How the Arizona Medicaid Program Works and How to Become Eligible


The Medicaid program in Arizona is known as AHCCCS (or the Arizona Health Care Cost Containment System). With this system in place, everyone in the state should have access to health coverage. But how can you know if you’re eligible to receive Medicaid benefits?

There are some basic eligibility requirements for AHCCCS such as U.S. citizenship (or meeting the noncitizen requirements), a certain income level, and being below a certain age. There are some exceptions for this, which we’ll mention a bit later, along with how an attorney can help you in this process. But first, let’s cover the basics on what Medicaid offers and how to apply.

What You Should Know About Arizona Medicaid

  • You must be a state resident or an eligible noncitizen to get benefits
  • Most people must earn below a certain income to qualify for Medicaid
  • If you’re older than 65, you may be able to access Medicare assistance
  • A branch of medicaid called ALTCS helps Arizona citizens pay for long-term care
  • An attorney can help you with your application process and any questions you may have about accessing Arizona Medicaid

Eligibility Requirements

To get AHCCCS benefits, you must earn $1,005 monthly or less in income, or $1,354 per month for a couple. You must be an Arizona resident and a citizen of the United States (or a qualifying noncitizen). If you’re legally present in the U.S., but aren’t eligible for AHCCCS benefits, you might be able to get subsidized private coverage with Undocumented immigrants might have access to AHCCCS assistance if they have an emergency need.

If you’re younger than 65 and aren’t receiving income from Social Security Disability, the application process will involve a disability determination. You must apply for retirement benefits, disability, or pension if these options are potentially viable for you. The eligibility rules for AHCCCS differ for most individuals who either have or are eligible for Medicare assistance. However, if you have Medicare and are pregnant or the caretaker/parent of a child, you might qualify for AHCCCS benefits.

Income Considerations

Income-based AHCCCS assistance will count most of your unearned and earned income. Some income won’t count though, such as SSI (Supplemental Security Income) benefits and certain retirement account contributions. If your family earns a total income of 138 percent or less of the FPL (Federal Poverty Level), which is $17,236 yearly in 2019 for a single person and $35,535 for a 4-person family, you should meet the income requirements for AHCCCS.

Keep in mind that some sources list the income limit percentage for AHCCCS as 133 percent. This is because, when the program counts your earnings, they will take 5 percent of the FPL off your income if you earn over 133 percent of FPL. If you have a child who is 18 or younger, they may qualify for KidsCare benefits if their 4-person household earns $52,788 or less on a yearly basis.

What If You’re Over 65?

If you’re over 65, Medicare is the program that you’ll most likely go through to receive health care assistance (though some who are younger also qualify for Medicare). When you’re employed, part of your earned income is taken from your check to contribute to Medicare, the public health insurance program that helps to cover medical costs for qualifying U.S. residents. In addition to being older than 65, here are some of the qualifications for Medicare:

  • You or your spouse has worked for long enough while paying into taxes for Medicare
  • You’ve been receiving SSDI (Social Security Disability Insurance) for at least two years
  • You have ALS (Lou Gehrig’s disease) or ESRD (end-stage kidney disease)
  • You’ve received CDB (Childhood Disability Benefits) for at least two years due to your parent’s contributions

How Working With an Attorney Can Help

Many state and federal government programs are complex and may unfairly deny benefits to applicants. Having a lawyer to speak with through the process can help for support and advice on the application process. They can point you in the right direction for determining eligibility for not only AHCCCS but also Social Security benefits, Food Stamps, Unemployment, and more.
While an attorney can’t always help you qualify if your income is too high for benefits, they can ensure that you receive fair treatment during the application process, such as communication about the results of your application and a timely application review. If your benefits are denied unfairly, they can also assist you in appealing the decision.

Frequently Asked Questions on Arizona Medicaid

Here are some common queries regarding Medicaid benefits for residents of Arizona:

Q: Are Medicaid and AHCCCS the same thing?

The Medicaid program in Arizona is called AHCCCS (the Arizona Health Care Cost Containment System), so yes, they are the same thing.

Q: Does Arizona Medicaid pay for assisted living?

Medicaid may help cover assisted living costs for those who qualify. Arizona has a program known as ALTCS (or the Arizona Long-Term Care System). This branch of Medicaid helps cover long-term needs for eligible residents, which can include assisted living care.

Q: How do you apply for Medicaid in Arizona?

You can submit an application online for Cash Assistance, Nutrition Assistance, and AHCCCS Medical Assistance with Health-e-Arizona Plus. You may fill out an application for yourself, or for a loved one.

Q: Does Medicaid cover dental in Arizona?

You might be able to use your AHCCCS benefits to cover some emergency dental costs, such as treatment fees for a jaw fracture, infection, or acute pain. Covered services may include required x-rays, anesthesia, oral surgery, an exam of cavities, and pain or antibiotic medications for your treatment. Note that restorative services or preventative dental care (like braces, dentures, fillings, or cleanings) aren’t covered.

What to Do if You Need Help with Medicaid in Arizona

If you’re stuck navigating the AHCCCS application process or have hit a road block in the process, speak with one of our elder law attorneys today. They can help point you in the right direction and give you the best shot at gaining health assistance benefits in Arizona. They’ll also help you appeal your denial if your application is rejected when applying for healthcare assistance.

Need Help Applying for ALTCS in Arizona?

If you need help setting up Medicaid, speaking with a lawyer is a good place to start. The application process itself can be complex and confusing, and making mistakes can set you back in attaining benefits and services. If your situation is complicated or you need help meeting the eligibility requirements, one of our attorneys can answer your questions.

Contact the JacksonWhite ALTCS team today at (480) 467-4337 and learn more your options for long term care.

Contact Our ALTCS Team Today

Call (480) 467-4337 or fill out our contact form to schedule your consultation.