How do I provide additional information, when requested? In order to apply for Ahcccs, you will need to contact your nearest social security office. What do I need to do? Subscribe to Newsletters 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. Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. I'm having an emergency. 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. 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. If eligibility cannot be determined, you will be sent a pre-populated renewal form with a Request for Information letter describing the information needed to complete the renewal. B - UFC/ACC health plan offers our members: Member Services also has free language interpreter services available for non-English speakers. Click the following to apply online for Nutrition, Cash or Medical Assistance: APPLY ONLINE. 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. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. AHCCCS Medicaid coverage generally starts the first day of the month in which you are found eligible. The easiest way to apply for benefits is online through Health-e-Arizona Plus. Proof that your employment ended and last date paid. One will be chosen for you by AHCCCS. News & Press Releases, Can't find what you're looking for? This care may be subject to a deductible, for example, or a hospital may have particular rules in place. Mail or Fax an Application. DEPARTMENT OF ECONOMIC SECURITY Your Partner For A Stronger Arizona. hb```@RAb,'@B!U!su2&O1 nw8X9lMV?Id+MSY6 L.I5#o4)se3%}g Phone applications are available Monday through Friday from 8 a.m. to 4 p.m. How to Apply for Food Stamps. endstream endobj startxref Citizenship and qualified non-citizen status. 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 . You can apply by calling 1-855-HEA-PLUS (1-855-432-7587) or fill out an application online. Apply in Person at your county office or Fill out paper application form and mail to your county office. 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. AHCCCS can only pay for your emergency services because of your status with United States Citizenship and Immigration Services. %%EOF Contact your local DES office for more information. This video is available in American Sign Language. Health insurance through AHCCCS helps individuals cover the cost of doctors office visits, physical exams, immunizations, prenatal care, hospital care and prescriptions they need. You are required to report any changes that may affect your Medical Assistance eligibility. About 65% of Valleywise patients utilize the Arizona Health Care Cost Containment System (written AHCCCS and pronounced access). Cash Assistance helps families meet their basic needs for well-being and safety and serves as their path to self-sufficiency. }Q]G];/NOI%=MA|F3\% Health-e-Arizona is the easiest way to apply for AHCCCS if you think you might qualify. Let us know if you need assistance in getting the necessary information. The statement must be made by a non-relative who doesnt live with you. This includes Nursing facilities and under the HCBS program assisted living facilities and . 0 2. idcs-56b6e9015b5b403987f3105c0544879a.identity.oraclecloud.com You may also begin the application process by phone by calling 1-855-432-7587. 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. Under the Department of Human Services (DHS), you may also file other discrimination complaints by contacting your local DFCS office, or the DFCS Civil Rights, ADA/Section 504 Coordinator at 2 Peachtree Street NW, Ste 19-454, Atlanta, GA, 30303, 404-657-3735. that has an agreement to bill AHCCCS for covered emergency services. Verification of all medical costs for the most recent months./li>. While some co-payments are mandatory depending on service and location, in some instances the provider may ask for the co-payment, but cannot deny service if you are unable to pay. Thank you for your interest in becoming a provider in the AHCCCS program. 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. 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. Applicants will receive a medical assistance letter that contains the official start date. Health Insurance for Children, Provider Enrollment This program is available to an NA household if every person in the household meets one or more of the following conditions: List of Restaurants Participating in the Meals Program. With Health-e-Arizona Plus, you can . 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. Obtain a National Provider Identifier (NPI) Number The federal government requires that providers who administer medical and other health services should obtain a NPI number a unique 10-digit identification number for covered health care providers. You will receive a letter telling you who your . You must keep proof of your income and child care expenses over the six-month period and give it to DES at your review. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. These cookies do not store any personal information. 2246 0 obj <>stream This program pays for Medicare Part A and B premiums If you do not provide the requested information by the due date, your eligibility will be stopped. Apply food stamp application form online on your state website. 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. A decision will be made by one of the following dates: When a decision is made regarding your case, you will be mailed a letter with the results. Providers should review the application and follow the instructions for completing the application to enroll their existing AHCCCS provider ID. Well assume youre ok with this but you can opt-out. You will find the fax cover sheets on the Providing Documents tab of the Health Arizona website . Benefits begin based on the date the application was submitted. Instructions on how to do so are included in the application. Learn about eligibility, needed information and the process to apply for benefits. AHCCCS: Arizona Health Care Cost Containment System. 3. https://www.azahcccs.gov/shared/Downloads/AHCCCSAtaGlanceApril2020.pdf. To qualify, you must be an Arizona resident with citizenship or qualified immigration status. 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.). If you have questions about AHCCCS coverage at Valleywise Health, call 1 (833) VLLYWSE. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. Please note that you must let DES know if your earnings increase by. You also can call the telephone number on the back of your EBT card and open a dispute claim. AHCCCS insurance covers you and your family for doctor visits, vaccines, prescriptions, emergency care, hospitalizations and more. Proof of citizenship for everyone who is applying for benefits. d|p3ft7k[L[31\~Z(C]x2pl 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 find the information on AHCCCS Covered Medical Services. AHCCCS offers health insurance for pregnant women who meet income and eligibility requirements. The Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. Ready to apply? %PDF-1.6 % The information on this page will help you prepare and apply for benefits. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. BCBSAZ Health Choice Pathway (HMO D-SNP) is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Apply food stamp application form online on your state website. TANF: Temporary Assistance for Needy Families. 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. Arizonas Medicaid health insurance. For additional documents, brochures and pamphlets related to the Nutrition Assistance program, please visit our Document Center. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council prescriptions emergency! Expenses over the six-month period and give it to DES at your.... Social security office qualify, you must let DES know if your earnings increase by found! Out an application online, needed information and the process to apply for AHCCCS, must. You for your emergency Services because of your status with United States citizenship and Immigration Services Health Pathway. 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