As the safety net healthcare system for Maricopa County, Valleywise Health extends its services to all in need, and in many cases, is available to help those who are uninsured find the health insurance coverage they need and deserve. About 65% of Valleywise patients utilize the Arizona Health Care Cost Containment System (written AHCCCS and pronounced “access”).
AHCCCS is Arizona’s Medicaid program that provides health insurance for people with limited income and resources. It covers programs for acute and long term care, behavioral health and children’s care. Currently the program enrolls nearly 2 million Arizona residents.
AHCCCS works by having you choose a health plan that covers your zip code area. If you are approved, you will choose a primary care doctor that works with that health plan. Your primary doctor then becomes the first person you go to for care, as well as the one to authorize any non-emergency medical services and to refer you to a specialist when necessary.
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. These specialists can be reached at (602) 344-2550 or by visiting www.valleywisehealth.org/patients.
What Does AHCCCS Cover?
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 you’re recently unemployed or simply unable to pay for private insurance. AHCCCS works with doctors, hospitals, pharmacies, specialists and more to make sure that you are covered for all of the following medical services:
- Doctor’s Visits
- Immunizations (shots)
- Prescriptions (Not covered if you have Medicare)
- Lab and X-rays
- Specialist Care
- Hospital Services
- Transportation to doctor
- Emergency Care
- Podiatry Services Performed by a Podiatrist
- Pregnancy Care
- Surgery Services
- Physical Exams
- Behavioral Health
- Family Planning Services
Covered only for children under age 21
- Vision Exams
- Dental Screening
- Dental Treatment
- Emergency Dental (Up to $1000 per contract year)
- Hearing Exams
- Hearing Aids
AHCCCS covers several behavioral health services, including supervised and therapeutic day programs, crisis services, rehabilitation programs for living skills, educational support, supported employment, and cognitive rehabilitation, medication management training, case management, housing support, personal assistance and much more. Visit the AHCCCS website for a breakdown of all the available behavioral health services covered.
AHCCCS also provides long term care services by contracting with doctors, nursing homes, assisted living facilities, hospitals, pharmacies and specialists. Applicants are assigned a case manager to coordinate their care. In addition to the services listed above, people who qualify for long term care can receive services such as:
- Nursing Facility
- Attendant Care
- Assisted Living Facility
- Adult Day Care Health Services
- Home Health Services
- Nursing Services
- Home Health Aides
- Home Therapy
- Home Delivered Meals
- Case Management
- Dental Services (up to $1000 per contract year)
Do I Qualify?
To determine eligibility, you need to fill out the online application on Health-e-Arizona PLUS (https://www.healthearizonaplus.gov/) or mail in a completed form to the Family Assistance Administration of Arizona. To qualify, you must be an Arizona resident with citizenship or qualified immigration status. You must also be under the income limit, which varies depending on age and size of household.
Again, if you need assistance determining your qualification status, consult Valleywise Health Eligibility Specialists by calling (602) 344-2550 or visiting www.valleywisehealth.org/patients.
How to Apply
You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). You can apply for yourself, your family, or someone close to you.
You can also download the form online, fill it out, and mail in to:
Arizona Department of Economic Security
Family Assistance Administration
P.O. Box 19009
Phoenix, Arizona 85005-9009
There are no fees for applying for AHCCCS. When seeking medical services, you may have to make a co-payment. While some co-payments are mandatory depending on service and location, in some instances the provider may ask for the co-payment, but cannot deny service if you are unable to pay.
When Does Coverage Start?
AHCCCS Medicaid coverage generally starts the first day of the month in which you are found eligible. Applicants will receive a medical assistance letter that contains the official start date.
If you are unsure about applying for AHCCCS coverage, you can visit their official website to get support. If you have questions about AHCCCS coverage at Valleywise Health, call 1 (833) VLLYWSE.
1. Health-e-Arizona Plus