Frequently Asked Questions

General Questions

• Q1: What should I think about when choosing a health plan?

  Keep these points in mind:

  • You can choose any Available Health Plans that serves your county.
  • All AHCCCS plans offer the same medical services.
  • Check with your doctor, pharmacy, or hospital to see if they work with the plan you want.
  • You can also check the plan’s website or call its Member Services line.
  • American Indian members may choose the American Indian Health Program or an AHCCCS Complete Care plan.
  • If you had AHCCCS in the last 90 days, you will be put back into your previous plan.

  If you need help choosing a plan, call a Beneficiary Support Specialist:
  (602)417-7100 or 1-800-334-5283
  Or email: BeneficiarySupportSpecialist@azahcccs.gov.

• Q2: How do I choose a health plan?

  You can pick a health plan on your application. If you do not pick one, AHCCCS will pick one for you. This is called auto enrollment.

  If you are auto enrolled, you can choose a different plan within your first 90 days, if another plan is available in your county.

  Here are steps to help you choose:

  • You can choose from health plans that are available in the county you live in.
  • You can check plans on the AHCCCS website under Available Health Plans.
  • Each plan has different doctors, hospitals, and clinics.
  • Choose a plan that includes the doctors or clinics you want.

  For help:

  • Visit the Available Health Plans page
  • Email BeneficiarySupportSpecialist@azahcccs.gov
  • Call (602)417-7100 or 1-800-334-5283

  If you or a family member is American Indian or Alaska Native, check the Available Health Plans for your options.

• Q3: Where can I see available health plan choices?

  You can see your choices online on the Available Health Plans page.
  Your options depend on:

  • The county you live in
  • The AHCCCS program you are approved for
  • Whether you are a Tribal member
• Q4: What happens if I do not choose a health plan?

  If you do not choose a plan, AHCCCS will choose one for you. You will get a Freedom of Choice letter. This letter gives you 90 days from the date on the letter to change your plan.

• Q5: Who is allowed to choose the health plan?

  Any of the following people may choose:

  • The customer
  • The customer’s legal or authorized representative
  • An adult in the same household who is part of the customer’s budget group
  • A responsible adult if the customer is a minor or cannot make decisions
• Q6: How do I contact my health plan?

  You can find contact information for each plan on the AHCCCS Available Health Plans page.

• Q7: When does my AHCCCS coverage start?

  Coverage usually starts on the first day of the month you are eligible. Your start date is listed in your approval decision letter.

• Q8: Why can’t I choose a health plan after reapplying?

  You will be placed back into the same plan if:

  • You were in that plan within the last 90 days, and
  • The plan is still offered in your county

  Also, the following customers do not get to choose a health plan:

  • People diagnosed with a Serious Mental Illness (SMI)
  • Children in Arizona foster care
• Q9: Can I change my plan for other reasons?

  Yes. You can ask to change for other reasons, but your current health plan must review and approve the request.

  Reasons you might ask for a change include:

  • Poor quality of care
  • Trouble getting case management
  • Transportation problems
  • Wanting a different doctor
  • Your doctor suggests changing plans
  • Long wait times
  • You need consistent (ongoing) care

  If your plan cannot fix the problem, they will send you a letter explaining this. If another plan can help, you will get a letter approving the change.

• Q10: When can I change my health plan?

  You can ask to change your plan if:

  • It is your annual enrollment time
  • You are within your first 90 days of enrollment, and you did not already choose a health plan
  • Your family is enrolled in different plans
  • You move to a place where your plan is not available

  You can also change plans in the first 90 days through HEAplus.

• Q11: Can American Indian members change plans anytime?

  Yes, American Indian members may change plans at any time.

• Q12: What is the 90‑day Freedom of Choice period?

  The first 90 days after you are approved for AHCCCS medical assistance is called the Freedom of Choice Period. If a health plan was assigned to you, you can change your Health Plan for any reason during this time.

• Q13: How can I change my health plan?

  You can call AHCCCS to ask for a health plan change at (602) 417-7100 or 1-800-334-5283. You can ask for a change if:

  • It is your annual enrollment period.
  • You were auto assigned to a plan and are still in your first 90 days.
  • Your family is split between different health plans, and you want the same plan.
  • You moved to a county where your current plan is not offered.

  If you need help choosing a plan or want to know if a doctor accepts your plan, you can talk to a Beneficiary Support Specialist at the same numbers above.

• Q14: How do I submit a written request to change plans?[

  Your written request must include:

  • Your current health plan name
  • The new health plan you want
  • A clear reason why you want to change

  Mailto:

  AHCCCS
  PO Box 25520
  Phoenix, AZ 85002

  You may also call a Beneficiary Support Specialist for help, or email:
  BeneficiarySupportSpecialist@azahcccs.gov

• Q15: Can I get treatment while my application is still being processed?

  Yes. You may be able to get drug, alcohol, or mental health treatment through the Regional Behavioral Health Authority (RBHA).

  Call the RBHA for your area:

  • Central Arizona: 800-564-5465
  • Northern Arizona: 888-788-4408
  • Southern Arizona: 866-495-6738
• Q16: What is the Annual Enrollment Period?

  The Annual Enrollment Choice period is held annually to allow you to change your health plan.

  • If you are a DDD member, it is based on your birth month.
  • You will be notified by mail telling you when your enrollment month is, as long as you have more than one health plan to choose from.
  • If you want to keep your current health plan, no action is required.
  • You can change plans during that month.
• Q17: Do all AHCCCS members have an annual enrollment?

  No, the annual enrollment process does not apply to any of the following customers:

  • Foster care children enrolled with Mercy Care Department of Child Safety Comprehensive Health Plan (DCS/CHP); and
  • Customers diagnosed with a Serious Mental Illness.
• Q18: What if I did not choose a health plan when I was approved?

  AHCCCS will pick one for you. You will get a Freedom of Choice letter telling you which plan you were given. You have 90 days from the date on the letter to change your plan.

• Q19: What is Continuity of Care?

  Continuity of care means you may keep seeing your doctor for certain serious needs, even if:

  • You change health plans, or
  • Your doctor is not in your new plan

  This applies if:

  • You have a life-threatening health condition, or
  • You are in your third trimester of pregnancy

  If you lose AHCCCS and regain it within 90 days, you will return to the same health plan.

• Q20: What if I move to a new address?

  You must report address changes to AHCCCS. When you move to another county, your health plan choices may change. AHCCCS will check which plans are offered in your new area.

• Q21: Are there any costs?

  Most members have no cost. Some programs may have small copays or premiums. You will get a letter if this applies to you.

• Q22: What if someone in my family is American Indian or Alaska Native?

  There are special health plan options available. Check the “Available Health Plans” section for more details.

• Q23: What services does AHCCCS cover?

  AHCCCS usually covers:

  • Doctor visits
  • Hospital care
  • Prescriptions
  • Lab tests
  • Vaccines
• Q24: How long will I stay covered?

  You stay covered as long as you still qualify. Tell AHCCCS if your situation changes.

• Q25: What kind of changes to my situation should I report?
  • An increase or decrease in the amount of income received by you, your spouse or your dependent children
  • An increase in the amount of your resources
  • If you open or close a financial account
  • If you sell, trade or give away assets or property
  • An address change if you, your spouse or your representative move
  • A phone number change
  • A change in your marital status
  • The death of any person in your household
  • A change in your health insurance premium or coverage (other than AHCCCS)
  • If you have medical expenses that are not covered by AHCCCS
  • If you plan to be out of Arizona for 30 days or more
• Q26: What if I have Medicare and AHCCCS?

  AHCCCS may help pay Medicare costs. Tell your health plan if you have Medicare.

• Q27: Can I get help if I don’t speak English or need help applying?

  Yes. Community Assistors can help. Many offer interpreters and application help.

• Q28: Does AHCCCS cover emergencies out of state?

  Yes, a customer who is temporarily out of the state but still a resident of Arizona is entitled to receive AHCCCS benefits under any of the following conditions:

  • Medical services are needed because of a medical emergency. You must send proof of the emergency when you submit the claim to AHCCCS.
  • The customer needs a special treatment that is only available in another state.[
  • The customer has a chronic medical condition requiring treatment during a temporary absence from the state, or their condition must be stabilized prior to returning to the state.