How to Apply for Medical Assistance

If you are waiting for your application to be processed or you are not eligible for AHCCCS medical assistance, you may qualify to receive drug and alcohol and mental health treatment services through other funding sources administered by the Regional Behavioral Health Authority (RBHA). For more information, contact the RBHA in your area: Central Arizona at 800-564-5465; Northern Arizona at 888-788-4408; Southern Arizona at 866-495-6738.

Apply Online

You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). You can apply for yourself, your family, or someone close to you.

You may be able to reduce office visits and postage delays by using Health-e-Arizona Plus.

Note: Health-e-Arizona Plus is offered in both English and Spanish.

Get Help Applying From a Community Assistor

Do you need help applying for AHCCCS Health Insurance, Nutrition Assistance (formerly Food Stamps), or TANF Cash Assistance? There are over 150 Community Partner organizations throughout the state using HEAplus to help Arizonans apply online. Find an assistor near you. (Encuentra un asistente cerca de ti)

Print an Application

Click on the link to DES below if you (or the person you are applying for) are one or more of the following:

An adult without children
A pregnant woman
A family with children
A child only

You can use one application to apply for AHCCCS Medical Assistance for everyone in your household. Applications for AHCCCS Health Insurance are available on the Department of Economic Security (DES) Application page:

Click on the link to the application below if you (or the person you are applying for) are one or more of the following:

65 years of age or older
An individual who is blind or disabled
A working individual with a disability (Freedom to Work)
An individual that wants help with Medicare costs only

The application below is to apply for AHCCCS Health Insurance and/or Medicare Costs Sharing programs. To open the form so you can print it, click on the link below.

Note: This application process does not apply for individuals who are in need of Arizona Long Term Care System (ALTCS) services, such as in home healthcare, nursing facility, or assisted living. To apply for Long Term Care, see below.

How to Apply for Arizona Long Term Care (ALTCS)

The Arizona Long Term Care System (ALTCS) is the State of Arizona’s Medicaid program that provides long term care services, at little or no cost, to financially and medically eligible Arizona residents who have an age related and/or physical disability or have a developmental disability and require skilled level of care.

However, program participants do not have to reside in a nursing home. Many ALTCS participants live in their own homes or an assisted living facility and receive needed in-home services.

A person must qualify both financially and medically to be eligible for ALTCS.

Medically, you must be in an immediate need of a nursing home level of care, or a care facility for individuals with intellectual disabilities, and require assistance with your activities of daily living (you are not required to reside in a facility).
Financially, a single applicant cannot exceed $2982.00 per month in gross monthly income, and resources cannot exceed $2000.00 per month.

You may register an ALTCS application online in Health-e-Arizona Plus by creating an HEAplus account. See How to Register an Application for Arizona Long Term Care System in Health-e-Arizona Plus.

Here is a video on using the ALTCS Customer Portal

Both a financial and medical interview will be completed after the application is registered.

You may also call 1-888-621-6880, or fax 1-888-507-3313 to apply for ALTCS.

Eligibility – status of pending application, determination results, Processing Period

The processing period begins the day after the application date and ends on the date that the decision letter is mailed. For the application to be timely, the letter must be mailed within the processing time frame.

The mailing date is the first business day after the decision has been processed in the system. Letters are printed after close of business on the date of the decision and mailed the following work day.

When the processing period ends on a weekend or holiday, the letters are mailed prior to the weekend or holiday.

Timeframes
If the customer is applying for:	Then the processing period is...
SSI-MAO or FTW based on disability	90 calendar days from the application date
MSP	45 calendar days from the application date
BCCTP	7 calendar days from the application date
Medical Assistance and is pregnant	20 calendar days from application date
Medical Assistance and is hospitalized	7 calendar days from the application date Note: Only if there no proof or other information needed for the determination. If there is anything still needed, the timeframe is 45 days
All other programs	45 calendar days from the application date

Processing Period Extensions

The application processing period may be extended beyond the processing time frame when:

The customer’s income is over the limit for the application month and the following month, but there is a reasonable expectation that the customer will be income-eligible in the third month;
When the customer appears to be eligible but documentation from a third-party is needed to make the eligibility determination and the third party has not responded. The customer and eligibility worker must continue to take all actions needed to get the information;
When a for a Policy Clarification Request (PCR) is needed that will affect the eligibility decision;
When a Disability Determinations Services Administration (DDSA) decision is pending; or
When the customer requests more time to get documentation or proof needed for the eligibility decision.

Determination and Eligibility Begin Dates

In general, eligibility for AHCCCS Medical Assistance is determined on a month-by-month basis. A customer may be eligible or ineligible for any specific month.

Rules that affect all programs:

For a person that moves to Arizona from out-of-state, Medical Assistance eligibility cannot start any earlier than the date of the move to Arizona.
For a person that has been in jail, prison or another detention facility, Medical Assistance eligibility cannot start any earlier than the date the person no longer meets the definition of an inmate.
For a newborn child, Medical Assistance eligibility cannot start any earlier than the newborn’s date of birth.

Otherwise, the date eligibility starts varies by program. See the table below:

Program	Eligibility Begin Date
Medicare Savings Program (MSP) – QMB	QMB eligibility begins with the month following the month that QMB eligibility is determined.
Breast and Cervical Cancer Treatment Program (BCCTP)	BCCTP eligibility begins on the later of: First day of the application month (the application month for BCCTP is the month of the BCCTP diagnosis); or First day of the first month in which the customer meets all the BCCTP eligibility requirements.
KidsCare	If eligibility is determined by the 25th day of the month, eligibility begins with the first day of the following month. If eligibility is determined after the 25th day of the month eligibility begins the first day of the second month following the determination.
All other programs	First day of a month, if the customer is eligible at any time during that month.