Medicaid in Arizona: What is AHCCCS?

If you're an Arizona resident who has been researching health insurance plans, you may have come across the acronym 'AHCCCS.' Keep reading to find out what it means and how it may apply to you. 

What is AHCCCS?

The Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. Each year, AHCCCS provides medical insurance to thousands of Arizonans, with eligibility services provided by DES. AHCCCS health insurance helps individuals afford essential medical services, including doctor’s visits, physical exams, immunizations, prenatal care, hospital stays, and prescriptions.

Who is Eligible for AHCCCS?

Eligibility for AHCCCS, Arizona's Medicaid program, is determined based on several factors including income, residency, and specific health needs. Generally, the following groups may qualify:

1. Low-income individuals and families: This includes those who meet certain income thresholds.

2. Pregnant women: Eligibility is based on income and family size.

3. Children: Those under 19 years old may qualify based on family income.

4. Parents and caretaker relatives: Must meet income requirements and have children under 18 in their care.

5. Aged, blind, and disabled individuals: Including those who receive Supplemental Security Income (SSI).

6. Individuals in need of long-term care: Such as those who qualify for the Arizona Long Term Care System (ALTCS).

7. Medicare beneficiaries: Certain low-income individuals who are eligible for both Medicare and Medicaid.

Applicants must also be Arizona residents and U.S. citizens or qualified non-citizens. Eligibility requirements can vary, so it is important to check the specific criteria or contact AHCCCS for detailed information.

What is ALTCS?

AHCCCS partners with various program contractors to deliver long-term care services. An Arizona Long Term Care (ALTCS) program contractor functions similarly to a Health Maintenance Organization (HMO). These contractors collaborate with doctors, nursing homes, assisted living facilities, hospitals, pharmacies, specialists, and other providers to deliver comprehensive care. Additionally, you will be assigned a case manager to coordinate your care.

People who qualify for long term care can receive services such as: Nursing Facility, Hospice, Attendant Care, Assisted Living Facility, Adult Day Care Health Services, Home Health Services, such as nursing services, home health aide, and therapy Home Delivered Meals, Case Management, and Dental Services (up to $1000 per contract year).

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