View, Print, or Download AHCCCS Publications

AHCCCS offers printable English/Spanish brochures and posters for most programs, including general AHCCCS health insurance, insurance for children, insurance for older adults, and others. Publications periodically revised without notice.

NOTE: Information provided in PDF files.

• Application For AHCCCS Health Insurance (AH-001)
  The official application for medical coverage for yourself, someone in your family, or for someone you are representing.
  
  • English [986KB]
  • Spanish [947KB]
• Arizona CoppeRx Card Brochure
  A brochure that provides basic information about the card. A temporary card is attached.
  
  • English [357KB]
  • Spanish [366KB]
• Baby Arizona Member Information Sheet
  • Bilingual [25KB]
• Estate Recovery Brochure (DE-810)
  • English [38KB]
  • Spanish [56KB]
• AZ Long Term Care System (ALTCS) Community Spouse Information Sheet (DE-817)
  • English [19KB]
  • Spanish [20KB]
• AZ Long Term Care System (ALTCS) Resource Transfer Information Sheet (DE-818)
  • English [17KB]
  • Spanish [17KB]
• AZ Long Term Care System (ALTCS) Trust Information Sheet (DE-819)
  • English [19KB]
  • Spanish [19KB]
• AZ Long Term Care System (ALTCS) Information Sheet (DE-828)
  • English [27KB]
  • Spanish [24KB]
• Freedom to Work (FTW) Brochure (DE-832)
  • Bilingual [54KB]
• KidsCare Program Brochure (KC-002)
  A brochure that provides an overview of the program, including the cost, services provided, and how to apply.
  
  • Bilingual [1.45MB]
• KidsCare Program Poster (KC-001)
  An 11" X 17" poster that provides general information about the program, including contact information.
  
  • Bilingual [1.12MB]

Contacts

If you have questions, please email Patty.Dennis@azahcccs.gov.

Disclaimer: All Spanish publications are a translation from original text written in English. This translation is unofficial and is not binding on the State of Arizona or any political subdivision of this State.

Aviso: La sección en español de esta pagina de Internet es una traducción del texto original en Ingles. La traducción no es oficial y no liga al estado de Arizona o cualquier subdivisión política en este Estado.