You are invited to participate in a survey regarding your experience using the AHCCCS website. This survey will take approximately two minutes. Your responses will help us ensure that you have a high quality experience.
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.
Click on the link to DES below if you (or the person you are applying for) are one
or more of the following:
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:
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, contact one of our ALTCS offices.
Adobe Acrobat Reader is required to view PDF files. This is a free program available
from the Adobe web site. Follow the download directions on the Adobe
web site to get your copy of Adobe Acrobat Reader.