You are invited to participate in a survey regarding your experience using the AHCCCS website. This survey will take approximately two minutes. Your responses will help us ensure that you have a high quality experience.
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 may be able to reduce office visits and postage delays by using Health-e-Arizona Plus.
Note: Health-e-Arizona Plus is offered in both English and Spanish.
Click on the link to DES below if you (or the person you are applying for) are one
or more of the following:
You can use one application to apply for AHCCCS Medical Assistance for everyone in
your household. Applications for AHCCCS Health Insurance are available on the Department
of Economic Security (DES) Application page:
Click on the link to the application below if you (or the person you are applying
for) are one or more of the following:
The application below is to apply for AHCCCS Health Insurance and/or Medicare Costs
Sharing programs. To open the form so you can print it, click on the link below.
These forms are saved in PDF format and you must have the Adobe Acrobat Reader installed
in your browser to open them. If you don't have Adobe Acrobat, you can get it here.
Note: This application process does not apply for individuals
who are in need of Arizona Long Term Care System (ALTCS)
services, such as in home healthcare, nursing facility, or assisted living. To apply
for Long Term Care, contact one of our ALTCS offices.