AHCCCS Works Frequently Asked Questions
- Q1: What are the AHCCCS Works requirements?
- Q2: Who is required to participate in AHCCCS Works?
- Q3: Who is exempt from AHCCCS Works?
- Q4: What qualifies as “medically frail”?
- Q5: Are American Indians/Alaska Natives required to participate?
- Q6: When does the program begin?
- Q7: Do members need to participate if they are already employed?
- Q8: How many AHCCCS members will participate in AHCCCS Works?
- Q9: How do members report community engagement hours?
- Q10: What happens if a member does not report enough hours or misses the monthly deadline?
- Q11: Do members lose AHCCCS benefits during the suspension period?
- Q12: Do members need to reapply for AHCCCS coverage after the suspension period?
- Q13: Can a member complete annual AHCCCS renewal during the suspension period?
Q1: What are the AHCCCS Works requirements?
A: Members who are required to comply with AHCCCS Works will participate in at least 80 hours of community engagement activities per month and report those hours by the 10th day of the following month. Activities that count toward the requirement are:
- Employment, including self-employment
- Less than full-time education
- Job or life skills training
- Job search activities
- Community service
Q2: Who is required to participate in AHCCCS Works?
A: AHCCCS Works applies to some able-bodied AHCCCS adults who are 19 to 49 years old and who do not qualify for one of the exemptions.
AHCCCS will notify members who may be required to participate. Upon implementation of the program, all members will have a three-month period in which to become familiar with requirements and tools available to ensure their success.
Q3: Who is exempt from AHCCCS Works?
A: Exempt individuals include:
- Pregnant women, up to the 60th day post-pregnancy
- Former Arizona foster youth up to age 26
- Members of federally recognized tribes
- Designated caretakers of a child under age 18
- Caregivers who are responsible for the care of an individual with a disability
- Members determined to have a serious mental illness (SMI)
- Members who are medically frail
- Members who have an acute medical condition
- Members who are in active treatment for a substance use disorder
- Members with a disability recognized under federal law and individuals receiving long term disability benefits
- Full-time high school, college, or trade school students
- Survivors of domestic violence
- Individuals who are homeless
- Individuals who receive assistance through SNAP, Cash Assistance or Unemployment Insurance or who participate in another AHCCCS-approved work program
Q4: What qualifies as “medically frail”?
A: Members who are medically frail and cannot comply with the requirements will be exempt. Examples of medically frail conditions are:
- Chronic substance use disorders,
- Serious and complex medical conditions; and
- Physical, intellectual or developmental disabilities that significantly impair the ability to perform one or more activities of daily living, such as eating, bathing, and dressing.
Additional details will be provided before the program begins.
Q5: Are American Indians/Alaska Natives required to participate?
A: Members of federally recognized tribes are exempt from AHCCCS Works.
Q6: When does the program begin?
A: AHCCCS Works is scheduled to begin no sooner that January 1, 2020. Individuals who are newly subject to the requirements will receive a three-month grace period before compliance is required. This period will give members time to become familiar with the requirements and the tool available to ensure their successful compliance.
Q7: Do members need to participate if they are already employed?
A: Members who are already working at least 80 hours per month do not need to engage in additional activities, but may need to report monthly compliance. For members who have earned income equivalent to at least 80 hours a month at minimum wage, AHCCCS will limit reporting requirements as much as possible.
Q8: How many AHCCCS members will participate in AHCCCS Works?
A: An estimated 120,000 current AHCCCS members will be required to comply with AHCCCS Works community engagement requirements.
Q9: How do members report community engagement hours?
A: AHCCCS Works members must complete at least 80 hours per month of community engagement activities and report them by the 10th day of the following month online, by mail, by phone and in person. More details about how to report hours will be coming.
Q10: What happens if a member does not report enough hours or misses the monthly deadline?
A: A member who does not report at least 80 hours of community engagement by the 10th day of the following month will be suspended from AHCCCS coverage for a two-month period.
The two-month suspension will occur on the first day of the month after AHCCCS sends the Notice of Suspension, unless the member reports and verifies that there was good cause (such as family emergency or natural disaster) for non-compliance or initiates an appeal of the suspension.
Q11: Do members lose AHCCCS benefits during the suspension period?
A: Members will not receive AHCCCS benefits during the two-month suspension period. However, a member’s coverage may be reinstated at any point during the suspension period if the member is no longer subject to the requirements (for example, if the member qualifies for an exemption at any point during the suspension period).
Q12: Do members need to reapply for AHCCCS coverage after the suspension period?
A: No. After the two-month suspension period, a member’s AHCCCS coverage will be automatically reinstated as long as they meet all other Medicaid eligibility criteria.
Q13: Can a member complete annual AHCCCS renewal during the suspension period?
A: Yes. A member’s annual redetermination will not be impacted by a non-compliance suspension.