Today there are over 135 Contracted Community Partner Organizations in more than 300 locations throughout the State ready to help Arizonans apply online for AHCCCS Health Insurance, Nutrition Assistance (formerly Food Stamps) and TANF Cash Assistance, using HEAplus. Trained application assistors from these organizations complete HEAplus applications during an interactive interview process. Applicants only need to sign the application at the end. With improved access to electronic data sources, assistors will be able to provide real-time eligibility determinations. Only if the system cannot verify income or citizenship through these electronic sources will supporting documentation be necessary. If that extra step is needed, the application assistors submit all verification documents to HEAplus electronically and track the outcome of the application, like they do today.
Here are the steps involved in becoming a Health-e-Arizona Plus Community Partner:
1. Submit a HEAplus Community Partner Application form telling us about your organization and how you would like to use HEAplus. Each organization must have a HEAplus Site Administrator who will control access to the system by your staff. You will need to identify this person on the application form.
HEAplus Community Partner Application Form ( http://www.azahcccs.gov/community/Downloads/Publications/011415HEAplusCommunityPartnerApplication.pdf)
2. Sign the Subscription Agreement: After we receive your information, we will draft a subscription Agreement for your signature and send it to you by e-mail.
3. Pay the Set-up Fee: AHCCCS has also lowered the price to be a Community Partner. Modest subscription fees are charged to pay for the hosting, maintenance, and enhancement of the system. You will receive an invoice for the set-up fee from Social Interest Solutions. The set-up fee is $500 and is due when you submit your signed Subscription Agreement. One Subscription Agreement and $500 set-up fee covers all locations within your organization.
4. Monthly Fees begin with the month in which the subscription agreement is effective. Monthly fees are based on the number of users your organization chooses to include in the subscription agreement and your organization type. A link to the fee schedule is provided below:
HEAplus Subscription Fees (http://www.azahcccs.gov/community/Downloads/Publications/HEAplusSubscriptionFees.pdf)
5. User Application Forms: User application forms are required from both the organization and each individual user before account access is approved in the HEAplus system. Links to information about submitting these forms and the required forms are available below.
Information About HEAplus User Application Forms ( http://www.azahcccs.gov/community/Downloads/Publications/011415InformationAboutHEAplusUserApplicationForms.pdf)
Organization User Application Form.pdf ( http://www.azahcccs.gov/community/Downloads/Publications/011415OrganizationUserApplicationForm.pdf)
Individual User Application Form ( http://www.azahcccs.gov/community/Downloads/Publications/011415IndividualUserApplicationForm.pdf)
6. Initial System Access: The following items must be received from your organization and processed before your organization can start using HEAplus:
• A signed Subscription Agreement
• The $500 set-up fee
• User Application forms
7. Complete Training: The Health-e-Arizona Training Team offers initial and ongoing training to your staff. Monthly HEAplus training sessions for new users will be offered by web conference. Ongoing training opportunities will be available monthly by web conferences.
For more information, please contact an AHCCCS representative at HEAAHCCCS@azahcccs.gov.
Not sure what to apply for? Screening tools can help you find out the programs you qualify for and how to apply.
If you switch to the Hospital Presumptive Eligibility (HPE) at this point, you will NOT be able to use this
application to submit as a full AHCCCS application. You will need to ensure that a full AHCCCS application
is submitted later, if the HPE application is approved.
Select ‘Return to Full Application’ to continue the full AHCCCS application. You will have an opportunity
to also submit a HPE application at the end of the full application process.
Select ‘Continue with HPE’ to apply ONLY for Hospital Presumptive Eligibility.
This application includes Nutrition Assistance and/or Cash Assistance.
You will not be able to help your customer apply for these programs
on this application if you choose to go to the Hospital Presumptive
Eligibility (HPE) application.
Select ‘Return to Full Application” to continue applying for all programs.
Select ‘Continue with HPE’ to apply for ONLY Hospital Presumptive Eligibility. You will need to create
another application if your customer wants to apply for Nutrition Assistance or Cash Assistance.
HPE is only available to persons who have not had HPE in the past 24 months.
Hospital Presumptive Eligibility (HPE) is not available to persons who are age 65
or older when there are no minor children in the household.
Hospital Presumptive Eligibility (HPE) is not available to persons who are
receiving Medicare unless there are minor children in the household.
To continue this application for all persons in this application,
click on the “Return to Full Application” button.
To continue applying for HPE for the other persons in this application, click on
the “Continue HPE for Other Persons” button.
Click “OK” to return to the full application.