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To qualify for AHCCCS Medical Assistance (MA), a customer must take all actions needed to get any cash benefits for which he or she might qualify. This includes:
· Making an application for benefits to the company or organization that pays the benefit;
· Providing the benefit source with all information needed to find out whether the person qualifies for the benefit;
· Asking for and accepting the largest amount of benefits for which he or she qualifies; and
· When there is a choice, having the benefits paid monthly or periodically instead of in a lump sum.
Only people who are applying for or receiving MA must apply for potential benefits. A customer’s spouse, parent or child that is not applying for or receiving MA is not required to apply for potential benefits.
For some benefit sources, like retirement pensions or state unemployment programs, the rules for who can qualify vary by employer or by state. However, federal cash benefits rules generally do not vary.
The following table provides common federal benefits and describes the most common reasons a customer may qualify:
If the benefit is… |
Then the customer may qualify when he or she… |
Veteran's pension or compensation |
· Is a wartime veteran who meets one of the following: o Is age 65 or older; or o Has a disability. · Is a person with a military service-connected injury or illness. · Is the surviving spouse (and not remarried) of a wartime veteran. · Is the surviving spouse (and not remarried) or a dependent parent of a veteran who died in active service or from a service-connected injury or illness. · Is unmarried and has a parent who died in active service or from a service-connected injury or illness and is one of the following; o Under the age of 18; o Between the ages of 18 and 23 and is attending a VA-approved school; o Over age 18 and was determined to have a disability before turning 18. A Veteran may need to reapply when their circumstances change such as income, age (see ages above), disability, household, or living arrangement. NOTE Changes in living arrangement may affect VA eligibility for a customer who was previously denied VA benefits for being over income. |
An apportionment of the Veteran’s pension or compensation benefit |
Is the applying spouse or child of a person receiving VA compensation or pension income and is not living with that person. |
Social Security Disability or Retirement |
· Has 40 qualifying quarters of work credit (Social Security Retirement only); · Has a disability and has earned enough qualifying quarters of work credit, based on the person’s age; · Is at least 62 years old and has a spouse or ex-spouse that receives Social Security retirement or disability benefits; · Has a parent who is deceased or who is receiving Social Security retirement or disability benefits, and the child meets one of the following: o Is under the age of 18; or o Is between the ages of 18 and 19 years old, and a full-time high school student; or o Is age 18 or older and has a disability that started before age 22. A customer may need to reapply when their circumstances change such as age (see ages above), disability, work history, or a parent or spouse dies. |
There are some situations when a person does not have to apply for cash benefits to qualify for MA. A customer does not have to apply for cash benefits to qualify for MA when:
· The benefits are based on need. These types of benefits include SSI-Cash and Cash Assistance benefits.
· There is proof that the person does not qualify for the benefit. For example, the person was denied for long-term disability benefits a month ago, a military record shows that the person does not meet the definition of a wartime veteran, or a benefits update showing that the person has not reached the retirement age.
· The person is working and would have to retire from that job to qualify for the pension or retirement benefit.
· The person has not reached full retirement age and can only qualify for a reduced “early retirement” benefit. See the SSA Retirement Chart to check when a person will reach “full retirement age” for Social Security Retirement benefits.
NOTE This exception does not apply to Social Security Disability Benefits.
Customers may apply for the following benefits online using these links:
| Benefit | Link |
| Railroad Retirement | The Railroad Retirement Board does not accept applications online. For more information regarding Railroad Retirement and Survivor Benefits, contact the RRB at https://www.rrb.gov, or the RRB Mesa, AZ office at (877) 772-5772. |
| Social Security Disability | |
| Social Security Retirement | |
| Unemployment benefits | |
| Veteran's benefits | Veterans can apply online: · Veteran's pension https://www.va.gov/pension/application/527EZ/introduction · Veteran's disability compensation https://www.va.gov/disability/file-disability-claim-form-21-526ez/introduction |
Surviving spouses and dependents cannot apply online. See https://benefits.va.gov/BENEFITS/Applying.asp for how to apply or call the VA at (800) 827-1000 for assistance. |
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| Veteran's benefits - apportionment | A spouse or child cannot apply online for an apportionment. The application can be found online at https://www.va.gov/vaforms/form_detail.asp?FormNo=21-0788. Deliver the application to the VA by: · Mailing it to the Department of Veterans Affairs Evidence Intake Center PO Box 4444 Janesville, WI 53547-4444; · Faxing it to 844-655-1604; or · Taking it to your local regional office. |
| Workmans Compensation |
Term |
Definition |
Cash benefits |
Means money payments to qualified individuals. These benefits include: · Social Security benefits; · Railroad Retirement; · Worker’s Compensation; · Short- or long-term disability benefits; · Veteran’s benefits; · Pension or retirement funds; and · Unemployment Insurance benefits. NOTE Indian gaming monies are not considered a potential cash benefit. |
Dependent Parent (for the purpose of compensation when the veteran died in active service or from a service-related injury or illness) |
A natural, adoptive, or foster parent of the Veteran or service member and the parent’s income is below a certain amount based on federal law. |
Qualifying Quarters of Work Credit |
A calendar quarter that meets the minimum amount of earnings as determined by the Social Security Administration (SSA). A person can earn up to four qualifying quarters each year. |
Wartime Veteran |
A person who served in the U.S. Military (Army, Marine Corps, Navy, Airforce, or Coast Guard), who was discharged under any condition EXCEPT dishonorable, and had active service during one of the following periods: · 04/06/1917 to 11/11/1918 (World War I) · 12/07/1941 to 12/31/1946 (World War II) · 06/27/1950 to 01/31/1955 (Korean Conflict) · 02/28/1961 to 05/07/1975 (Vietnam War) · 08/02/1990 to present (Persian Gulf War) |
Proof of application for potential benefits includes:
· DE-134, DE-135, or DE-136 signed by a representative of the agency verifying that the customer applied;
· Letter from income source signed by a representative of the agency verifying that the customer applied;
· Phone call to the benefit source to confirm that the customer has applied;
· Copy of a paper benefits application that has been stamped by the receiving agency or signed by an agency representative;
· Copy of the confirmation number issued at the end of the online application process; or
· Copy of an email confirmation showing that the customer has submitted an application for potential benefits online.
Program |
Legal Authorities |
All programs, except KidsCare |
42 CFR 435.608 AAC R9-22-305 AAC R9-28-401.01 B.8 AAC R9-29-204.5 |