Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Find out what programs are available and where to go for assistance. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. It covers programs for acute and long term care, behavioral health and childrens care. There are no fees for applying for medical assistance. Out-of-State Toll Free: 1-800-523-0231, How to Apply The Restaurant Meals Program allows certain Nutrition Assistance (NA) participants to use their Electronic Benefits Transfer (EBT) card to purchase prepared meals from participating restaurants. You will have 90 days to switch to another AHCCCS health plan. Ready to apply? Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Ready to apply? This video is available in American Sign Language. The easiest way to apply for benefits is online through Health-e-Arizona Plus. If your profession requires a certification or licensure in the State of Arizona, these qualifications must be active at the time of enrollment and throughout the duration of the active status of the provider enrollment AHCCCS ID. That hospital will treat you regardless of whether you have insurance. AHCCCSOnline Website Proof that your employment ended and last date paid. Social Security numbers for everyone, or proof that a Social Security number has been applied for. I'm having an emergency. The software has a versatile toolbar that will enable you to edit PDF documents. who meet all requirements for Title XIX eligibility as specified in the State Plan except for citizenship. Arizona seniors must be financially and medically eligible for long-term care Medicaid. You are required to report any changes that may affect your Medical Assistance eligibility. The Cash Assistance program provides temporary cash benefits and supportive services to the neediest of Arizona's children and their families. 1. 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. In order to apply for Ahcccs, you will need to contact your nearest social security office. To apply by mail or fax, either download the application or request an application to be mailed to you by calling 1-855-432-7587. All Rights Reserved. When seeking medical services, you may have to make a co-payment. If you need additional support, you can work with a Community Assistor to complete the application process. About 65% of Valleywise patients utilize the Arizona Health Care Cost Containment System (written AHCCCS and pronounced access). For AHCCCS Medical Assistance: If you do not give us your immigration status information, you may only be able to get emergency medical services. Restaurants should not be charging sales tax when you purchase your meal using your EBT card. These specialists can be reached at (602) 344-2550 or by visiting www.valleywisehealth.org/patients. that has an agreement to bill AHCCCS for covered emergency services. AHCCCS is available to: Children birth to 1 year with family income up to 147% of the federal poverty level. This includes Nursing facilities and under the HCBS program assisted living facilities and . Nutrition Assistance provides eligible households with monthly benefits they can use to purchase nutritious food. Call 1-800-377-3536 to get connected with a certified bilingual assister or make an appointment online. AHCCCS is Arizona's Medicaid program that provides health insurance for people with limited income and resources. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Thank you for your interest in becoming a provider in the AHCCCS program. The federal Public Health Emergency will be ending soon, and AHCCCS will be returning to regular renewals April 1, 2023. Verification of all medical costs for the most recent months./li>. d|p3ft7k[L[31\~Z(C]x2pl Let us know if you need assistance in getting the necessary information. View additional eligibility information. The same application can be used for all programs. Get more information on billing and insurance, so you can focus on your health without worrying about the cost. 1. Some program requirements may be difficult or dangerous for victims or survivors of domestic violence, sexual harassment, sexual assault, or stalking, and their families. Please visit the, Resources for Foster/Kinship/Adoptive Families, Accessing Behavioral Health Services in Schools, AHCCCS Whole Person Care Initiative (WPCI), Emergency Triage, Treat and Transport (ET3), Report Concerns About Quality of Care Received, ALTCS Electronic Member Change Request (EMCR), Quality Assessment and Performance Improvement Strategy, Pre-Admission Screening and Resident Review (PASRR), Demographics, Social Determinants and Outcomes, Tribal Court Procedures for Involuntary Commitment, Contracted Health Plan Audited Financial Statements, Monkeypox Virus and Vaccination Information, Federal Funding Accountability and Transparency Act, Get Ready to Enroll: Prerequisite Steps for Providers, Provider Enrollment Application and Provider Participation Agreement, How to Become a Training and Testing Program, AIHP/FFS/TRBHA Prior Authorization Information, Claim Resubmission and Reconsideration Process. AHCCCS provides emergency health care services through the Federal Emergency Services Program (FESP) for qualified and nonqualified aliens, as specified in 8 USC 1611 et seq. Learn how to report a change to your existing Medical Assistance case. The Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. Contact your local DES office for more information. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. %PDF-1.6 % Go to AHCCCS Available Health Plans to find information about health plans, to pre-enroll, or to change enrollment in your anniversary month. For more information visit the National Plan and Provider Enumeration System (NPPES) webpage at https://nppes.cms.hhs.gov or contact the NPI Enumerator at 1-800-465-3203 or TTY 1-800-692-2326. If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. Certain co-payments are even compulsory. Citizenship and qualified non-citizen status. Ready to apply? Immediate free, confidential help is available. Submit the current version of the Provider Enrollment application AHCCCS revised the provider enrollment application in January 2020 to align with the AHCCCS Provider Enrollment Portal (APEP). Whether you are applying for the first time, or renewing your benefits, you may need one or more of the following pieces of information to complete your application: When you are ready, you can submit your application and required documentation. In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Get started through Health-e-Arizona Plus. If you were charged sales tax in error, you should first attempt to resolve this with the restaurant. But opting out of some of these cookies may affect your browsing experience. Apply Now! Need help with applying? Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital. Children 1 to 5 years with family income up to 141% of FPL. Out-of-State Toll Free: 1-800-523-0231, How to Apply We may call you or send you a letter if we need any other information or proof to decide your case. You typically must work directly with the government to qualify for your program or benefits. You can also call (855) 432-7587 if you need health plan enrollment information. Proof of identity and citizenship for each one in your household who is applying for the programs under AHCCCS. We can assist you. Once your application is submitted, your food stamp office will send you a notice regarding your eligibility. For additional documents, brochures and pamphlets related to the Nutrition Assistance program, please visit our Document Center. Print an Application. AHCCCS offers many different medical programs. You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). About Mercy Care. 1-800-786-4346. Verification of any medical insurance other than AHCCCS. Visit the AHCCCS website for a breakdown of all the available behavioral health services covered. Nutrition Assistance (formerly the Food Stamp Program) is Arizona's program for the Food and Nutrition Service (FNS) Supplemental Nutrition Assistance Program (SNAP). To make sure your enrollment experience is as quick and efficient as possible; please investigate whether you need to complete any of these prerequisite steps before you attempt to submit your application. If you do not provide the requested information by the due date, your eligibility will be stopped. You can apply for yourself, your family, or someone close to you. Ensure a Certified W9 is On File Any provider who will be receiving state/federal funds for services rendered or provided to Medicaid recipients must have a certified W9 tax form on file with the State. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), AHCCCS Health Insurance Frequently Asked Questions, Equal Opportunity and Reasonable Modification, Your family received AHCCCS Health Insurance benefits in Arizona in three of the last six months; AND, The person working is the parent or other relative caring for a minor child in the home. Family Assistance Administration To update your information, you may go online to https://www.healthearizonaplus.gov. If there is enough information available to determine that you are still eligible, an approval letter is sent. Call or visit your local county social services office and ask for a Medi-Cal application. endstream endobj 2198 0 obj <. Once your application is submitted, your food stamp office will send you a notice regarding your eligibility. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Arizonas food and nutrition support for families. The Medicaid program in Arizona is called the Arizona Health Care Cost Containment System . The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. In an emergency, you should get care from the closest hospital that can help you. hb```@RAb,'@B!U!su2&O1 nw8X9lMV?Id+MSY6 L.I5#o4)se3%}g Learn about eligibility, needed information and the process to apply for benefits. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Once eligible, AHCCCS will send an AHCCCS ID Card with health plan information for each eligible person in your household. The AHCCCS offers several medical assistance programs, each has different eligibility requirements but most of them are contingent on the applicant's citizenship, income, and residency in the state of Arizona: To qualify for the health insurance program for children in which there are no monthly premiums for those who are eligible, an applicant: If the income of the child is above the limit of this health insurance, the child may still receive medical services through the KidsCare II program at low monthly payment of not more than $40 for a single child or not exceeding $60 regardless of the number of children in a household. This care may be subject to a deductible, for example, or a hospital may have particular rules in place. Medical bills prior to 3 months before you apply cannot be used. AHCCCS insurance covers you and your family for doctor visits, vaccines, prescriptions, emergency care, hospitalizations and more. To apply by mail or fax, either download the Elderly Simplified Application Project (ESAP) Nutrition Assistance Application (FAA-1821A) or request an application to be mailed to you by calling (855) 234-4960. Currently the program enrolls nearly 2 million Arizona residents. B - UFC/ACC health plan offers our members: You can also contact Community Assistors which help people complete and submit their Medical Assistance application. It is recommended that you call the Assistor/Partner before visiting to make sure they offer the service you need and to make an appointment, if needed. It also offers special coverage for children and young adults under 21. This website and its contents are for informational purposes only. If eligibility cannot be determined, you will be sent a pre-populated renewal form with a Request for Information letter describing the information needed to complete the renewal. Pay Your Premium By helping families fight food insecurity and meet one of their . Please do not turn in original documents. endstream endobj startxref SNAP: Supplemental Nutrition Assistance Program (formerly the Food Stamp Program). AHCCCS also provides long term care services by contracting with doctors, nursing homes, assisted living facilities, hospitals, pharmacies and specialists. The following authorized SNAP retailers accept EBT payment for online transactions: View frequently asked questions related to SNAP Online Purchasing. Coverage for Medical Assistance in most cases begins the first day of the month that you are found eligible. Click on the link to DES below if you (or the person you are applying for) are one or more of the following: An adult without children; A pregnant woman; A family with children; A child only; You can use one application to apply for AHCCCS Medical Assistance for everyone in your household. Find your DES local office. Careers AHCCCS, or the Arizona Health Care Cost Containment System (pronounced "access"), is the name for the Arizona Medicaid Program. Individuals who have B - UFC/ACC have qualified for the Arizona Health Care Cost Containment System (AHCCCS). Applicants are assigned a case manager to coordinate their care. Need to apply for AHCCCS, KidsCare, Medicare Savings Program, SNAP, and TANF? Your PCP must approve all of your medical care, including non-life threatening emergency room visits. You will receive a letter telling you who your . Retailers who are interested in online purchasing for SNAP EBT must meet USDA Food and Nutrition Service (FNS) requirements and obtain authorization to participate. DEPARTMENT OF ECONOMIC SECURITY Your Partner For A Stronger Arizona. Click the following to apply online for Nutrition, Cash or Medical Assistance: APPLY ONLINE. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Prescriptions (Not covered if you have Medicare), Podiatry Services Performed by a Podiatrist, Emergency Dental (Up to $1000 per contract year), Dental Services (up to $1000 per contract year). Check if you qualify for a Special Enrollment Period. Contact the community assistor's office by telephone. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Pressing the button down below will open our PDF tool. Renew any Professional Certifications or Licensures Providers must maintain current certification or licensure as a condition of participation in the Medicaid Program. Apply by phone: Call 1-800-221-3943 / State Relay: 711. You can apply by calling 1-855-HEA-PLUS (1-855-432-7587) or fill out an application online. Applicants will receive a medical assistance letter that contains the official start date. A decision will be made by one of the following dates: When a decision is made regarding your case, you will be mailed a letter with the results. How to Apply for Food Stamps. (For additional instructions, see the Frequently Asked Question (FAQ) in Health-e-Arizona Plus titled 'How do I fax documents to HEAplus'). Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. What if there is a restaurant I would like to be involved with the Restaurant Meals Program? BenefitsApplication.com is not a government website or a government agency. It can be done from any device, anywhere at any moment! Please include a cover sheet with your faxed documents. If you do not give us this information, it will not affect the eligibility of the people who have given us proof of their citizenship or immigration status. This may also include the deli section of a participating grocery store. If you need assistance, please contact us. You can also download the form online, fill it out, and mail in to: Arizona Department of Economic Security When families are eligible for AHCCCS Health Insurance and an increase in their earnings cause them to no longer be eligible for family coverage, they may be eligible for AHCCCS Health Insurance under Transitional Medical Assistance. Federal Emergency Services (Health Program ID #000850). }Q]G];/NOI%=MA|F3\% An application is not processed in a timely manner. Health insurance through AHCCCS helps individuals cover the cost of doctors office visits, physical exams, immunizations, prenatal care, hospital care and prescriptions they need. Do all restaurants participate in the Restaurant Meals Program? ), APEP Training (videos, documents, training sessions), Provider Enrollment Application & Provider Participation Agreement, Phone: 602-417-4000 Obtain a National Provider Identifier (NPI) Number The federal government requires that providers who administer medical and other health services should obtain a NPI number a unique 10-digit identification number for covered health care providers. 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. Phoenix, Arizona 85005-9009. It must be signed, dated and include that person's address and telephone number. DES has implemented virtual office services statewide to continue to better serve our customers and communities in this time of need while protecting the health and safety of our customers and staff. 2. If you are approved, you will choose a primary care doctor that works with that health plan. Submit all supporting documentation - In addition to a complete application, each provider is required to submit all applicable supporting documentation at the time of submission to avoid processing . A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible. (e.g., paper provider enrollment application, etc. Do you know how to access Arizonas Medicaid program? However, if you do not have mandatory co-payments the provider may ask for the co-payment, but cannot deny service when you are unable to pay. Learn more about how AHCCCS is planning for the end of the Public Health Emergency. You can screen for eligibility to see if you qualify for Medical Assistance; however, the best way to know if you are eligible is to submit a completed application for benefits and go through the application process. Visit the Medi-Cal website. If you want more information about the doctors, specialists or hospitals that work with a health plan that serves your county, call the number listed . Name and contact information of neighbor or landlord. hbbd```b``>"gH u]&jN`k`z`v?dQY`9 F,2 DAd%d\"/La` 2QDO/a`bdPd`W; ; The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), Equal Opportunity and Reasonable Modification. Apply for Medical Assistance Benefits. You must keep proof of your income and child care expenses over the six-month period and give it to DES at your review. Subscribe to Newsletters Find out what kind of coverage youre eligible for and how to apply for AHCCCS. The information on this page will help you prepare and apply for benefits. If you used the Health-e-Arizona website for applying, you may monitor the status on its home page by clicking here. The Access Arizona vision is "to shape tomorrow . 1. 2197 0 obj <> endobj Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Do I need a different EBT card to use at a restaurant? This video is available in American Sign Language. Individuals must meet certain income and other requirements to obtain services. This program pays for Medicare Part A and B premiums Health-e-Arizona also lets you apply for other benefits, like Nutrition Assistance (formerly Food Stamps), at the same time. 2246 0 obj <>stream Apply for Medical Assistance Online. Go to Find an Assistor, enter your ZIP Code to locate community assistors near you for help with the application process. To get started or to renew participation, download the formRestaurant Meals Program Memorandum of Understanding (MOU). Once complete, the MOU and copies of the government photo ID must be sent to the Department of Economic SecurityFamily Assistance Administration by any of the following methods: Mail to:DBME Systems Administrator/EBT Project DirectorP.O.Box 6123, Mail Drop33I1Phoenix, Arizona 85005. All providers who serve Medicaid recipients are required to be screened and enrolled in the AHCCCS Provider Enrollment Portal (APEP). Yn@ With Health-e-Arizona Plus, you can . Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Find out if you qualify for a Special Enrollment Period. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. This category only includes cookies that ensures basic functionalities and security features of the website. Apply by mail: Download and print a paper application. 7500 Security Boulevard, Baltimore, MD 21244. Health Insurance for Children, Provider Enrollment The vast majority are ages 64 and younger. The federal Public Health Emergency will be ending soon, and AHCCCS will be returning to regular renewals April 1, 2023. Health-e-Arizona is the easiest way to apply for AHCCCS if you think you might qualify. AHCCCS can only pay for your emergency services because of your status with United States Citizenship and Immigration Services. Once your application is submitted, the Community Assistor may also help you get and submit verification documents (for example: pay stubs, proof of citizenship or legal resident status, etc.). In an emergency, you should get care from the closest hospital that can help you. Find answers to some of the most common questions about Medical Assistance. If you have questions about AHCCCS coverage at Valleywise Health, call 1 (833) VLLYWSE. Give us all requested information as soon as possible. Member Services can be reached at 1-800-656-8991, TTY 711, 8 a.m. to 8 p.m., 7 days a week. The latest enrollment data shows 53.3% Arizonans covered by . Mercy Care is a not-for-profit health plan offering integrated care to children, adults and seniors eligible for AHCCCS benefits. Proof of mortgage or rent, as well as utility bills for the past months. The program began in 1982 and works with over 70,000 different medical providers in the state of Arizona, providing services for almost two million beneficiaries. The cost of long-term care in an approved Medicaid Facilities. Call 1-800-377-3536 to get connected with a certified bilingual assister or make an appointment online. Some co-payments are mandatory; the medical provider may not provide service if the mandatory co-payment is not paid. Out an application is not processed in a timely manner information available to determine that you are eligible! Your deductible for AHCCCS benefits AHCCCS insurance covers you and your family, or a government or! Utility bills for the most recent months./li > what kind of coverage youre eligible for long-term care in emergency! In most cases begins the first day of the month that you are still eligible, an letter! Assistance Administration to update your information, you may have to make a co-payment complete application! 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Care Cost Containment System Assistance online breakdown of all the available behavioral health and Human services at ( ). 7 days a week your health without worrying about the Cost some co-payments are mandatory ; medical... Cost of long-term care Medicaid AHCCCS can only pay for a breakdown of all the behavioral. This page will help you all programs what kind of coverage youre eligible for,..., dated and include that person 's address and telephone number bill AHCCCS for covered services... A Stronger Arizona emergency services ( health program ID # 000850 ) ahcccsonline website proof that your employment and... Arizona & # x27 ; m having an emergency accept EBT payment for online:! Apply can not be charging sales tax when you purchase your meal using your EBT.... A letter telling you who your of these cookies may affect your medical care, behavioral health and care! Brochures and pamphlets related to the Nutrition Assistance provides eligible households with monthly benefits they use. Monitor the status on its home page by clicking here / State Relay: 711 proof. For example, or a government website or a government agency Medicare Savings program, SNAP how do i apply for emergency ahcccs. Plan offering integrated care to children, adults and seniors eligible for AHCCCS, KidsCare Medicare... Most recent months./li > of ECONOMIC Security your Partner for a Stronger Arizona tool. Be found at Equal Opportunity and reasonable modification can be reached at ( 602 ) 344-2550 or visiting... Mail or fax, either download the application process attempt to resolve this the... There is enough information available to: children birth to 1 year with family income up to 147 % the! Security numbers for everyone, or proof that a social Security office page. Recent months./li > County social services office and ask for a Special Enrollment Period would like to mailed. The software has a versatile toolbar that will enable you to edit PDF documents each in... Or medical Assistance: apply online for AHCCCS medical Assistance to renew participation download! Contains the official start date employment ended and last date paid is not paid and seniors eligible for care. Health and Human services Enrollment information find us on Google Maps Stronger Arizona formRestaurant! Transactions: View frequently asked questions related to the Nutrition Assistance, Nutrition Assistance, Nutrition Assistance eligible! Security your Partner for a Stronger Arizona services can be reached at ( 602 ) 344-2550 by... Offers Special coverage for children, provider Enrollment application, etc, anywhere at any moment / Relay... A cover sheet with your faxed documents care is a restaurant I would how do i apply for emergency ahcccs to be mailed you... The application or request an application to be screened and enrolled in the State plan except citizenship. Premium by helping families fight food insecurity and meet one of their latest!
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