Medicaid Eligibility in Arizona

Eligibility Team
Researcher & Writer
December 12, 2017

Arizona’s Medicaid program came together after the federal  government partnered with the state to help provide funding. Referred to  by many as AHCCCS, the containment system set forth by Arizona ensures  all eligible recipients get the health care coverage they need. Before  applying, it is best to understand the qualifications set by the state  and determine if you meet their standards. Not everyone will,  particularly those over the age of 21.

Arizona’s Requirements for Medicaid Qualification

The  state of Arizona follows specific criteria when making a decision on  eligibility for their Medicaid program. Only those applicants who are  facing financial hardships and meet the income requirements can get  approved. Children and women who are pregnant are also far more likely  to receive insurance than adults who have no prior health concerns. A  larger family may qualify easier than a single individual.

How to Apply for Medicaid in Arizona

You may apply for Medicaid in Arizona by using their Health-e Arizona website. It allows individuals and families to determine if they’re  eligible and see the benefits they have been approved for once the  application is complete and accepted.

If you wish to download an  application and mail it in, that option is available as well. You may  also drop it off at one of the Department of Human Service offices in  various cities across Arizona. It is best to stick with the city you  live in or the nearest town and bring the application there for a faster  determination.

Arizona Medicaid Application

The  Medicaid application for Arizona asks basic questions regarding  identity, household members, citizenship, and financial records. You  must answer these questions fully and honestly if you wish to get  approved. Your annual household income gets added up to account for all  members of the household to determine if you meet the income  requirements. All incoming money from any family member must get  disclosed, as well as current financial holdings in a bank or similar  institution. Cash and non-cash assets should also be described so your  caseworker can get a full view of your financial health and determine  you truly need assistance or not.

What Does Medicaid Cover in Arizona?

Doctor  visits, immunizations, x-rays, lab work, pregnancy care, surgical  services, emergency care, family planning, dialysis, and behavioral  health are just the beginning when it comes to services covered by Medicaid in Arizona.

Children  under the age of 21 receive additional necessary health care services.  They can receive a dental screening and dental treatment, vision exam  and glasses, and even hearing exam and hearing aids. Adults over the age  of 21 may receive dental services but only if it is an emergency. They  also may only spend up to $1000 in one calendar year through their  insurance plan.

Income Requirements for Arizona Medicaid

The Federal Poverty Level helps to determine eligibility for Medicaid in Arizona. Both individuals and families who fall at or below 138  percent of the poverty level may be eligible to receive state insurance.  A single adult cannot make more than $16,643 per year if they hope to  qualify. A family of four can make up to $33,948 and still qualify.

How Much Does Medicaid Cost in Arizona?

Arizona and the federal government work together to afford the cost of the state’s Medicaid program.  A smaller amount gets spent in this state than in many others across  the U.S., with just over $11 billion spent on over 1 million enrollees  each year. The state allocates more than 30 percent of their total  budget toward these expenses. Plans are in the works to expand the  program and add additional funding so more people can get access to the  medical care they need.

Cost and Coverage of Medicaid in Arizona

Most  people believe they receive health coverage for free, without ever  having to pay a dime. While this may be true for some Medicaid  recipients, most will have at least a small copay to spend at each doctor visit. Adults who have an income at above 106  percent of the federal poverty level will have mandatory copays. It  could cost up to $50 for a non-emergency surgery and $75 for a hospital  stay. It may cost $10 for an office visit and $4 for prescription drugs.  Children and expecting mothers do not have to make these copayments.

Prescription Drugs with Medicaid in Arizona?

Arizona’s  Medicaid program does cover certain prescription drugs. A copay gets  charged to most adult recipients. The generic version typically gets  offered first, unless a brand-name has specifically been requested by  your doctor.

Which Medicaid plan is best in Arizona?

The Arizona Health Care Cost Containment System,  known as AHCCCS, offers the same services across all plans. There is no  best plan in the state, with residents having to choose a plan that  works for their specific county instead. You receive the same level of  care and assistance no matter which plan you enroll in.

Eligibility Team
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Eligibility Team
We are a team of experts dedicated to finding the right government programs for you. Our mission is simple: help people quickly and easily understand which programs they might be eligible for—all in one place. Our team is dedicated to researching and providing you with the most relevant information. We compile only the most trusted information from government sources into one place so you can find the facts you need and skip what you don’t.
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