To apply by mail or fax, either download the Elderly Simplified Application Project (ESAP) Nutrition Assistance Application (FAA-1821A) or request an application to be mailed to you by calling (855) 234-4960. Medical coverage may continue for up to 12 months when: Your family's eligibility for Transitional Medical Assistance coverage must be reviewed every six months. That hospital will treat you regardless of whether you have insurance. 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. If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. Some details must be faxed to complete your application. Please note that you must let DES know if your earnings increase by. Health insurance through AHCCCS helps individuals cover the cost of doctors office visits, physical exams, immunizations, prenatal care, hospital care and prescriptions they need. Pressing the button down below will open our PDF tool. 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.). Phone: 602-417-4000 Before choosing a health plan, check with your doctor, pharmacy or hospital to see if they work with the plan that you want. BCBSAZ Health Choice Pathway (HMO D-SNP) is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Health-e-Arizona Plus is an on-line application for Arizona Residents. Apply food stamp application form online on your state website. AHCCCS is Arizona's Medicaid program that provides health insurance for people with limited income and resources. The Arizona Health Care Cost Containment System (AHCCCS) is Arizona's version of Medicaid and it provides health insurance to low income Arizonans through a health plan. Health Insurance for Children, Provider Enrollment TTY users can call: 916-445-0553. Medicaid for adults and children with limited income. 1. Fee-for-Service Fee Schedules, Contact Us Apply by mail: Download and print a paper application. Find answers to some of the most common questions about Medical Assistance. AHCCCS offers many different medical programs. Pay Your Premium To make sure your enrollment experience is as quick and efficient as possible; please investigate whether you need to complete any of these prerequisite steps before you attempt to submit your application. DES has implemented virtual office services statewide to continue to better serve our customers and communities in this time of need while protecting the health and safety of our customers and staff. We can assist you. Go to Find an Assistor, enter your ZIP Code to locate community assistors near you for help with the application process. Individuals who have B - UFC/ACC have qualified for the Arizona Health Care Cost Containment System (AHCCCS). Ready to apply? Once eligible, AHCCCS will send an AHCCCS ID Card with health plan information for each eligible person in your household. %%EOF Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. What can I do if I disagree with the decision? In a true emergency, go straight to the hospital. About 65% of Valleywise patients utilize the Arizona Health Care Cost Containment System (written AHCCCS and pronounced access). Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Phoenix, Arizona 85005-9009. You can find a Community Assistor in your ZIP Code on the Get Help screen of Health-e-Arizona Plus. AHCCCS works by having you choose a health plan that covers your zip code area. You also can call the telephone number on the back of your EBT card and open a dispute claim. If you do not call us to choose your PCP, you will be assigned to the BCBSAZ Health Choice PCP who is closest to your home. You can apply for yourself, your family, or someone close to you. In Arizona, one in every three residents, or 2.5 million Arizonans, is enrolled in AHCCCS. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. News & Press Releases, Can't find what you're looking for? Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Please visit the, Resources for Foster/Kinship/Adoptive Families, Accessing Behavioral Health Services in Schools, AHCCCS Whole Person Care Initiative (WPCI), Emergency Triage, Treat and Transport (ET3), Report Concerns About Quality of Care Received, ALTCS Electronic Member Change Request (EMCR), Quality Assessment and Performance Improvement Strategy, Pre-Admission Screening and Resident Review (PASRR), Demographics, Social Determinants and Outcomes, Tribal Court Procedures for Involuntary Commitment, Contracted Health Plan Audited Financial Statements, Monkeypox Virus and Vaccination Information, Federal Funding Accountability and Transparency Act, Get Ready to Enroll: Prerequisite Steps for Providers, Provider Enrollment Application and Provider Participation Agreement, How to Become a Training and Testing Program, AIHP/FFS/TRBHA Prior Authorization Information, Claim Resubmission and Reconsideration Process. If you want more information about the doctors, specialists or hospitals that work with a health plan that serves your county, call the number listed . Arizona seniors must be financially and medically eligible for long-term care Medicaid. Based on your eligibility data from the prior application: If you are no longer eligible for the program you are currently enrolled in, you will be screened for eligibility in any other Medical Assistance program. How do I provide additional information, when requested? Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. 2. 2246 0 obj <>stream You can find the information on AHCCCS Covered Medical Services. We also use third-party cookies that help us analyze and understand how you use this website. Provider Enrollment has established a fax and email address to specifically send paper-related documents. Currently the program enrolls nearly 2 million Arizona residents. Again, if you need assistance determining your qualification status, consult Valleywise Health Eligibility Specialists by calling (602) 344-2550 or visiting www.valleywisehealth.org/patients. 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. Insurance plans cant make you pay more in. If you have questions about AHCCCS coverage at Valleywise Health, call 1 (833) VLLYWSE. Also, your provider must approve visits to specialists such as surgeons. Subscribe to Newsletters The process can be completed through Health-e-Arizona Plus. AHCCCS insurance covers you and your family for doctor visits, vaccines, prescriptions, emergency care, hospitalizations and more. Give the manager or owner of the restaurant this flyer about the Restaurant Meals Program for merchants. For more details or information on your case, go online to www.yes.state.nm.us and click on "Check My Benefits," or call the ISD Information Line, available 24/7, at 1-855-309-3766. To qualify, you must be an Arizona resident with citizenship or qualified immigration status. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. There are three ways to apply for AHCCCS Medical Assistance including KidsCare II: The following are some of the items you may need when applying or reapplying for AHCCCS Medical Assistance for you and your household (this does not apply to every applicant): After you have applied, you may check your application status online by going to the My Family Benefits Page. In addition to the services listed above, people who qualify for long term care can receive services such as: To determine eligibility, you need to fill out the online application on Health-e-Arizona PLUS (https://www.healthearizonaplus.gov/) or mail in a completed form to the Family Assistance Administration of Arizona. This website and its contents are for informational purposes only. Call 1-800-377-3536 to get connected with a certified bilingual assister or make an appointment online. It is mandatory to procure user consent prior to running these cookies on your website. It covers programs for acute and long term care, behavioral health and childrens care. hb```@RAb,'@B!U!su2&O1 nw8X9lMV?Id+MSY6 L.I5#o4)se3%}g 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. Do not voluntarily withdraw from AHCCCS Health Insurance just because your earnings increase. This may also include the deli section of a participating grocery store. You must also be under the income limit, which varies depending on your age and size of your household. News & Press Releases, Can't find what you're looking for? You typically must work directly with the government to qualify for your program or benefits. Enter your zip code to get started. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Box 19009 | $"GJGj H1Vx@% %`l@Av|7u@Zc`fM`T`e Member Services also has free language interpreter services available for non-English speakers. If you have questions or need help completing your online application, call 1-855-HEA-PLUS (1-855-432-7587), Monday through Friday, 7:00 a.m. - 6:00 p.m. You can also call (855) 432-7587 if you need health plan enrollment information. Go to AHCCCS Available Health Plans to find information about health plans, to pre-enroll, or to change enrollment in your anniversary month. Well assume youre ok with this but you can opt-out. Find out if you qualify for a Special Enrollment Period. It must be signed, dated and include that person's address and telephone number. AHCCCSOnline Website Children 6 to 18 with family income up to 133% of FPL. Careers Provider Assistance Unit: (602) 417-7670 option 5. DEPARTMENT OF ECONOMIC SECURITY Your Partner For A Stronger Arizona. In order to apply for Ahcccs, you will need to contact your nearest social security office. It also offers special coverage for children and young adults under 21. Your PCP must approve all of your medical care, including non-life threatening emergency room visits. This video is available in American Sign Language. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) View additional eligibility information. }Q]G];/NOI%=MA|F3\% A statement verifying your address and the names of everyone living with you. If you were charged sales tax in error, you should first attempt to resolve this with the restaurant. Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. Policy Manuals You may also report Medicaid fraud by calling (toll free) 1-800-533-0686. P.O. https://www.azahcccs.gov/shared/Downloads/AHCCCSAtaGlanceApril2020.pdf. This video is available in American Sign Language. Family Assistance Administration Fee-for-Service Fee Schedules, Contact Us Need to apply for AHCCCS, KidsCare, Medicare Savings Program, SNAP, and TANF? Our PA representatives are skilled to provide help to many basic enrollment questions. You will find the fax cover sheets on the Providing Documents tab of the Health Arizona website . No, participating restaurants are listed on the webpage and updated quarterly. Pay Your Premium You can also monitor the status of your application online at Health-e-Arizona Plus. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. You may also begin the application process by phone by calling 1-855-432-7587. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. BCBSAZ Health Choice Pathway is a subsidiary of Blue Cross Blue Shield of Arizona. ]. You can apply for medical coverage through AHCCCS, Nutrition Assistance (formerly know as the Food Stamp program), and Cash Assistance. Apply in person: Apply in person at your county of residence's local county office or at a local application assistance site. Not many people are aware about what services does altcs provide. DES only determines eligibility for the following programs: Eligibility for the Medical Assistance program is based on the following requirements: The requirements differ for each program. These specialists can be reached at (602) 344-2550 or by visiting www.valleywisehealth.org/patients. In an emergency, you should get care from the closest hospital that can help you. how do i apply for emergency ahcccs . You can then complete the application and submit it by mail or fax. 0 Health Insurance for Children, Provider Enrollment For additional documents, brochures and pamphlets related to the Nutrition Assistance program, please visit our Document Center. Once your application is submitted, your food stamp office will send you a notice regarding your eligibility. You will have 90 days to switch to another AHCCCS health plan. Health-e-Arizona is the easiest way to apply for AHCCCS if you think you might qualify. 7500 Security Boulevard, Baltimore, MD 21244. An application is not processed in a timely manner. The statement must be made by a non-relative who doesnt live with you. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Covered Services Submit all supporting documentation In addition to a complete application, each provider is required to submit all applicable supporting documentation at the time of submission to avoid processing delays. Complete bank statement for the past months. The AHCCCS offers several medical assistance programs, each has different eligibility requirements but most of them are contingent on the applicant's citizenship, income, and residency in the state of Arizona: To qualify for the health insurance program for children in which there are no monthly premiums for those who are eligible, an applicant: If the income of the child is above the limit of this health insurance, the child may still receive medical services through the KidsCare II program at low monthly payment of not more than $40 for a single child or not exceeding $60 regardless of the number of children in a household. In-person services may be unavailable or limited in manners that support social distancing. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. We do not claim responsibility for its accuracy. Health insurance through AHCCCS helps individuals cover the cost of doctors office visits, physical exams, immunizations, prenatal care, hospital care and prescriptions they need. Please visit the, Resources for Foster/Kinship/Adoptive Families, Accessing Behavioral Health Services in Schools, AHCCCS Whole Person Care Initiative (WPCI), Emergency Triage, Treat and Transport (ET3), Report Concerns About Quality of Care Received, ALTCS Electronic Member Change Request (EMCR), Quality Assessment and Performance Improvement Strategy, Pre-Admission Screening and Resident Review (PASRR), Demographics, Social Determinants and Outcomes, Tribal Court Procedures for Involuntary Commitment, Contracted Health Plan Audited Financial Statements, Monkeypox Virus and Vaccination Information, Federal Funding Accountability and Transparency Act, Get Ready to Enroll: Prerequisite Steps for Providers, Provider Enrollment Application and Provider Participation Agreement, How to Become a Training and Testing Program, AIHP/FFS/TRBHA Prior Authorization Information, Claim Resubmission and Reconsideration Process. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). Restaurants should not be charging sales tax when you purchase your meal using your EBT card. These cookies will be stored in your browser only with your consent. Click on the link to DES below if you (or the person you are applying for) are one or more of the following: An adult without children; A pregnant woman; A family with children; A child only; You can use one application to apply for AHCCCS Medical Assistance for everyone in your household. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. Verification of all medical costs for the most recent months./li>. Proof of identity and citizenship for each one in your household who is applying for the programs under AHCCCS. Banner - University Family Care/AHCCCS Complete Care (B - UFC/ACC) is an integrated health insurance plan. Apply by phone: Call 1-800-221-3943 / State Relay: 711. One will be chosen for you by AHCCCS. Cash Assistance helps families meet their basic needs for well-being and safety and serves as their path to self-sufficiency. The vast majority are ages 64 and younger. Name and contact information of neighbor or landlord. Coverage for Medical Assistance in most cases begins the first day of the month that you are found eligible. Learn about eligibility, needed information and the process to apply for benefits. 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