Medicaid is a program that provides health coverage to eligible low-income Arizona residents. Medicaid covers families with children and pregnant women, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid, however questions concerning immigration status and eligibility should be directed to the Arizona Department of Social Services.
- For certain categories of people, eligibility for Medicaid is based on the amount of your household income.In Arizona you may be eligible for Medicaid if you are an infant, a child, pregnant, or a parent of a dependent child and your family income meets the Medicaid income standards.
Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account. For more information, you should contact the Arizona Health Care Cost Containment System (AHCCCS) at (800) 654-8713 or visit them online at: www.ahcccs.state.az.us/site/.
Low income persons eligible for Medicaid in Arizona*
Category Income eligibility (as percent of federal poverty level)
Infant 0-1 140% (monthly income of about $2,053 for family of 3)
Child 1-5 133%
Child 6-19 100%
Pregnant woman 150%
Childless adults 100%
* Eligibility information was compiled State Health Facts Online, the Henry J. Kaiser Family Foundation and may have changed since this guide was published. Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.
To get an idea of how your income compares to the federal poverty level,* use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2008:
Size of Family Unit — Poverty Guideline (annual income)
1 — $10,400
2 — $14,000
3 — $17,600
- For larger families add $3,600 for each additional person.
- So, for example, using this guideline, 140% of the federal poverty level for a family of 3 would be an annual income of $24,640, or a monthly income of $2,053.
- Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.
- Parents who receive benefits under Temporary Assistance for Needy Families (TANF) (also known as EMPOWER) should also know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 24-month transitional period. In addition, your children may continue to qualify for Medicaid if your family’s income meets certain income standards.
- Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits are automatically eligible for Medicaid.
Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage for a limited time.
- People who have medical expenses may also qualify for Medicaid under the Medical Expense Deduction (MED) option. You may qualify if your income is 40% of the federal poverty level after deducting allowable medical expenses and if your resources are within the allowable limits. For example, people who have catastrophic illnesses requiring an inpatient hospital stay may qualify if they do not have health insurance that covers these inpatient services. Call (800) 352-8401 or go to www.ahcccs.state.az.us/Services/Programs/MED.asp for more information about MED.
- People who are either elderly, physically or developmentally disabled and who have need for long term care services may qualify for Medicaid under the Arizona Long Term Care Program (ALTCS). To qualify individuals must have income, which is below 300% of the federal SSI maximum benefit rate (i.e., monthly income of $1,911 for a one person household) and be determined to be at immediate risk of institutionalization in either a nursing facility or an intermediate care facility. For all eligible persons, ALTCS offers a complete array of acute medical care services, institutional services, behavioral health services, home-and-community based services and case management services.
- People who are age 65 or over and who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.If your household income is at or below 100% of the federal poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance. This is called the Qualified Medicare Beneficiary (QMB) program.
If your household income is between 100 - 120% of the federal poverty level, Medicaid will pay for your monthly Medicare Part B premiums only. This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.
If your household income is between 121% - 175% of the federal poverty level, Medicaid may pay for all or part of your Medicare Part B premium. These are called the Qualified Individual 1 (QI-1) and Qualified Individual 2 (QI-2) programs.
- There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for AHCCCS programs, contact AHCCCS. To apply, Arizona residents can use one simple form provided by AHCCCS. You can download the application form from the AHCCCS website at www.ahcccs.state.az.us or you can get an application by mail by calling (602) 417-5010 then press 11 or call toll free (800) 528-0142.