Fee-for-Service Fee Schedules, Contact Us Proof of identity and citizenship for each one in your household who is applying for the programs under AHCCCS. Verification of any medical insurance other than AHCCCS. Certain co-payments are even compulsory. Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. hb```@RAb,'@B!U!su2&O1 nw8X9lMV?Id+MSY6 L.I5#o4)se3%}g 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. Look for signs that the restaurant accepts EBT. 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. However, it may affect the benefit amount. With Health-e-Arizona Plus, you can . You will have 90 days to switch to another AHCCCS health plan. If you are unable to access services virtually, the DES Family Assistance Administration has offices statewide to assist you with the application process. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. To qualify, you must be an Arizona resident with U.S. citizenship or qualified immigration status. Applicants are assigned a case manager to coordinate their care. Learn more about how AHCCCS is planning for the end of the Public Health Emergency. If there are non-U.S. citizens in your family, include Alien Registration Cards. 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. Complete bank statement for the past months. You will receive a letter indicating whether you have mandatory co-payments. Give us all requested information as soon as possible. For AHCCCS Medical Assistance: If you do not give us your immigration status information, you may only be able to get emergency medical services. There are no fees for applying for medical assistance. If this process seems daunting, Valleywise Health is here to help as Eligibility Specialists are available to field your questions (in English and Spanish), help you determine your eligibility and help you begin the process of applying and receiving coverage. Subscribe to Newsletters 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. Individuals must meet certain income and other requirements to obtain services. Before choosing a health plan, check with your doctor, pharmacy or hospital to see if they work with the plan that you want. 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. Medicare Savings Program: This is a program for individuals on low income that are eligible for Medicare. This tool enables one to access this form quickly. Getting emergency care. 7500 Security Boulevard, Baltimore, MD 21244. Apply Now! Currently the program enrolls nearly 2 million Arizona residents. AHCCCS is Arizonas Medicaid program that provides health insurance for people with limited income and resources. The federal Public Health Emergency will be ending soon, and AHCCCS will be returning to regular renewals April 1, 2023. It can be done from any device, anywhere at any moment! In Arizona, this is completed through the Health-e-Arizona Plus (HEAplus) online application. Need help with applying? The latest enrollment data shows 53.3% Arizonans covered by . 2226 0 obj <>/Filter/FlateDecode/ID[<7E13598C50AB214791283D6D87E75447>]/Index[2197 50]/Info 2196 0 R/Length 134/Prev 724933/Root 2198 0 R/Size 2247/Type/XRef/W[1 3 1]>>stream The Affordable Care Act (ACA) requires states to utilize a single streamlined application approved by the Secretary of Health and Human Services. Nutrition Assistance recipients will be able to make online purchases for grocery items with authorized SNAP retailers. Alien Registration Cards, if there are non-U.S. citizens applying for benefits in your household. All AHCCCS health plans provide the same covered medical services. This website uses cookies to improve your experience. Some co-payments are mandatory; the medical provider may not provide service if the mandatory co-payment is not paid. You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). Please include a cover sheet with your faxed documents. How do I provide additional information, when requested? News & Press Releases, Can't find what you're looking for? You must also be under the income limit, which varies depending on your age and size of your household. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, Change Report for Nutrition, Cash, and Medical Assistance Benefits, Publications for Nutrition, Cash, and Medical Assistance Benefits, Work Requirements for Able-Bodied Adults Without Dependents, The Emergency Food Assistance Program (TEFAP), Senior Farmers Markets Nutrition Program (SFMNP), WIC Farmers Markets Nutrition Program (FMNP), Cash and Nutrition Assistance Policy Manual, USDA Programs Nondiscrimination Statements, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), flyer about the Restaurant Meals Program for merchants, Restaurant Meals Program Memorandum of Understanding (MOU), USDA Food and Nutrition Service authorized Arizona to participate in the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot, Women, Infants, and Children (WIC) Farmers Market Nutrition Program, Equal Opportunity and Reasonable Modification, Is homeless and does not have a fixed or regular nighttime residence. You are required to report any changes that may affect your Medical Assistance eligibility. A statement verifying your address and the names of everyone living with you. 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. Let us know if you need assistance in getting the necessary information. If you do not provide the requested information by the due date, your eligibility will be stopped. 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. Apply in Person at your county office or Fill out paper application form and mail to your county office. If there is enough information available to determine that you are still eligible, an approval letter is sent. AHCCCS Medicaid coverage generally starts the first day of the month in which you are found eligible. 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. idcs-56b6e9015b5b403987f3105c0544879a.identity.oraclecloud.com Instructions on how to do so are included in the application. If you do not like the one chosen for you. DES works with families, community organizations, advocates and state and federal partners to realize our collective vision that every child, adult, and family in Arizona will be safe and economically secure.DES serves more than 3 million Arizonans. Do restaurants charge sales tax for meals? Do all restaurants participate in the Restaurant Meals Program? 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. Careers If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. Nutrition Assistance provides eligible households with monthly benefits they can use to purchase nutritious food. Member Services also has free language interpreter services available for non-English speakers. Proof that your employment ended and last date paid. Last Updated: February 24, 2021 at 3:23 am. AHCCCS also provides long term care services by contracting with doctors, nursing homes, assisted living facilities, hospitals, pharmacies and specialists. Proof of mortgage or rent, as well as utility bills for the past months. Some program requirements may be difficult or dangerous for victims or survivors of domestic violence, sexual harassment, sexual assault, or stalking, and their families. That hospital will treat you regardless of whether you have insurance. 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. It must be signed, dated and include that person's address and telephone number. Retailers who are interested in online purchasing for SNAP EBT must meet USDA Food and Nutrition Service (FNS) requirements and obtain authorization to participate. 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. They will also help you understand eligibility rules and what may be required of you to participate in the program. Social Security numbers (if none, verification that a Social Security number has already been applied for). TANF: Temporary Assistance for Needy Families. You typically must work directly with the government to qualify for your program or benefits. 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.). To serve you better and assure that you receive the benefits you qualify for, please: You can mail or fax copies of the requested information. Phone applications are available Monday through Friday from 8 a.m. to 4 p.m. Arizonas cash assistance program. Apply in Person at your county office or Fill out paper application form and mail to your county office. Your application will be approved or denied within 45 calendar days or less, depending on your case. Do I need a different EBT card to use at a restaurant? Apply by phone: Call 1-800-221-3943 / State Relay: 711. Many providers will need to take action before they are ready to enroll as a Medicaid provider with AHCCCS. Arizona's Medicaid Program will cover the following: Medical expenses including doctor visits and prescription medications. Apply for Medical Assistance Benefits. Also, many SNAP Community Partners are also Community Assistors that can help you apply for Medical Assistance. Careers 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. AHCCCS works by having you choose a health plan that covers your zip code . 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. If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. For more information, see the flyer about the Restaurant Meals Program for merchants. Click the following to apply online for Nutrition, Cash or Medical Assistance: APPLY ONLINE. In a true emergency, go straight to the hospital. You also have the option to opt-out of these cookies. We also use third-party cookies that help us analyze and understand how you use this website. Providers should review the application and follow the instructions for completing the application to enroll their existing AHCCCS provider ID. No, participating restaurants are listed on the webpage and updated quarterly. You can apply by calling 1-855-HEA-PLUS (1-855-432-7587) or fill out an application online. They must have limited income, limited assets, and a medical need for care. Apply personally at a local FAA office, at the Department of Economic Security (DES) office, at the hospital, or at certain clinics. Name and contact information of neighbor or landlord. Birth certificates for everyone who is applying for benefits. Health-e-Arizona also lets you apply for other benefits, like Nutrition Assistance (formerly Food Stamps), at the same time. 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. Contact your local DES office for more information. (e.g., paper provider enrollment application, etc. Covered Services Sources: The Medicaid program in Arizona is called the Arizona Health Care Cost Containment System . This video is available in American Sign Language. . AHCCCSOnline Website Pressing the button down below will open our PDF tool. 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. 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. endstream endobj startxref You can apply for medical coverage through AHCCCS, Nutrition Assistance (formerly know as the Food Stamp program), and Cash Assistance. Just as Valleywise Health provides premier, compassionate care to all those who need it, AHCCCS is there to ensure you have the coverage you need whether youre recently unemployed or simply unable to pay for private insurance. Ensure a Certified W9 is On File Any provider who will be receiving state/federal funds for services rendered or provided to Medicaid recipients must have a certified W9 tax form on file with the State. }Q]G];/NOI%=MA|F3\% Your PCP must approve all of your medical care, including non-life threatening emergency room visits. KidsCare: Arizonas Childrens Health Insurance Program (CHIP) for children under age 19 who are not eligible for AHCCCS insurance. Out-of-State Toll Free: 1-800-523-0231, How to Apply %PDF-1.6 % Go to AHCCCS Available Health Plans to find information about health plans, to pre-enroll, or to change enrollment in your anniversary month. About Mercy Care. 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how do i apply for emergency ahcccs