Medical Assistance (MA) Chapter 400 AHCCCS Medical Assistance Programs >> 401 Adults
401 Adults
Service Package
Customer Costs
Programs and Legal Authorities
Note: This program is effective January 1, 2014. For policy in effect before January 1, 2014, please refer to the previous policy manual at:
The conditions of eligibility for the Adult program are:
Valid application (MA533);
Age 19 to 64 (MA501);
Resident of Arizona (MA531);
Provide or apply for a valid Social Security number (MA532);
US citizen (MA507) or appropriate non-citizen status (MA524);
Not incarcerated (MA525);
Does not qualify for Medicare (MA523);
Children for which the individual is the primary caretaker must have insurance coverage (MA518);
Apply for potential benefits (MA526);
Assignment of rights to medical benefits and cooperation (MA503); and
Income at or below 133% of the FPL (MA615.7).
Adult Program
The Adult group is for people who do not qualify for AHCCCS Medical Assistance (MA) in any of the following programs:
Caretaker Relative;
Pregnant Woman;
SSI-MAO; and
Young Adult Transitional Insurance (YATI).
Service Package
Customers who meet all of the requirements for the Adult program receive full AHCCCS Medical Assistance services package. Customers who meet all requirements except U.S. citizenship or qualified non-citizen status receive emergency services only. See MA302 for details about the service packages.
Customers approved for full coverage under the Adult program are enrolled in an AHCCCS Health Plan (Chapter 1100).
Emergency Services are paid for by AHCCCS on a fee-for-service basis.
Customer Costs
Customers do not pay a premium for coverage under the Adult program. Customers in the Adult program temporarily do not have co-payments.
Programs and Legal Authorities
This requirement applies to the following program:
Legal Authorities
42 USC 1396a(a)(10(A)(1)(XIII)
42 CFR 435.119