B Premium Billing and Payment

Policy

The AHCCCS Division of Business and Finance (DBF) sends a bill for the premium to the customer on the first day of each month.  If the first day of the month is a weekend or holiday, the bills are mailed on the first workday of the month.

The billing statement notifies the customer of:

·        The current amount due; and

·        Past due amounts.

1)    When Are Premium Payments Due?

Premiums are prospective.  This means:

·        The premium is due on the 15th of the month following the month the person is approved for AHCCCS FTW.

·        The premium for each following month is due by the 15th of that month.

If a payment is not received by the 15th of the month, it is considered late.

2)    How Can Payments be Made?

The customer or anyone else may pay the premium by:

·        Cashier’s check or personal check;

·        Money order; or

·        Credit or debit card.

Payments can be made online using AHCCCS’ Online Premium Payment service or can be mailed to the following address:

STATE OF ARIZONA AHCCCS

File 749228

Los Angeles, CA 90074-9228

Important! When mailing a payment, it may take five to seven days to be processed and credited.

Payments may be made in advance.  For example, the customer may pay quarterly, bi-annually or annually.

3)    Premium Payment During an Appeal Process

When an AHCCCS FTW customer with a premium wants to have AHCCCS Medical Assistance continued during the appeal process, the customer must:

·        Request a hearing prior to the effective date of discontinuance; and

·        Pay the premium for the first month of the appeal period in advance.

Premium Payment During an Appeal Process Example

4)    Appeal of the Premium Amount

If the customer appeals the amount of the premium for an FTW approval, the customer must pay the assessed premium throughout the hearing process.

If a customer appeals an increase in the AHCCCS FTW premium and the appeal request is received prior to the effective date of the premium increase, the premium amount is decreased to the lower amount until a hearing decision is made.

5)    When Are Changes in the Premium Amount Effective?

A decrease in a customer’s premium is effective the month after proof of the income or Impairment Related Work Expenses (IRWE) change is provided.

An increase in a customer’s premium is effective the first month after a 10-day advance notice is sent to the customer.  When there are less than 10 days before the first day of the next month, the premium is increased the first day of the month after that.

Definitions

Legal Authority