The Arizona Health Care Cost Containment System (AHCCCS) offers health care plans for Arizona residents that are sponsored by the Medicaid program. AHCCCS offers a number of health plans for eligible participants who do not have insurance coverage, including plans for seniors, families with children, or adults without children, and plans designed just for kids. Each program requires you to meet eligibility prerequisites, including residency and income requirements.
AHCCCS Health Providers
AHCCCS offers health plans through a number of health insurance providers, including Health Choice Arizona, Phoenix Health Plan, University Family Care and Maricopa Health Plan. Participants choose providers depending on their county of residence. For example, AHCCCS offers plans through Health Choice Arizona and Phoenix Health Plan for residents of Apache County, while providers for Pima County include APIPA, Pima Health Plan and University Family Care, among others. You will find the same services covered by all plans, but each specific plan has particular doctors, hospitals and pharmacies you must work with.
Health Maintenance Organization Structure
AHCCCS health plans work in the same way a Health Maintenance Organization (HMO) plan works. Plans have networks of approved doctors, specialists, pharmacies and hospitals. After obtaining approval for a plan, you can choose a primary physician. The doctor you select serves as your first point of contact for receiving medical treatments and services. The primary doctor will refer you to specialists for any services she cannot provide.
Coverage
AHCCCS covers doctor's visits, hospital services, emergency care, surgery services, specialist services and laboratory services. Specific services and treatments can include X-rays, prenatal care, dialysis, podiatry services and annual women's exams. Programs also cover your prescription drugs, unless you have Medicare. Your dependent children can receive additional benefits until the age of 21, including vision exams, dental treatments, hearing aids and glasses.
Plan Categories
Thirteen different plan categories are available for you to choose from in the Arizona Health Care Cost Containment System, depending on your individual status and needs. Plans include coverage for families with children, pregnant women, adults with no children, individuals 65 years of age and older, and programs for children only.
Eligibility
You may qualify for an AHCCCS plan if you are a resident of Arizona and a U.S. citizen or qualified immigrant, have a Social Security number or have applied to receive one, and have applied for income from unemployment, Social Security or a pension. Plans have eligibility income limits, which vary by plan. For example, the income limit for the families-with-children plan is $903 per month for a family with one child, $1,526 for a family with three children, and $2,150 per month for a family with five children. Once you are deemed eligible for a program, you might receive coverage with no monthly premiums.
American Indian Health
The state also has programs designed specifically for American Indians, offered through the American Indian Health program. Providers within the American Indian Health program include American Indian Health Program (AIHP), American Indian Health Provider Technical Assistance, and American Indian Health Facilities (ITUs). ITU stands for Indian Health Service, Tribally-Operated 638 Programs, and Urban Indian Health Programs.
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