1502.00 Customer’s Responsibility to Report Changes

 

A. What is the Customer Required to Report?

 

Customers or their representatives are required to report any events that may affect eligibility, continued eligibility or the amount the customer must pay.

 

The changes a customer is required to report vary among programs:

 

Change

SSI MAO

MCS

BCCTP

AHCCCS FTW

ALTCS

Address change of the customer, including a temporary or permanent move out of state

X

X

X

X

X

The customer or spouse’s admission to or discharge from a medical facility, private institution or public institution

X

X

X

X

X

Changes in household composition

X

X

X

X

X

Death of the customer or other household member

X

X

X

X

X

Marriage, separation or divorce of the customer

X

X

X

X

X

Changes in school attendance of dependent children age 18-22 (including the customer)

X

X

X

X

X

Increase or decrease in the income of the customer, the customer’s spouse or dependents or a determination of eligibility for additional benefits.

X

X

X

X

X

Obtaining or terminating the customer’s First or Third Party insurance

X

QMB

ONLY

X

X

X

Changes in the customer’s medical insurance premiums, non-covered and remedial medical expenses, and shelter expenses

 

 

 

 

X

Changes in the customer’s work related expenses

X

X

 

X

 

A change in the amount of the CSMIA made available to the community spouse

 

 

 

 

X

Changes in the income paid to a trust or disbursements made from a trust

X

X

 

 

X

A change in the resources of the customer of the customer’s spouse (including the receipt, transfer, sale or gifting of any real or personal property).

 

 

 

 

X

Medical improvement of the customer

 

 

 

 

X

A change in the citizenship or non-citizen status of the customer

X

X

X

X

X

Receipt of a Social Security number for the customer

X

X

X

X

X

Any other changes that may affect the customer’s eligibility

X

X

X

X

X

Any other changes that may affect the customer’s premium or share of cost

 

 

 

X

X

 


 

B. When Should Changes Be Reported?

 

Changes must be reported in advance, as soon as the future event becomes known. Unanticipated changes must be reported within 10 days of the date the change occurred.

 

EXCEPTION: Special reporting requirements apply to trustees of Special Treatment Trusts. Trustee reporting requirements are described in MS 804.09.

 

 


 

C. How Can Changes Be Reported?

 

Changes can be reported in person, by phone or in writing.

 


 

D. How is the Customer Informed?

 

AHCCCS informs customers about their responsibility to report changes in a variety of ways:

 

If the Customer…

Then reporting requirements are explained…

Applies using an Application for AHCCCS Medical Services and Medicare Cost Sharing (DE-103)

On page C of the DE-103.

Applies for ALTCS

  • Verbally by the Eligibility Specialist during the interview;

  • On the Rights and Responsibilities of Customers (DE-113).

Is approved for AHCCCS Health Insurance

On each written notice of approval or change.