AHCCCS Member Resources

Additional information for AHCCCS members can be found on this page.

Policy Manual

The purpose of the Eligibility Policy Manualis to provide detailed documentation that supports eligibility decisions for the various health insurance programs offered through AHCCCS.

Notice to the Public | Rich Text Version

Arizona’s Eligibility Policy Manual for Medical, Nutrition, and Cash Assistance

Reference Documents

Eligibility Standards Desk Aid | Rich Text Version

AHCCCS has almost 100 different one-page guides about various aspects of the health care system. Topics include: behavioral health care; various member services; foster care, kinship and adoptive families; and the grievance and appeal processes.

See all the one-page Empowerment Tools at www.azahcccs.gov/OIFATools

ALTCS Member-Directed Options

Member directed models or options allow members to have more control over how certain services are provided, including services like attendant care, personal care and homemaker services. The models are not a service, but rather define the way in which services are delivered. Member-directed options are available to most Arizona Long Term Care System (ALTCS) members who live in their own home. The options are not available to members who live in an alternative residential setting or nursing facility. ALTCS members or their representatives are encouraged to contact their case manager to learn more about and consider member-directed options.

Agency with Choice Resources

Agency with Choice a member-directed option available to ALTCS members living in their own home. Under the Agency with Choice option, the provider agency and the member enter into a relationship and share employer-based responsibilities for the paid caregiver. The provider agency maintains the authority to hire and fire the caregiver and provide or arrange for the required minimum standardized training for the caregiver. The member, or their individual representative, may choose to assume one or more of the following employer-based responsibilities:

  • Recruit and select caregivers, including specifying the qualifications of the caregiver over and above the standard qualifications required by AHCCCS
  • Dismiss caregivers
  • Manage caregivers, including determining duties and schedules
  • Supervise caregivers
  • Training caregivers, including identifying special training needs

AHCCCS Member Communication

Click on "Member Notice" for the latest communication regarding the new Agency with Choice, member-directed option. Click on "FAQs" for answers to common questions pertaining to Agency with Choice.

Self Directed Attendant Care (SDAC) Resources

Self Directed Attendant Care (SDAC) is a member-directed option that has been available to members since 2008. Under the SDAC option, the member or member’s legal guardian serves as the legal employer of the paid caregiver and assumes all employer-based responsibilities. The member or member’s legal guardian is supported by a Fiscal Employer Agent that takes care of the taxes, payroll withholding and paychecks for the caregiver.

Policy

Additional Information & Brochure

SDAC Brochure | Rich Text Version

American Indians and Alaska Natives (AI/AN) enrolled in AHCCCS or Children's Health Insurance Program (KidsCare) may choose to receive their coverage through the AHCCCS American Indian Health Program (AIHP) or one of the AHCCCS-contracted managed health plans.

AHCCCS American Indian Health Program Member Handbook

AHCCCS American Indian Health Program (AIHP) provides medically necessary services for enrolled members, including preventive and behavioral health care services. See the Member Handbook (linked below) for more information about AIHP.

Member Guide | Rich Text Version

Obtaining Services

AIHP members may receive health care services from Indian Health Facilities (the Indian Health Service, tribally-operated "638" health programs, urban Indian health clinics) and other AHCCCS-registered Providers.

Unique Program Choices

AI/AN members can switch their enrollment between AHCCCS AIHP and an AHCCCS managed health care plan and back again at any time. However, a member can change from one managed health care plan to another (for example, Mercy Care Plan to Maricopa Health Plan) only once a year.

American Indian AHCCCS Member Enrollment Choices | Rich Text Version

Contact

There are two ways for AHCCCS members to change their AHCCCS enrollment:

  • Online: www.healthearizonaplus.gov
  • Phone:
    • To change from American Indian Health Program to a managed care health plan, call 602-417-7000 (Maricopa County) OR 1-800-962-6690 (Outside Maricopa county).
    • To change from a health care plan to American Indian Health Program, the American Indian Health Program (AIHP) Change Request Form must be submitted to AHCCCS. Only AHCCCS registered Indian Health Service (IHS), Tribally owned/and or operated 638 facilities and Urban Indian Health Organizations (receiving Title V funding from IHS) may use this form.