Like many states, Medicaid in Arizona goes by a different name. For example, California calls its Medicaid program Medi-Cal while in Massachusetts it’s MassHealth. In Arizona, Medicaid goes by the name AHCCCS.
Pronounced “access” by most people, AHCCCS stands for Arizona Health Care Cost Containment System. Arizona was the last state in the union to implement a Medicaid program, holding out until 1982. In this post, we describe how Medicaid works in Arizona, including eligibility requirements and benefits.
What Is Medicaid?
Medicaid is state-run health insurance, although there are federal guidelines. Most states also receive federal funds for their Medicaid programs, particularly if they chose to participate in the Medicaid expansion program offered as a provision of the Affordable Care Act (commonly referred to as Obamacare).
Former Arizona Governor Jan Brewer accepted federal funding to expand AHCCCS. The federal government funds 93 percent of the costs to provide healthcare to AHCCCS recipients considered part of the expansion. As of July 2018, those funds helped provide healthcare to 487,021 Arizonans who did not qualify for pre-expansion Medicaid.
How Do You Qualify for AHCCCS?
People sometimes confuse Medicare and Medicaid. Medicare is a federal program funded via income tax. American citizens age 65 and older qualify for Medicare. You may also qualify if you are under age 65 and meet certain medical conditions. But there is never an income requirement for Medicare.
Qualifying for Medicaid is different, as the main requirement is income-based. Income limits are based on federal poverty guidelines. In Arizona, it looks like this:
| Number in Household | Yearly Income Limit |
|---|---|
| 1 | $12,490 |
| 2 | $16,910 |
| 3 | $21,330 |
| 4 | $25,750 |
| 5 | $30,170 |
| 6 | $34,590 |
| 7 | $39,010 |
| 8 | $43,430 |
If more than eight people live in your household, add $4,420 to the 8-member income limit for each additional person.
The income limitations vary according to each AHCCCS program.
| Program Name | Family Income Limit |
|---|---|
| Children, birth to age 1 | 147% of the poverty level |
| Children aged 1 – 5 years | 141% of the poverty level |
| Children aged 6 – 18 years | 133% of the poverty level |
| KidsCare (aka CHIP)* | 200% of the poverty level |
| Pregnant women | 156% of the poverty level |
| Parents | 138% of the poverty level |
| Childless adults* | 138% of the poverty level |
| Adults aged 65 and older | 100% of the poverty level |
| Individuals who are blind or have a disability | 100% of the poverty level |
Programs marked with an asterisk (*) are part of the Medicaid expansion.
AHCCCS includes a wide range of programs encompassing numerous age groups and health conditions. Find the full details on AHCCCS Programs and Covered Services.
Applying for AHCCCS
If you meet income requirements, applying for Medicaid in Arizona is easy. The AHCCCS website offers a variety of online application options, as well as forms you can print and mail. If you’re looking for assistance paying your Medicare costs, you may qualify for Medicare cost-sharing, even if your income is above the levels listed above.
AHCCCS and Arizona Long-Term Care System (ALTCS)
At Long-Term Assurance, we’re experts in one particular AHCCCS program: Arizona Long-Term Care System (ALTCS). The program benefits Arizonans who require a level of care equal to that provided by a nursing facility. This is often referred to as long-term care.
To qualify for ALTCS, you do not have to live in a nursing home. You may also receive needed services while living in your own home or an assisted living facility.
How to Qualify for ALTCS
ALTCS has two types of requirements: non-financial and financial.
Non-financial eligibility requirements for ALTCS
Non-financial eligibility requirements include:
- AHCCCS determines you require nursing home-level care
- Applying for all potential cash benefits, including VA and pensions
- Being a resident of Arizona
- Being a U.S. citizen or qualified immigrant
- Having a Social Security Number (or having applied for one)
- Living in approved housing, such as your own home, an assisted living facility, or a nursing home certified by AHCCCS
ALTCS applicants must meet all of the above requirements to be considered eligible.
Financial eligibility requirements for ALTCS
To determine ALTCS eligibility, AHCCCS looks at both your monthly income and countable resources.
Countable income includes:
- Disability
- Retirement pensions
- Social Security
- Supplemental Security Insurance
- Wages
As of January 2019, the monthly income limit for ALTCS is $2,313 for an individual.
Resources are limited to $2,000. Countable resources include:
- Bank account funds including checking, savings, and credit unions
- Cash
- Certain life insurance policies (cash value)
- Additional vehicles
- Real property (not the home you live in)
- Stock, bonds, and certificates of deposit
AHCCCS does not count the home you live in, household and personal belongings, one vehicle, burial plots, and up to $1,500 designated for burial.
How Can Long-Term Assurance Help?
Even if your income or resources exceed these amounts, you may still be able to qualify. We help our clients set up qualified trusts and otherwise plan for their long-term care needs.
To schedule your consultation, call us toll-free at 877-286-0402. You may also fill out our contact form and we’ll call you as soon as possible.
