This program is effective January 1, 2014. For policy in effect before January 1, 2014, please refer to the previous policy manual at: http://www.azahcccs.gov/shared/Downloads/EligibilityManual/AEPM/ahcccseligibilitypolicymanual.htm
The conditions of eligibility for the Adult program are:
Valid application (MA533
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
Income at or below 133% of the FPL (MA615.7
The Adult group is for people who do not qualify for AHCCCS Medical Assistance (MA) in any of the following programs:
●Young Adult Transitional Insurance (YATI).
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.
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:
42 USC 1396a(a)(10(A)(1)(XIII)
42 CFR 435.119