Apply for AHCCCS Health Insurance/KidsCare

Apply Online

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.

Health-e-Arizona Plus

Note: Health-e-Arizona Plus is offered in both English and Spanish.


Print an Application

 

Click on the link to DES below if you (or the person you are applying for) are one or more of the following:

  • An adult without children
  • A pregnant woman
  • A family with children
  • A child only

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:

  • 65 years of age or older
  • An individual who is blind or disabled
  • A working individual with a disability (Freedom to Work)
  • An individual that wants help with Medicare costs only

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.



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