408 KidsCare

Policy

The conditions of eligibility for KidsCare are:

·        Valid application (MA533);

·         Under age 19 (MA501);

·        Resident of Arizona (MA531);

·        Social Security number (MA532);

·        US citizen (MA507) or appropriate non-citizen status (MA524);

·        Not incarcerated (MA525);

·        Not in an institution for mental disease (IMD) (MA514);

·        Ineligible for Medicaid (MA522)

·        Assignment of rights to medical benefits and cooperation (MA503);

·        Cooperation with Medicaid requirements (MA522);

·        No current health insurance coverage (MA515);

·        No health insurance coverage for the last three months (MA516);

·        Not eligible for the State employees health benefits plan (MA517);

·        Income under 200% of the FPL (MA615.13); and

·        Payment of a premium, if required (MA1204).

Definitions

Service Package

Customers eligible for KidsCare receive AHCCCS Medical Services (MA302.1).

Enrollment

Customers approved for coverage under KidsCare are enrolled in an AHCCCS Complete Care (ACC) plan.

NOTE     KidsCare customers are guaranteed a 12-month eligibility period for their first-time enrollment in KidsCare. See Guaranteed Enrollment Periods for more information. See Premiums During 12-Month Guarantee and Appeals Process for information about premiums during the guarantee period.

Customer Costs

Some customers may be required to pay a premium, but are exempt from co-payments.

NOTE     American Indians and Alaskan Natives are not required to pay a premium or co-payment.

Legal Authority

This policy applies to the following program: