FAQs

If you have a problem with your doctor or health plan, contact your health plan's Member Services department. The phone number can be found on your AHCCCS ID card or on the health plan’s website.

If you have a problem with your eligibility decision, call Customer Support at 1-855-HEA-PLUS (432-7587). 

After you ask for an appeal, you will have the chance to talk with an AHCCCS or Department of Economic Security (DES) worker. This is called a pre-appeal conference.

If you ask for an appeal over the telephone or in person during business hours the pre-appeal conference will happen at that time. If you ask for an appeal by any other method or by telephone after business hours, an AHCCCS or DES worker will call you to have the pre-appeal conference.

The pre-appeal conference gives you a chance to talk about your case with the worker. It also gives you the chance to get a copy of the law, rule or policy that was used to make the decision about your case. It is not mandatory to attend the pre-appeal conference, but it is suggested. Sometimes problems can be solved with the worker and you may not have to go to the appeal hearing.

If a solution is not reached at the pre-appeal conference, a Notice of Appeal letter will be sent to your mailing address. The letter will give you the date, time and location of the appeal hearing.

Official business days and hours:

         Monday through Friday 8:00 AM – 5:00 PM (Arizona Time)

         Closed State Holidays and for Work Furloughs

State Holidays:

         New Year’s Day – January 1

         Martin Luther King Jr. / Civil Rights Day - Third Monday in January

         President’s Day – Third Monday in February

         Memorial Day – Last Monday in May

         Independence Day – July 4

         Labor Day – First Monday in September

         Columbus Day – Second Monday in October

         Veterans Day – November 11

         Thanksgiving Day - Fourth Thursday in November

         Christmas Day – December 25

If the decision is in your favor, AHCCCS or the Department of Economic Security (DES) will make corrections within 10 calendar days.

If the decision is not in your favor, you may need to pay back any benefits you got while you were waiting for the appeal decision.

If you do not agree with the judge’s decision, you can ask for your case to be reviewed again. You have 15 calendar days from the date of the appeal decision to submit a written request.

If you want to withdraw because the case was found to be incorrect and has been fixed, please speak with an appeal specialist first.

If you do not qualify for AHCCCS Medical Assistance, you may be able to get tax credits to help pay for your health insurance premiums.  Click here for more information.

You can also:

•         visit the Health Insurance Marketplace at https://www.healthcare.gov/getting-lower-costs-on-coverage/

•         call the Health Insurance Marketplace Call Center 24 hours a day at 1-800-318-2596 (TTY 1-855-889-4325)  

You can ask for an appeal if you do not agree with any of the following:

•          Your application has been denied.

•          Your benefits stopped.

•          Your benefits are reduced.

•          A decision is not made on your application within the required number of days and the delay is due to AHCCCS or the Department of Economic Security. For more information about application time frames, see FAQ "How long does it take to start getting benefits after I apply?"

For more information about appeals see the following FAQs:

•          "How do I ask for an appeal?"

•          "What is the deadline to ask for an appeal?"

•          "What happens after I ask for an appeal?"

•          "What happens at the appeal hearing?"

•          "Can I keep getting benefits while I wait for a decision on the appeal?"

See FAQ "How long does it take to start getting benefits after I apply?" for more information about the number of days to make a decision.

How do I get my User Name?

To get your User Name:

NOTE: Health-e-Arizona Plus may need more information to find your User Name. When additional fields display, enter the information and click “Next.”

How do I reset my Password?

To reset your password:

NOTE: When the system finds the User Name, you will be taken to the “Confirm Your Identity” page.

As of 10/1/2023, Able-Bodied Adults Without Dependents (ABAWD) who are age 18 through 52 may receive only three (3) full months of Nutrition Assistance benefits in a 36-month period, unless they either comply with the work program requirements or qualify for an exemption. Click Here for more information.

AHCCCS Medical Assistance is Arizona's name for Medicaid.  The medical coverage provided may include doctor's office visits, physical exams, shots, prenatal care, hospital care and prescriptions.

An Electronic Benefit Transfer (EBT) alternate card holder is an additional person that you can select to have an EBT card for your benefits.

You can have up to two EBT alternate card holders.  You can choose if they have access to Nutrition Assistance, Cash Assistance, or both benefits. 

The alternate card holder:

•         is issued their own EBT card

•         can select or is mailed their own EBT Personal Identification Number (PIN)

•         has access to the EBT benefits you chose

It is important that you know that benefits spent using the alternate card are treated as though you spent them yourself and will NOT be replaced.

You must give us written authorization to establish the EBT alternate card holders. You can do this by filling out the Designation of EBT Alternate Card Holder form.  This is also the form that you can use to remove an EBT alternate card holder.

The alternate card holder must go to the local office to get the EBT card.

Some individuals receive income because they provide direct care to an ALTCS (Arizona Long Term Care Services) member who lives in their home. Direct Care includes Attendant Care, Personal Care, and Habilitation Services for an ALTCS Member. This income may be considered Difficulty of Care income. It does not include medical services that can only be performed by a health professional.

Difficulty of Care income is not counted toward the income limit for some AHCCCS programs.

AHCCCS uses electronic sources to obtain income information. These sources do not identify income from providing direct care to an ALTCS member living with the caregiver as Difficulty of Care income. Therefore, these payments may not have been excluded in the income calculation.

If you receive Difficulty of Care income and have been denied or discontinued for being over the income limit, please contact AHCCCS at 602-417-5010 to report the Difficulty of Care income.

Grant Diversion (GD) is:

• A one-time lump sum payment to help people with bills while looking for a job.
• A nonrecurring payment of 3 months of the Cash Assistance (CA) program in a 12 month period.
• For people whose job history shows that they can find a full-time job within 3 months.

You must:

• Be eligible for CA to get GD.
• Not be receiving CA.
• Not have received CA benefits in the month you applied.
• Not have received GD benefits in the last 12 months.
• Choose to receive your benefits as GD.

Nutrition Assistance (formerly known as Food Stamps) is Arizona’s federal Supplemental Nutrition Assistance Program (SNAP). The goal of Nutrition Assistance is to help low income families provide adequate nutrition to their families.

For more information about the Affordable Care Act, click here.

You have the following number of days from the date of your decision letter to ask for an appeal:

•          Medical Assistance: 35 days

•          Nutrition Assistance: 90 days

•          Cash Assistance: 35 days

•          Tuberculosis Control: 30 days

If you ask for an appeal after the deadline, you will need to tell us why it is late.

The Jobs Program helps people who are getting Cash Assistance find a job. The free program offers training and support services to help build job skills, and is required for those who are able to work.

The best way to find out if you can get Nutrition Assistance is to apply.  You can also visit our online screener to do a quick check based on your household size before you apply. 

Each household has different needs, so this information should only be used as a guide. 

We count the gross income of all the people in your household.  Gross income is the amount of income before deductions like taxes, insurance, etc.  Some situations may change the gross monthly income amount allowed or counted for your household.

Nutrition Assistance Gross Monthly Income Eligibility Standard effective October 1, 2016

(130% of the Federal Poverty Level)

Household size of:

1, the gross income limit is $1287
2, the gross income limit is $1736
3, the gross income limit is $2184
4, the gross income limit is $2633
5, the gross income limit is $3081

For each additional person add $451

Nutrition Assistance Gross Monthly Income for households that have a disabled or elderly person effective October 1, 2016 

(165% of the Federal Poverty Level)

Household size of:

1, the maximum gross income limit is $1634
2, the maximum gross income limit is $2203
3, the maximum gross income limit is $2772
4, the maximum gross income limit is $3342
5, the maximum gross income limit is $3911

For each additional person add $572

•         60 years of age or older,

•         disabled, or

•         homeless.

The program is only available at some grocery store delis and restaurants.  For a list of the restaurants, see Meals Program Restaurants.

Tribal TANF is a program that allows tribal governments the opportunity to develop, establish and administer their own Cash Assistance programs.  The Tribal TANF program provides temporary cash assistance to eligible participants.

Some items that may be bought with Nutrition Assistance benefits include:

• Foods for the household to eat, such as:
  • breads and cereals;
  • fruits and vegetables
  • meats, fish and poultry; and
  • dairy products. 
• Seeds and plants which produce food for the household to eat.

In some areas, restaurants can be authorized to accept SNAP benefits from qualified homeless, elderly, or disabled people in exchange for low-cost meals.

Click here for a list of items that you can NOT buy with your Nutrition Assistance benefits.

•        Alcoholic beverages and tobacco.

•        Non-food items such as soap, paper products, cleaning supplies, and cooking utensils.

•        Items used for gardening such as fertilizer, peat moss, and similar products.

•        Items that are not to be eaten by people such as laundry starch, dog and cat food, seeds packaged as bird seed, or decorative dye used to color hard cooked eggs.

•        Vitamins and minerals, in any form.

•        All health aids, such as aspirin, cough drops or syrups, cold remedies, antacids, and all prescription medicines.

•        Hot foods and prepared meals (except when the person is part of the Restaurant Meals Program ). 

Click here for a list of items that you CAN buy with your Nutrition Assistance benefits.

Contact a Health Insurance Marketplace representative:

•         online at https://www.healthcare.gov/contact-us          

•         by phone (24 hours a day) at 1-800-318-2596 (TTY 1-855-889-4325)  

You will receive your AHCCCS ID card in the mail 5 to 10 days after you are approved. You can also print a temporary card by going to your Health-e-Arizona Plus account Tools area.

A Health-e-Arizona Plus account is not needed to do the following:

•          Complete a screener to see if you may be eligible for any public assistance programs

•          Find an office near you where you can apply or get help applying for benefits

•          Print a blank application from the Forms section of the Help Center.

•          Link to a website where you can register to vote

•          Get information about other help in your community

A Health-e-Arizona Plus account is needed to do the following:

•          Apply for public assistance programs

•          Choose someone to represent you in the application process

•          Be told when additional information is needed

•          Ask for an appeal when you disagree with a decision or it takes too long to make a decision on your case

•          Get help verifying your information

•          Refer your application to the Health Insurance Marketplace to see if you can get a tax credit to help pay for insurance coverage

•          Provide information

•          See and print letters about your case

•          Set your account so that letters about your case are not sent by U.S. Mail (paperless)

•          Print temporary AHCCCS Health Insurance cards

•          Renew benefits

•          Report a change

•          Ask for help while you are filling out the application

•          See and make changes to an application completed for you by someone else (e.g. a Community Assistor or someone you chose to represent you)

•          See the status of your case

•          See alerts and reminders

An application may be completed by you or anyone you choose who knows or can get the information needed to complete the application for you and your household members.  You can use this application to apply for anyone in your household, even if they already have benefits, including health insurance.

Your household includes:

·         Your spouse, if married

·         Your children under age 22 who live with you

·         Your partner who lives with you (but only if you have a child together who needs health insurance or Cash Assistance)

·         People you claim on your income tax return even if they do not live with you

·         Relatives in your care who are under the age of 19 and live with you

·         People who you live with that purchase and prepare food with you

We recommend that you complete an application for benefits by:

Going online to www.healthearizonaplus.gov              

There are several ways for you to give us the needed documents:

• Online: www.healthearizonaplus.gov Select the following links for HEAplus Tip Sheets for directions:
  • Uploading Documents to Health-e-Arizona Plus
  • E-mailing Documents to Health-e-Arizona Plus
  • Faxing Documents to Health-e- Arizona Plus
• Mail: PO Box 19009,
  Phoenix, AZ 85005-9009
• In person: To find an office near you:
  • Select this link for AHCCCS locations
  • Select this link for DES/FAA locations
  • Call 1-855-HEA-PLUS (1-855-432-7587)

Choose the link below for directions for uploading documents to Health-e-Arizona Plus.

Uploading Documents to Health-e-Arizona Plus

The representative is someone that you pick to help with the application process.  The representative needs to know or be able to get the information to complete the application process for you and your household members.  To pick a representative, a form must be completed and signed.

For Nutrition Assistance (NA) applications: State employees who are involved in issuing  NA or retailers who accept NA, may only be a representative for NA when authorized in writing by the Region Program Manager. 

You (the applicant) are responsible for ALL information provided on the application and stated at the interview by your representative.  Both you and your representative can be held legally responsible for giving false information and can be put in jail for fraud.

For EBT purposes see FAQ: "What is an EBT Alternate Card Holder?"

Giving us an SSN for someone who does not want benefits is optional.  However, not giving us an SSN may keep us from getting information for you and slow down the application process.

Choose the link below for directions for faxing documents to Health-e-Arizona Plus.

Faxing Documents to Health-e-Arizona Plus

To get the most help, you need to give us information about citizenship and immigration status for each person who is applying. 

For Nutrition Assistance and Cash Assistance:

Giving us the citizenship or immigration status for each person who is eligible for benefits allows us to include them in the benefit amount.  If you do not give us this information, it will not affect the eligibility of the people who have given us proof of their citizenship or immigration status.  However, it may affect the benefit amount. 

For AHCCCS Medical Assistance:

If you do not give us your immigration status information, you may only be able to get emergency medical services.

If you are not applying for any benefits or if you chose not to provide citizenship or immigration information, we will not try to find out this information from U.S. Citizenship and Immigration Services (USCIS).  We will not report you, your family, or a household member to U.S. Immigration and Customs Enforcement (ICE) unless you inform us that you, a member of your family, or a household member is not lawfully residing in the U.S. 

Under federal law, certain non-citizens such as refugees or political asylees may qualify for Medical Assistance, Nutrition Assistance, and/or Cash Assistance.  For those non-citizens, USCIS guidelines state that use of these benefits will not affect your ability to become a Lawful Permanent Resident.

Choose the link below for directions for e-mailing documents to Health-e-Arizona Plus.

E-mailing Documents to Health-e-Arizona Plus

You can report changes through any of the following:

Online:     https://www.healthearizonaplus.gov/

Phone:     (855) HEA-PLUS (432-7587)

Mail:         P.O. Box 19009

                 Phoenix, AZ 85005

You will get a letter when it is time to renew your benefits. This letter:

• Gives you information that you may need to confirm, and
• Tells if you need to do anything to complete the renewal.

It is easiest to renew your benefits when you have a Health-e-Arizona Plus (HEAplus) account. When you login to your account, HEAplus will remind you to complete the renewal. Review the information and answer the questions.

If you do not have a HEAplus account, you can turn in the completed and signed renewal letter or application by:

• Mail: PO Box 19009, Phoenix, AZ 85005
• Fax using the HEAplus Fax Cover Sheet attached to the renewal letter. The fax coversheets have a barcode that identifies your application.
• Calling toll-free 1-855-HEA-PLUS (1-855-432-7587).
• Going to an eligibility office.

If you turn in an application more than 60 days before it is time for your renewal, the application will be considered a change. You will still need to complete the renewal process when it is time to renew. If you do not complete the renewal, your benefits will stop.

You can request a voluntary withdrawal at any time to stop getting benefits. However, if there has been a change in your household, you may still be eligible for benefits that can help you and your family. Report the change to find out if you and your family are still eligible. Possible changes could be, but are not limited to, the following:

  
• Started a new job
  
• Income increased
  
• Now have private health insurance
  
• Someone moved in or out of your home

AHCCCS Medical Assistance – You can request that your benefits be stopped in the following ways:

  
• Use your HEAplus account.
  1. If you submitted your Medical Assistance application through your HEAplus account, log into your account.
  2. Click on the “Voluntary Withdrawal” link in the menu on the left side of your home page.
  3. Read the pop-up message, then click on the “Voluntary Withdrawal” button if you want to continue.
  4. Follow the instructions to select an application and the persons whose benefits should be stopped. Tell us if you want the benefits stopped immediately or at the end of the month.
  5. Submit the withdrawal to stop getting benefits. When you are done, you will see a Voluntary Withdrawal Summary screen that confirms you have completed the process.
  
• Call HEAplus Customer Support at 1-855-HEA-PLUS (432-7587). An agent can help you submit your request.
  
• Mail a written, signed request to PO Box 19009, Phoenix, AZ 85005. Please include the following information: Your name, your DES Case Number or the HEAplus Application ID Number, the names of the persons included in the voluntary withdrawal request, and if you want benefits to stop immediately or at the end of the month.
  
• Fax a written, signed request to 1 (844) 680-9840 (outside Maricopa county) or (602) 257-7031 (area codes 480, 602, 623). Please include the following information: Your name, your DES Case Number or the HEAplus Application ID Number, the names of the persons included in the voluntary withdrawal request, and if you want benefits to stop immediately or at the end of the month.
  
• Go to a DES/FAA office to submit your request verbally or in writing. For the office nearest you, click on “Find Someone to Help” in the Help Center. Then click on “Find State Eligibility Offices.” Enter your ZIP Code, and click on “Search.”

Nutrition Assistance or Cash Assistance – You can request that your benefits be stopped in the following ways:

  
• Call HEAplus Customer Support at 1-855-HEA-PLUS (432-7587). An agent can help you submit your request.
  
• Mail a written, signed request to PO Box 19009, Phoenix, AZ 85005. Please include the following information: Your name, your DES Case Number or the HEAplus Application ID Number, and the names of the persons included in the voluntary withdrawal request.
  
• Fax a written, signed request to 1 (844) 680-9840 (outside Maricopa county) or (602) 257-7031 (area codes 480, 602, 623). Please include the following information: Your name, your DES Case Number or the HEAplus Application ID Number, and the names of the persons included in the voluntary withdrawal request.
  
• Go to a DES/FAA office to submit your request verbally or in writing. For the office nearest you, click on “Find Someone to Help” in the Help Center. Then click on “Find State Eligibility Offices.” Enter your ZIP Code, and click on “Search.”

To file a complaint, call 1-855-HEA-PLUS (432-7587). A complaint can be filed when you want to make a complaint about things such as:

•          general complaints

•          office conditions

•          office staff

If you do not agree with a delay or a decision about your benefits, you can file for an appeal. For more information about appeals see the following FAQs:

"What if I do not agree with the delay or decision?"

"How do I ask for an appeal?"

"What is the deadline to ask for an appeal?"

"What happens after I ask for an appeal?"

"What happens at the appeal?"

"Can I keep getting benefits while I wait for an appeal?"

Medical Assistance:

You can apply just for the child.  Your income may or may not be considered depending on the medical program you qualify for.

Nutrition Assistance:

You cannot apply just for the child.  You and your household must be included with the child. Income for the entire household must be considered.

Cash Assistance:
You can apply just for the child.  However, income for anyone taking care of the child being applied for will be considered.  This includes income from a spouse and any minor children in the home.

During the appeal hearing, those attending will be able to present information about the case.

A judge will listen to all sides and may ask some questions, before making a decision.

The appeal hearing is held in person or by telephone. The following people may attend:

•          The applicant

•          The applicant’s representative

•          Legal counsel

•          The Administrative Law Judge

•          An AHCCCS worker

•          A Department of Economic Security (DES) worker

We send you letters when there is something you need to know about your benefits or to ask you for more information.  You can view them in your Health-e-Arizona Plus account.  Your homepage will show when you have an unread letter. 

We will send you letters when:

·         Information is needed from you

·         You need to take an action

·         It is time to renew your benefits

·         We made a decision about your benefits (such as approvals and denials)

·         We made a change to your benefits (such as stopping, decreasing, or increasing)

·         Something has happened that will affect your benefits (such as missing an interview)

·         There is general information about your benefits.

It is important that you read each letter and follow the directions.

We will send you letters by U.S. Mail unless you choose to go paperless.  If you go paperless, you will be alerted by e-mail and/or text that you have a new letter in Health-e-Arizona Plus. While you are logged into Health-e-Arizona Plus, click on “Manage My Alerts and Notifications” in the tool bar to make these choices.

Letters we sent to you have been returned by the U.S. Postal Service.  Letters could have been returned for any of the following reasons:

It is important to keep your address current in case information needs to be sent to you. Changing your address can be done in one of the following ways:

•         Right now online: http://www.healthearizonaplus.gov

•         By phone: 

           1-855-HEA-PLUS (432-7587)

•         By mail:     

            PO Box 19009

      Phoenix AZ 85005

You can have your letters sent to the address of someone you know, such as a friend or relative, or someone who is willing to accept mail on your behalf. If you choose to do this, it is important that you add their name to “In Care Of.” Otherwise, your mail may be returned and your benefits may be stopped.

For the Medical Assistance Program: 

The Health-e-Arizona Plus application date is the date the signed application was submitted.

For Cash Assistance and Nutrition Assistance: 

When the application is submitted DURING official business hours, the date of application is the date the signed application was submitted.

When the application is submitted AFTER official business hours, the date of application is the NEXT official business day.

            Official business days and hours:

• Close your Internet browser
• Reopen the browser
• Log back into Health-e-Arizona Plus

Additional information regarding Medical Assistance, Nutrition Assistance, and Cash Assistance can be found at any of the following:

·         The AHCCCS website at www.azahcccs.gov

·         The Department of Economic Security (DES) Family Assistance Administration (FAA) website at https://des.az.gov/services

·         Arizona’s Eligibility Policy Manual

Additional information regarding the new health care changes can be found at https://questions.cms.gov/faq.php?id=5005&rtopic=1993

Also, you can contact a Customer Support Specialist by:

·         Calling during normal business hours at 855-HEA-PLUS (432-7587).

·         Typing your question (chatting) during normal business hours. 

        This can be done from any page in Health-e-Arizona Plus by clicking on “Help Center” at the top of the page and then clicking on chat.

·         Sending an e-mail.

        This can be done from any page in Health-e-Arizona Plus by clicking on “Help Center” at the top of the page and then click on e-mail.

To report member fraud for AHCCCS Medical Assistance:

• Go to www.azahcccs.gov/fraud/ReportFraud/
• From Area Codes 602,623 and 480, call 602-417-4193
• From all other Area Codes, call (888) ITS-NOT-OK or (888) 487-6686
• Send e-mail to AHCCCSFraud@azahcccs.gov

To report provider fraud for AHCCCS Medical Assistance:

• Go to www.azahcccs.gov/fraud/ReportFraud/
• From Area Codes 602,623 and 480, call 602-417-4045
• From all other Area Codes, call (888) ITS-NOT-OK or (888) 487-6686
• Send e-mail to AHCCCSFraud@azahcccs.gov

To report fraud for Nutrition Assistance and Cash Assistance:

• Go to des.az.gov/how-do-i/report-suspected-fraud
• Call the Automated Fraud Hotline at (800) 251-2436

To report Commercial Health Insurance fraud:

• Go to www.azinsurance.gov/fraud.html
• Call (602) 364-2140

https://servicearizona.com/VoterRegistration/selectLanguage

At any time in Health-e-Arizona Plus, you can click on Register to Vote on the tool bar at the top of the screen.

Health-e-Arizona Plus cannot accept an incomplete application for Medical Assistance, but you can submit an incomplete application online for Nutrition Assistance and Cash Assistance.

We need a completed application before we can know if you are eligible for benefits. An incomplete application must contain at least your name, address, signature, and the date you signed it in order to save the date of your application.

An incomplete paper application may be submitted for all programs.

If you have applied and you are waiting for a decision, you can choose to voluntarily withdraw the application. Your application will be denied based on your voluntary withdrawal request.

AHCCCS Medical Assistance – You can request that your application be withdrawn in the following ways:

  
• Use your HEAplus account.
  1. If you submitted your Medical Assistance application through your HEAplus account, log into your account.
  2. Click on the “Voluntary Withdrawal” link in the menu on the left side of your home page.
  3. Read the pop-up message, then click on the “Voluntary Withdrawal” button if you want to continue.
  4. Follow the instructions to select an application and the person(s) you are withdrawing the application for. The effective date will be immediate.
  5. Submit the withdrawal. When you are done, you will see a Voluntary Withdrawal Summary screen that confirms you have completed the process.
  
• Call HEAplus Customer Support at 1-855-HEA-PLUS (432-7587). An agent can help you submit your request.
  
• Mail a written, signed request to PO Box 19009, Phoenix, AZ 85005. Please include the following information: Your name, your DES Case Number or the HEAplus Application ID Number, and the names of the persons included in the voluntary withdrawal request.
  
• Fax a written, signed request to 1 (844) 680-9840 (outside Maricopa county) or (602) 257-7031 (area codes 480, 602, 623). Please include the following information: Your name, your DES Case Number or the HEAplus Application ID Number, and the names of the persons included in the voluntary withdrawal request.
  
• Go to a DES/FAA office to submit your request verbally or in writing. For the office nearest you, click on “Find Someone to Help” in the Help Center. Then click on “Find State Eligibility Offices.” Enter your ZIP Code, and click on “Search.”

Coverage for prior medical expenses is only for medical services received in the three months before the application month. It is available to persons who:

• Were under age 19 when the service was received; or
• Were pregnant when the service was received; or
• Had a pregnancy end in the past five months and were in their postpartum period when the service was received.

The person must also meet all other eligibility requirements for the month in which the service was received. The services received must be covered under AHCCCS Medical Assistance.

Even if you have already paid the bill, answer the question about prior medical expenses on the application. We will see if you are eligible for coverage during those months when we review your application.

If you receive a letter asking you to complete a fraud investigation for Cash Assistance, you must cooperate. If you do not cooperate your benefits may be stopped. You will receive a notice at least ten (10) days before the effective date your benefits will stop.

AHCCCS will not be mailing out 1095-B forms this year. The 1095-B is not required for this tax year. If you, someone in your household, or your tax dependents received AHCCCS medical assistance anytime during this year, and would like to receive a copy of your 1095-B form, you may request a copy through any of the following:

• E-mail address: mcdumemberescalation@azahcccs.gov
• Phone number: 1-833-810-4200 (English) or 1-833-810-4300 (Spanish)
• Mail: 801 E Jefferson St MD 3400 Phoenix, AZ 85034

For tax related questions, tax information, and IRS forms, visit http://www.irs.gov. AHCCCS Medical Assistance (except Federal Emergency Services and Medicare Savings Program) is considered Minimum Essential Coverage under the Affordable Care Act. For more information about Minimum Essential Coverage, visit http://www.irs.gov/Affordable-Care-Act.
There is no fee for not having Minimum Essential Coverage for 2019.

People who receive health insurance coverage through the Health Insurance Marketplace (also known as an Exchange) will receive Form 1095-A. This form will not come from AHCCCS. Please contact the Health Insurance Marketplace if you have any questions about Form 1095-A by calling 1-800-318-2596 (TTY: 1-855-889-4325).
People who receive health insurance coverage through an employer will receive a 1095-B form or 1095-C form. These forms will not come from AHCCCS. Please contact the employer if you have questions about health insurance coverage through an employer.
If you, someone in your household, or your tax dependents, received AHCCCS medical assistance anytime during the year and would like to receive a copy of your 1095-B form, you may request a copy through any of the following:

• E-mail address: mcdumemberescalation@azahcccs.gov
• Phone number: 1-833-810-4200 (English) or 1-833-810-4300 (Spanish)
• Mail: 801 E Jefferson St MD 3400 Phoenix, AZ 85034

Medicare Part A is insurance through the Social Security Administration. This insurance covers hospital care, limited skilled nursing facility fees, hospice fees, lab tests, surgery, and limited home health care. Medicare is usually free but some people may be required to pay a premium.

Conditional Medicare Part A is for customers who are:

• Not eligible for premium free Medicare Part A and
• Unable or unwilling to pay the Medicare Part A premium.

1. Apply for Conditional Medicare Part A with the Social Security Administration.
2. Be approved for Conditional Medicare Part A.
3. After being approved for Conditional Medicare Part A, apply for QMB through AHCCCS. The Conditional Medicare Part A approval may take a few days to show in our system.
4. Upon QMB approval, AHCCCS will notify Social Security.
5. Social Security will enroll you in Medicare Part A. AHCCCS will pay the premiums.

It can take up to 45 days to process your QMB application.You will get a letter when a decision has been made.

It may take up to 3 months after being approved for QMB to see an increase in your checks. Social Security will notify you when the change has taken place.