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In general, AHCCCS cannot pay for any services while a person is incarcerated. When a change is reported that a customer is incarcerated, eligibility may be stopped or suspended depending on where the person is an inmate.
Inmates in an Arizona Department of Corrections (ADC) prison or in certain county jails may have their benefits suspended rather than stopped.
AHCCCS has Intergovernmental Agreements (IGAs) with Apache, Cochise, Coconino, Maricopa, Mohave, Navajo, Pima, Pinal, Yavapai, and Yuma Counties to suspend enrollment. AHCCCS also has an IGA with ADC to suspend benefits of inmates with less than 12 months left in their sentences. When the customer has longer than 12 months left to serve, benefits are stopped.
Term |
Definition |
Inmate of a Penal Institution |
A person who is: · An inmate in a federal or state prison; · An inmate of a county, city, or tribal jail; · An inmate of a prison or jail, prior to arraignment, conviction, or sentencing; · Incarcerated but can leave prison on work release or work furlough, and must return at specific intervals; · A child in a juvenile detention center due to criminal activity or held as a material witness; · A person involuntarily placed in a secure treatment facility that is part of the criminal justice system. |
Not an Inmate of a Public Institution |
A person who is: · After arrest, but before booking, escorted by police to a hospital for medical treatment and held under guard; · Voluntarily living in a public institution; · Released on probation, parole, or a release order with the condition of home arrest, work release, community service, or medical treatment; or · Admitted as an inpatient to a medical institution; · A child held in a juvenile detention center for the care, protection, or in the best interest of the child, if there is a specific plan for that person that makes the stay at the detention center temporary; · A child on intensive probation with the condition of home arrest, treatment in a psychiatric hospital, or a residential treatment center, or outpatient treatment; · A child in a juvenile detention center after disposition when there is a plan to release the child to the community, and the release is only pending arrangements suitable to the child’s needs. |
Public Institution |
An institution that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control. The term “public institution” does NOT include: · Medical institutions; · Intermediate care facilities; · Publicly operated community residence that serves no more than 16 residents; or · State-licensed child care institutions for foster children that house no more than 25 children. |
Voluntarily living in a public institution |
Means living in a public institution by choice, not as an extension of incarceration. The person is free to leave the institution if he or she chooses. |
Proof of incarceration includes:
· The customer’s statement;
· Electronic records of incarceration from the Arizona Department of Corrections or a county jail;
NOTE When the customer’s statement conflicts with other information or proof, the detention facility is contacted to confirm the person’s status.
This applies to all programs.
Changes must be reported as soon as the future event becomes known. Unanticipated changes must be reported within 10 calendar days of the date the change occurred.
Program |
Legal Authorities |
All Programs (except KidsCare) |
42 CFR 435.1009 and 1010 42 CFR 435.916 AAC R9-22-310 AAC R9-28-406 AAC R9-22-1915 AAC R9-22-2003 |
KidsCare |
42 CFR 457.310 (c)(2)(i) 42 CFR 457.343 ARS 36-2983(G)(4) AAC R9-31-303(9) |