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About You

Personal Information
First Name
You must create a personal account to use the system. Enter information about yourself on this page, even if you are applying for benefits for someone else.

Gender

Contact Information
You will be able to read letters sent to you within your Health-e-Arizona Plus account.

Do you want to keep getting these letters by U.S. Mail?

Do you want to get alerts about your applications through e-mail, text message, or both?

About You
About this page

You must create a personal account to use the system. This page is to identify the user of the account that is being created. Enter information about yourself on this page, even if you are applying for benefits for someone else. If someone besides you needs an account, they will need to create their own account.


How to complete this page

To create an account you must provide your first name, last name, gender, date of birth, email address and select ‘Yes’ or ‘No’ to the questions on this page.


If you select ‘Yes’, we will ask for more details.


When you are finished, click ‘Next’ to move to the next page.


Changing your user account information does not report changes or submit a new application.


You may submit a new application or report changes for an existing application when you return to your home page.