AHCCCS Member News


AHCCCS Proposed Copays for 1/1/15 New Icon

August 8, 2014
Copayments are amounts members pay directly to a provider for each item or service they receive at the time of a service, unless otherwise exempt. Below is a link to the description of copayments, including the copayments AHCCCS proposes to charge for members in the new adult group beginning January 1, 2015, subject to approval by the Centers for Medicare and Medicaid Services. Members will be notified of any changes in copayments before they happen.

KidsCare II Re-Opens

November 16, 2012
On November 1, 2012, AHCCCS reopened enrollment in the KidsCare II program and all applications are being considered for eligibility. Eligibility requirements for KidsCare II remain the same. Additionally, children on the wait list that was started Sept 7, are being automatically enrolled into the program if they meet the eligibility requirements for KidsCare II and do NOT need to reapply at this time. AHCCCS will continue to consider all applications for KidsCare II until the program reaches maximum enrollment based on available funding. More information about the KidsCare II program is available on the link below or call the toll free hotline (operated by a Community Partnership) at: 1-800-377-3536.

KidsCare II

August 24, 2012 Updated

As of August 17, 2012, there were 18,773 children approved for the KidsCare II program. Based on recent application and approval rates, AHCCCS anticipates the program will reach its funding capacity of 25,000 children sometime the week of September 3, 2012. At that time, the KidsCare II program will be frozen until further space becomes available. All applications will continue to be reviewed for Medicaid first and if it appears the applicant may be eligible for KidsCare or KidsCare II, the application will be placed on the wait list. Should additional space become available, the KidsCare Office will contact the applicant’s household. For more information about the program call the toll free hotline (operated by a Community Partnership) at 1-800-377-3536.


Settlement in Ball v. Betlach Updated Tag

September 11, 2012
A hearing will be held on October 22, 2012 (changed from the original date of October 1, 2012) to review the proposed settlement in Ball v. Betlach. More information is available in the Notice of Settlement, Proposed Order Approving Settlement and Settlement Agreement below, including the location of the hearing, a brief history of the case, the terms of the proposed settlement, the effect of the settlement on class members’ rights and the benefits of the settlement.

Notice of Settlement
Proposed Order Approving Settlement
Settlement Agreement


New FPL Limits Effective April 1, 2012 and July 1, 2012

Tues July 17, 2012
The AHCCCS Eligibility Policy Manual has been updated with the Federal Poverty Level (FPL) limits effective 4/1/2012 (click here) and Share of Cost Standards effective 7/1/12 (click here).


Notice of Co-pays for Taxi Rides for AHCCCS Care Members in Maricopa and Pima Counties

Thurs March 1, 2012
Beginning April 1, 2012, AHCCCS Care members in Maricopa and Pima counties will be charged a $2 co-pay each way for medically necessary taxi rides for services such as going to and from your doctor or the pharmacy. For example, if the taxi takes a member from their home to the doctor, they will be charged $2.00 for that ride. If a taxi is called back to pick the member up at the doctor’s office to take them to the pharmacy, they will be charged $2.00 for that ride. If that taxi does not wait for the member at the pharmacy and a taxi is called to take them back home, they will be charged another $2.00 for that ride. So the total co-pay in this example will be $6.00.

AHCCCS Care is for people who are: 1) not pregnant, 2) not 65 or over or 3) not determined disabled, or 4) do not have an eligible deprived child living with them and are not eligible for any other program. For information on who is considered a deprived child, see Arizona Administrative Code R9-22-1427.

If the member does not pay the co-pay, the taxi company can deny giving the member a ride.

These co-pays do not apply to:

  • Individuals under age 19
  • People determined to be Seriously Mentally Ill (SMI) by the Arizona Department of Health Services.
  • People who are acute care members and who are residing in nursing homes, or residential facilities such as an Assisted Living Home and only when the acute care member’s medical condition would otherwise require hospitalization. The exemption from copayments for acute care members is limited to 90 days in a contract year.
  • People who receive hospice care.
  • American Indian members who have used at any time the Indian Health Service, tribal health programs operated under P.L. 93-638, or urban Indian health programs
  • Family planning services and supplies.
  • Services related to a pregnancy or any other medical condition that may affect the pregnancy

Member Letter [PDF, 20KB ]


SCAN Healthplan Transition

Wed Feb 22, 2012
Effective May 1, 2012, SCAN Health Plan will no longer be available to AHCCCS Long Term Care System members. Members who are currently enrolled with SCAN Health Plan will be sent a letter about this change and will be reassigned to Bridgeway Health Solutions, Evercare Select or Mercy Care Plan in late February. Members may stay in their reassigned health plan, or choose another available health plan and inform AHCCCS of this change between March 1, 2012 – March 30, 2012. AHCCCS is committed to ensuring minimal disruption to members during this transition. For more information, click on the link below:

SCAN Transition 2/8/12 [PDF, 33Kb]

Missed Appointment Fee

Thu Dec 15, 2011
Beginning January 1, 2012, adults eligible for AHCCCS for Families with Children and individuals eligible for AHCCCS Care who reside outside of Maricopa and Pima counties may be charged a $3 fee by their provider (doctor, nurse practitioner, and physician assistant) if they miss their appointment without cancelling it at least 24 hours before the appointment or are more than 20 minutes late to the appointment.

For more information, see the Member Information Sheet below:

Member Information


MVD Photos to Help Protect Members and Prevent Fraud

Tue, December 2, 2011
Beginning December 15, 2011, we will be adding photos to our online verification tool that providers use to verify a member’s eligibility. This new feature is one of many efforts by AHCCCS to help protect members and prevent fraud. For all AHCCCS members who have an Arizona driver’s license or a State issued Identification (ID) card, AHCCCS will get their picture from the Arizona Department of Transportation Motor Vehicle Division (MVD). When providers use the online member verification tool and enter a member’s social security number, the member’s picture, if available from MVD, will be shown on the verification screen along with other AHCCCS coverage information. The picture will help providers to quickly confirm the member’s identity.


Pima Health Plan Termination

Mon Aug 22, 2011

Acute Care Members
Effective October 1, 2011, Pima Health Plan will no longer be available to AHCCCS Acute care members. Members currently enrolled with Pima Health Plan were sent a letter about this change on August 8, 2011. The letter informs members that AHCCCS has assigned them to other health plans available in Pima County. Reassignment will be effective October 1, 2011. Members can stay in their reassigned health plan or choose another available health plan and inform AHCCCS of this change no later than September 7, 2011. To change health plans, call AHCCCS customer service, Monday through Friday, 8:00 am to 5:00 pm, at: 602-417-7100 from area codes 602,623, and 480 or, 1-800-334-5283 from area codes 520 and 928.

ALTCS Members
Effective October 1, 2011, Pima Health Plan will no longer be available to AHCCCS Long Term Care System members. Members currently enrolled with Pima Health Plan were sent a letter about this change on August 19, 2011. The letter informs members that AHCCCS has reassigned them to Evercare Select or Mercy Care Plan. Reassignment will be effective October 1, 2011. Members can stay in their reassigned health plan or choose another available health plan and inform AHCCCS of this change no later than October 31, 2011. Changes to reassigned health plans will be effective on January 1, 2012. To change health plans, call AHCCCS customer service, Monday through Friday, 8:00 am to 5:00 pm, at: 602-417-7100 from area codes 602, 623, and 480 or, 1-800-334-5283 from area codes 520 and 928.


Change in ALTCS Transfer Policies

Thur Apr 28, 2011
Effective with ALTCS applications filed on and after May 1, 2011, uncompensated transfer penalty periods will be reduced and ended only when ALL transferred assets are returned. Penalty periods will no longer be shortened when only a partial return is made. For more information, click on the link below:

ALTCS Transfer Change [8KB]


New FPL Limits Effective April 1, 2011

Tue Mar 1, 2011
The new Federal Poverty Level limits effective April 1, 2011 are now available:

2011 Federal Poverty Guidelines


Notice Procedures for Services

Thurs Feb 17, 2011
AHCCCS covers 1.35 million Arizonans through contracted Health Plans. AHCCCS Health Plans receive thousands of requests for services requiring prior authorization on a daily basis. Federal law requires that all denials of services requiring prior authorization be sent in writing since the member has the right to appeal the notification. There is no similar requirement for written notice of approvals of a service since there is no need for an appeal in that instance.

Accordingly, to increase efficiencies and maintain costs, approvals for procedures requiring prior authorization are communicated to members by phone. These phone notifications are documented in internal records.


Incomplete Phone Numbers on Some AHCCCS ID Cards

Fri Nov 5, 2010
During the time period from September 28, 2010 to November 1, 2010, some AHCCCS ID cards were issued missing the last digit of the behavioral health provider telephone number. The problem has been corrected for cards produced in November. The full telephone numbers of the providers are:

Behavioral Health Provider Phone Numbers
Provider Telephone Number
Cenpatico 1-866-495-6738
Community Partnership of Southern AZ (CPSA) 1-800-771-9889
Gila River Tribal Regional Behavioral Health Authority 1-800-259-3449
Magellan 1-800-564-5465
Navajo Nation Behavioral Health Contractor 1-866-841-0277
Northern Arizona Regional Behavioral Health Authority (NARBHA) 1-800-640-2123
Pascua Yaqui Regional Tribal Behavioral Health Authority 1-877-342-0912
White Mountain Apache Tribe 1-877-336-4811


Flu and Pneumococcal Vaccines for AHCCCS Members

Tue Nov 2, 2010
Seasonal flu and pneumococcal vaccines are available for all AHCCCS members.

  • Members: Contact your AHCCCS Health Plan Member Services Department to find out where you can get your vaccines. If your Health Plan contracts with retail pharmacies to administer the seasonal flu and pneumococcal vaccines (available for adults 21 years and older ONLY), a prescription from your AHCCCS doctor is required. Visit our health plan list for contact information.
  • Providers: Contact the member's Health Plan Provider Services Department to find out if your facility is authorized to provide and administer the flu and pneumococcal vaccines. Visit our health plan list for contact information.

Flu and Pneumococcal Vaccines for Fee for Service (FFS) Recipients

Tue Nov 2, 2010
Seasonal flu and pneumococcal vaccines are available for many AHCCCS FFS members.

  • Members: Contact AHCCCS Claims Customer Service at (602) 417-7670 Option 4 to find out where you can get your vaccines. In addition to IHS/638 facility pharmacies, retail pharmacies can also administer the seasonal flu and pneumococcal vaccines (available for adults 21 years and older ONLY), a prescription from your AHCCCS doctor is required.
  • Providers: Contact Claims Customer Service at (602) 417-7670 Option 4 to find out if your facility is authorized to provide and administer the flu and pneumococcal vaccines.

PAS Tool Revision

Mon Mar 7, 2010 The final rules for the ALTCS PAS tool for children under 6 have been approved. The implementation date for the new PAS tool is March 21, 2011.

Final Rules

Tue Oct 12, 2010
AHCCCS is proposing to update the ALTCS PAS tool used for children under age 6. The new tool has been developed and piloted and is now being finalized. More information is provided below: