comprehensive coverage purchase health insurance. Obamacare plans are divided into four tiers: Bronze, Silver, Gold, and Platinum. Bronze plans have the lowest monthly premiums but higher out-of-pocket costs when you see a doctor. Silver and Gold plans require higher premiums but lower out-of-pocket costs. Platinum plans have the highest premiums but cover the most when you need medical treatment. Choosing the right plan depends on how often you expect to need medical care and what you can afford to pay.
In addition to health insurance, you can also enroll in dental insurance during the Open Enrollment Period. For example, the Arizona State Retirement System offers a Choice Value plan, a Choice Economy plan, and a Choice Premier plan. The monthly premiums for the Choice Value and Choice Economy plans are unchanged for 2025, while the Choice Premier plan's monthly premium has increased. The Choice Plus PPO plan will not be offered in 2025. If you are currently enrolled in the Choice Plus PPO plan and take no action during the Open Enrollment Period, you will be automatically enrolled in the Choice Premier plan.
It is important to note that the Open Enrollment Period is distinct from the Initial Enrollment Period (IEP) for Medicare. Medicare is a federal health insurance program available to individuals aged 65 and older, certain younger individuals with disabilities, and those with end-stage renal disease (ESRD). In Arizona, individuals typically become eligible for Medicare when they turn 65, although some may qualify earlier due to certain disabilities or medical conditions. To avoid late enrollment penalties, it is essential to enroll in Medicare during the IEP.
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Frequently asked questions
You can apply for medical insurance in Arizona through Health-e-Arizona Plus (HEAplus). You can apply for yourself, your family, or someone close to you.
To be eligible for medical insurance in Arizona, you must meet certain income and other requirements. For example, if you are applying for ALTCS, you cannot exceed $2901 in gross monthly income and $2000 in resources per month.
When applying for medical insurance in Arizona, you may need proof of citizenship, Alien Registration Cards (for non-U.S. citizens), Social Security numbers, birth certificates, and a statement verifying your address and the names of everyone living with you.
The quickest way to apply for AHCCCS is online at www.healthearizonaplus.gov. This is for anyone eligible for AHCCCS, including those who are also eligible for Medicare and have income and asset limits for eligibility.
The Open Enrollment period in Arizona typically runs from November 1 to January 15. During this time, individuals can enroll in a health insurance plan for the next calendar year. Outside of this period, you may be eligible for a Special Enrollment Period if you have experienced certain life events, such as getting married, having a baby, or losing other health coverage.
