How do I provide additional information, when requested? Ensure a Certified W9 is On File Any provider who will be receiving state/federal funds for services rendered or provided to Medicaid recipients must have a certified W9 tax form on file with the State. The KidsCare program requires payment of monthly premiums. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. AHCCCS insurance covers you and your family for doctor visits, vaccines, prescriptions, emergency care, hospitalizations and more. If eligibility cannot be determined, you will be sent a pre-populated renewal form with a Request for Information letter describing the information needed to complete the renewal. Once eligible, AHCCCS will send an AHCCCS ID Card with health plan information for each eligible person in your household. AHCCCS is available to: Children birth to 1 year with family income up to 147% of the federal poverty level. Restaurants should not be charging sales tax when you purchase your meal using your EBT card. We will keep all information you provide private, as required by law. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. B - UFC/ACC health plan offers our members: Health-e-Arizona Plus is an on-line application for Arizona Residents. Many providers will need to take action before they are ready to enroll as a Medicaid provider with AHCCCS. There are three ways to apply for AHCCCS Medical Assistance including KidsCare II: Apply online by going to www.healthearizona.org and fill out all the needed information. If you have questions about AHCCCS coverage at Valleywise Health, call 1 (833) VLLYWSE. If you do not provide the requested information by the due date, your eligibility will be stopped. Social Security numbers (if none, verification that a Social Security number has already been applied for). Arizonas Medicaid health insurance. It also offers special coverage for children and young adults under 21. To apply by mail or fax, either download the application or request an application to be mailed to you by calling 1-855-432-7587. How to Apply for Food Stamps. Instructions on how to do so are included in the application. The latest enrollment data shows 53.3% Arizonans covered by . Provider Enrollment has established a fax and email address to specifically send paper-related documents. You will receive a letter telling you who your . If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. Beneficiaries of this program are provides with a debit card that can only be used at authorized grocery . Give us all requested information as soon as possible. Need help with applying? (For additional instructions, see the Frequently Asked Question (FAQ) in Health-e-Arizona Plus titled 'How do I fax documents to HEAplus'). Give the manager or owner of the restaurant this flyer about the Restaurant Meals Program for merchants. If you are approved for emergency services only, you may receive medical services from any provider (doctor, hospital, etc.) Social Security numbers for everyone, or proof that a Social Security number has been applied for. There are no fees for applying for AHCCCS. For more information visit the National Plan and Provider Enumeration System (NPPES) webpage at https://nppes.cms.hhs.gov or contact the NPI Enumerator at 1-800-465-3203 or TTY 1-800-692-2326. You should review your receipts before leaving the restaurant. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Proof of life insurance, retirement plans, securities, and savings bonds. Phone applications are available Monday through Friday from 8 a.m. to 4 p.m. AHCCCS works with doctors, hospitals, pharmacies, specialists and more to make sure that you are covered for all of the following medical services: AHCCCS covers several behavioral health services, including supervised and therapeutic day programs, crisis services, rehabilitation programs for living skills, educational support, supported employment, and cognitive rehabilitation, medication management training, case management, housing support, personal assistance and much more. What if there is a restaurant I would like to be involved with the Restaurant Meals Program? that has an agreement to bill AHCCCS for covered emergency services. What can I do if I disagree with the decision? 1-800-786-4346. Policy Manuals Careers There are three ways to apply for AHCCCS Medical Assistance including KidsCare II: The following are some of the items you may need when applying or reapplying for AHCCCS Medical Assistance for you and your household (this does not apply to every applicant): After you have applied, you may check your application status online by going to the My Family Benefits Page. idcs-56b6e9015b5b403987f3105c0544879a.identity.oraclecloud.com AHCCCS works by having you choose a health plan that covers your zip code area. Your PCP must approve all of your medical care, including non-life threatening emergency room visits. Immediate free, confidential help is available. The Health Insurance offered by the AHCCCS for eligible children does not have monthly premiums for those who qualify. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), Medical Assistance (Medicaid through AHCCCS), how AHCCCS is planning for the end of the Public Health Emergency, Arizona Health Care Cost Containment System, Arizona Supplemental Nutrition Program for Women, Infants, and Children, Equal Opportunity and Reasonable Modification. I am a restaurant that is interested in participating in the Restaurant Meals Program. Pay Your Premium Learn more about how AHCCCS is planning for the end of the Public Health Emergency. In addition to the services listed above, people who qualify for long term care can receive services such as: To determine eligibility, you need to fill out the online application on Health-e-Arizona PLUS (https://www.healthearizonaplus.gov/) or mail in a completed form to the Family Assistance Administration of Arizona. Fee-for-Service Fee Schedules, Contact Us Mercy Care is a not-for-profit health plan offering integrated care to children, adults and seniors eligible for AHCCCS benefits. You can also contact Community Assistors which help people complete and submit their Medical Assistance application. For additional documents, brochures and pamphlets related to the Medical Assistance program, please visit our Document Center. The Affordable Care Act (ACA) requires states to utilize a single streamlined application approved by the Secretary of Health and Human Services. They must have limited income, limited assets, and a medical need for care. Birth certificates for everyone who is applying for benefits. The information on this page will help you prepare and apply for benefits. This website uses cookies to improve your experience while you navigate through the website. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Go to AHCCCS Available Health Plans to find information about health plans, to pre-enroll, or to change enrollment in your anniversary month. To qualify, you must be an Arizona resident with U.S. citizenship or qualified immigration status. Your email will automatically create a service ticket for Provider Enrollment to review and resolve. Enter your zip code to get started. Call 1-800-377-3536 to get connected with a certified bilingual assister or make an appointment online. Coverage for Medical Assistance in most cases begins the first day of the month that you are found eligible. Submit all supporting documentation In addition to a complete application, each provider is required to submit all applicable supporting documentation at the time of submission to avoid processing delays. All legal service programs in Arizona differ, and their criteria for accepting cases vary as well. You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). All AHCCCS health plans provide the same covered medical services. If you are unable to access services virtually, the DES Family Assistance Administration has offices statewide to assist you with the application process. Covered Services The Restaurant Meals Program allows certain Nutrition Assistance (NA) participants to use their Electronic Benefits Transfer (EBT) card to purchase prepared meals from participating restaurants. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. You also have the option to opt-out of these cookies. Find out if you qualify for a Special Enrollment Period. Insurance plans cant make you pay more in. To update your information, you may go online to https://www.healthearizonaplus.gov. The statement must be made by a non-relative who doesnt live with you. Getting emergency care. Alien Registration Cards, if there are non-U.S. citizens applying for benefits in your household. Check if you qualify for a Special Enrollment Period. Copyright BenefitsApplication.com 2016. Find out which information you may need to provide to determine eligibility. Proof of citizenship for everyone who is applying for benefits. We also use third-party cookies that help us analyze and understand how you use this website. Speak with your eligibility specialist, to determine whether you may be exempt from these requirements. I'm having an emergency. Retailers who are interested in online purchasing for SNAP EBT must meet USDA Food and Nutrition Service (FNS) requirements and obtain authorization to participate. Phone: 602-417-4000 Provider Assistance (PA) is an option to speak with a level I customer service representative. Please include a cover sheet with your faxed documents. You can then complete the application and submit it by mail or fax. Go to Find an Assistor, enter your ZIP Code to locate community assistors near you for help with the application process. 2226 0 obj <>/Filter/FlateDecode/ID[<7E13598C50AB214791283D6D87E75447>]/Index[2197 50]/Info 2196 0 R/Length 134/Prev 724933/Root 2198 0 R/Size 2247/Type/XRef/W[1 3 1]>>stream The vast majority are ages 64 and younger. Name and contact information of neighbor or landlord. Nutrition Assistance provides eligible households with monthly benefits they can use to purchase nutritious food. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Apply in Person at your county office or Fill out paper application form and mail to your county office. You can then complete the application and submit it by mail or fax. 2246 0 obj <>stream Individuals must meet certain income and other requirements to obtain services. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Providers should review the application and follow the instructions for completing the application to enroll their existing AHCCCS provider ID. Learn about eligibility, needed information and the process to apply for benefits. To get started or to renew participation, download the formRestaurant Meals Program Memorandum of Understanding (MOU). (e.g., paper provider enrollment application, etc. Find out what kind of coverage youre eligible for and how to apply for AHCCCS. For more details or information on your case, go online to www.yes.state.nm.us and click on "Check My Benefits," or call the ISD Information Line, available 24/7, at 1-855-309-3766. Some details must be faxed to complete your application. Also, many SNAP Community Partners are also Community Assistors that can help you apply for Medical Assistance. This video is available in American Sign Language. The following authorized SNAP retailers accept EBT payment for online transactions: View frequently asked questions related to SNAP Online Purchasing. Some Assistors will be available to guide you through the entire process, and others will provide you with access to computers, scanners, telephones, copy machines and/or fax machines that you can use for free. You can find a Community Assistor in your ZIP Code on the Get Help screen of Health-e-Arizona Plus. One will be chosen for you by AHCCCS. Nutrition Assistance (formerly the Food Stamp Program) is Arizonas program for the Food and Nutrition Service (FNS) Supplemental Nutrition Assistance Program (SNAP). 0 You will receive a letter indicating whether you have mandatory co-payments. Health insurance through AHCCCS helps individuals cover the cost of doctors office visits, physical exams, immunizations, prenatal care, hospital care and prescriptions they need. The easiest way to apply for benefits is online through Health-e-Arizona Plus. 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. You may also report Medicaid fraud by calling (toll free) 1-800-533-0686. Provider Assistance Unit: (602) 417-7670 option 5. You can apply for medical coverage through AHCCCS, Nutrition Assistance (formerly know as the Food Stamp program), and Cash Assistance. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. You must also be under the income limit, which varies depending on your age and size of your household. Complete bank statement for the past months. The Medicaid program in Arizona is called the Arizona Health Care Cost Containment System . Ready to apply? 1. DES has implemented virtual office services statewide to continue to better serve our customers and communities in this time of need while protecting the health and safety of our customers and staff. TANF: Temporary Assistance for Needy Families. Need to apply for AHCCCS, KidsCare, Medicare Savings Program, SNAP, and TANF? Apply in person: Apply in person at your county of residence's local county office or at a local application assistance site. Phoenix, Arizona 85005-9009. An application is not processed in a timely manner. These cookies will be stored in your browser only with your consent. Let us know if you need assistance in getting the necessary information. Prescriptions (Not covered if you have Medicare), Podiatry Services Performed by a Podiatrist, Emergency Dental (Up to $1000 per contract year), Dental Services (up to $1000 per contract year). Apply by phone: Call 1-800-221-3943 / State Relay: 711. Once your application is submitted, your food stamp office will send you a notice regarding your eligibility. It can be done from any device, anywhere at any moment! Arizona's Medicaid Program will cover the following: Medical expenses including doctor visits and prescription medications. If you are unsure about applying for AHCCCS coverage, you can visit their official website to get support. The co-payment may be waived by the medical provider. Providers should review the application and follow the instructions for completing the application to enroll their existing AHCCCS provider ID. The Cash Assistance program provides temporary cash benefits and supportive services to the neediest of Arizona's children and their families. Go to AHCCCS Available Health Plansto find information about health plans, to pre-enroll, or to change enrollment in your anniversary month. Just as Valleywise Health provides premier, compassionate care to all those who need it, AHCCCS is there to ensure you have the coverage you need whether youre recently unemployed or simply unable to pay for private insurance. AHCCCS is Arizona's Medicaid program. Mail or Fax an Application. That hospital will treat you regardless of whether you have insurance. The information on this page will help you prepare and apply for benefits. Health-e-Arizona Plus Some medical assistance programs may require the participant to make a co-payment when receiving medical services. By helping families fight food insecurity and meet one of their . There are no fees for applying for medical assistance. If you have any questions, you may call 1-855-432-7587, Monday through Friday 7:00 a.m. - 6:00 p.m.
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