October 31, 2024

Who is Eligible for AHCCCS?

Learn who is eligible for AHCCCS and how AHCCCS income limits affect your ability to qualify for healthcare coverage, treatment options and more.

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who is eligible for ahcccs?

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Last Update on October 31, 2024

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AHCCCS (Arizona Health Care Cost Containment System) is Arizona’s Medicaid program, designed to provide healthcare to individuals and families who meet the specific AHCCCS income limits and eligibility criteria.1

It covers various groups, including low-income families, children, pregnant women, elderly individuals, and those with disabilities.

Let’s explore some of the key factors that help determine who is eligible for AHCCCS.

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Key Points

AHCCCS Eligibility Requirements

These requirements are the foundation for AHCCCS eligibility but keep in mind that different programs may adjust slightly based on age, health conditions, or family composition.2

To qualify for AHCCCS, you must first meet these requirements:

  • Residency: You need to be an Arizona resident.
  • Income: Your income must fall within the AHCCCS income limits, which are based on the Federal Poverty Level (FPL).
  • Citizenship: You must be a U.S. citizen or qualified non-citizen.

AHCCCS Income Limits

AHCCCS income limits are essential for determining eligibility, but it’s important to note that these qualifying income limits vary based on the size and composition of your household.

For example:

  • Pregnant women can qualify with household incomes up to 156% of the FPL.
  • Children under 19 are eligible if the household income is up to 205% of the FPL.
  • Low-income adults generally qualify if their income is at or below 138% of the FPL.

 

These numbers change annually, so it’s important that you consistently check for updates to know if you qualify.

AHCCCS Age Restrictions

Your age can also affect your eligibility for different AHCCCS programs:

  • KidsCare: Available for children under 19, especially those whose family incomes exceed standard Medicaid limits.
  • Adults: AHCCCS covers low-income adults up to the age of 65 based on income limits.
  • Seniors (65+) and disabled individuals: These individuals may qualify for long-term care under the Arizona Long Term Care System (ALTCS), a program designed for those needing ongoing support.

 

This ensures that AHCCCS addresses healthcare needs at every stage of life.

Citizenship and Residency

AHCCCS also requires you to verify both citizenship and residency.

This means you must be a U.S. citizen or a qualified non-citizen (lawful permanent resident), as well as an Arizona resident, to apply.

If you’re undocumented, emergency Medicaid may provide limited coverage to see to your urgent medical needs.

However, full AHCCCS benefits are reserved primarily for individuals with proper citizenship or residency status.

Gather Documents for a Smoother AHCCCS Application

Before applying for AHCCCS, make sure to gather all necessary documents, such as proof of income, Arizona residency, and U.S. citizenship or legal residency status. Doing this can help speed up the application process and ensure you receive the medical care coverage you need as quickly as possible.

Other Ways to Qualify for AHCCCS

While the general qualifications of AHCCCS apply to most cases, there are a few exceptions. 

Here are some alternative ways to qualify for AHCCCS when facing specific health challenges or disabilities.

These situations include:

  • Pregnancy: Pregnant women have higher income limits.
  • Disabilities: Individuals with physical or developmental disabilities may qualify for specialized services through ALTCS.

 

Programs like these ensure that even those who don’t meet the traditional AHCCCS income limits can still receive essential healthcare.

Frequently Asked Questions

What is AHCCCS, and who can apply?

AHCCCS is Arizona’s Medicaid program that provides low-income individuals and families access to healthcare services. To apply, you must be a resident of Arizona and meet specific income, age, and citizenship or residency requirements. AHCCCS is available to various groups, including children, pregnant women, elderly individuals, and those with disabilities.
AHCCCS income limits vary based on household size and the specific program you are applying for. Generally, eligibility is determined by the Federal Poverty Level (FPL), and individuals or families must fall below a certain percentage of that level to qualify. It’s important to check the current FPL guidelines, as these limits are updated annually.
Yes, non-citizens can qualify for AHCCCS if they are lawful permanent residents or meet other qualifying criteria for non-citizens, such as refugees or asylees. However, undocumented individuals are not eligible for full AHCCCS coverage but may qualify for emergency Medicaid in certain cases. It’s essential to check the specific residency requirements to confirm eligibility.

Understanding AHCCCS Eligibility and Next Steps

Qualifying for AHCCCS can be life-changing, providing access to essential health services for those who need it most.

Understanding the eligibility criteria—such as income requirements, household size, and specific needs like disability or pregnancy—can help individuals determine if they’re eligible and take the next steps to apply.

For those who believe they qualify, applying for AHCCCS can open doors to valuable health coverage, offering support for both physical and mental well-being.

At Cornerstone Healing Center, we provide a range of addiction and mental health treatment programs covered by AHCCCS.

If you or a loved one needs support, explore the programs and services available through AHCCCS coverage and take a step toward healing.

Reach out today to learn more about how we can support you on your journey to recovery and wellness.

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Author & Reviewers

lionel estrada lisac clinical director
CLINICAL DIRECTOR & REVIEWER

Lionel is the Clinical Director of Cornerstone’s Scottsdale treatment facilities. He has had over 4 years at Cornerstone. He is personally in recovery and passionate about helping others overcome substance abuse and mental health challenges; he is trained as an EMDR, adopting a trauma-informed approach to treat the underlying issues.

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