hbbd```b``>"gH u]&jN`k`z`v?dQY`9 F,2 DAd%d\"/La` 2QDO/a`bdPd`W; ; Medical bills prior to 3 months before you apply cannot be used. Necessary cookies are absolutely essential for the website to function properly. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. Give the manager or owner of the restaurant this flyer about the Restaurant Meals Program for merchants. These specialists can be reached at (602) 344-2550 or by visiting www.valleywisehealth.org/patients. AHCCCS offers health insurance for pregnant women who meet income and eligibility requirements. If you were charged sales tax in error, you should first attempt to resolve this with the restaurant. A single individual applying for Nursing Home Medicaid in 2023 in AZ must meet the following criteria: 1) Have income under $2,742 / month 2) Have assets under $2,000 3) Require the . The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification. This category only includes cookies that ensures basic functionalities and security features of the website. An application is not processed in a timely manner. Name and contact information of neighbor or landlord. Enrollment in BCBSAZ Health Choice Pathway (HMO D-SNP) depends on contract renewal. endstream endobj 2198 0 obj <. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The cost of long-term care in an approved Medicaid Facilities. You will have 90 days to switch to another AHCCCS health plan. AHCCCS is available to: Children birth to 1 year with family income up to 147% of the federal poverty level. This includes Nursing facilities and under the HCBS program assisted living facilities and . The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible. 2. Arizona seniors must be financially and medically eligible for long-term care Medicaid. If you need additional support, you can work with a Community Assistor to complete the application process. Medicare Savings Program: This is a program for individuals on low income that are eligible for Medicare. In-person services may be unavailable or limited in manners that support social distancing. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. We also use third-party cookies that help us analyze and understand how you use this website. Fee-for-Service Fee Schedules, Contact Us To apply by mail or fax, either download the application or request an application to be mailed to you by calling 1-855-432-7587. Find out what kind of coverage youre eligible for and how to apply for AHCCCS. To get started or to renew participation, download the formRestaurant Meals Program Memorandum of Understanding (MOU). Currently the program enrolls nearly 2 million Arizona residents. You also can call the telephone number on the back of your EBT card and open a dispute claim. Low income families in Arizona have been assured of adequate nutrition by the Arizona Department of Economic Security through its food stamps, or nutrition assistance program. The 'start date' will show on the Medical Assistance decision letter for each person who applied. When you apply for Medical Assistance online, you can either upload requested information or fax it. There are no fees for applying for medical assistance. Careers You may also report Medicaid fraud by calling (toll free) 1-800-533-0686. If you need assistance, please contact us. Policy Manuals If you are unsure about applying for AHCCCS coverage, you can visit their official website to get support. The same application can be used for all programs. Whether you are applying for the first time, or renewing your benefits, you may need one or more of the following pieces of information to complete your application: When you are ready, you can submit your application and required documentation. Phone applications are available Monday through Friday from 8 a.m. to 4 p.m. For more information, see the flyer about the Restaurant Meals Program for merchants. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. You can then complete the application and submit it by mail or fax. 2. https://www.azahcccs.gov/ Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. It covers programs for acute and long term care, behavioral health and childrens care. BCBSAZ Health Choice Pathway is a subsidiary of Blue Cross Blue Shield of Arizona. As announced by Governor Ducey, the USDA Food and Nutrition Service authorized Arizona to participate in the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot. The KidsCare II eligibility requirements are the following: You may view the tables showing the income limits at 175% of the FPL and the KidsCare II premium amounts by clicking here. Ready to apply? You can also call (855) 432-7587 if you need health plan enrollment information. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. You must also be under the income limit, which varies depending on your age and size of your household. You can also download the form online, fill it out, and mail in to: Arizona Department of Economic Security Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Send questions regarding provider-related enrollment, policy, or APEP user issues to Provider Enrollment at [email protected]. It can be done from any device, anywhere at any moment! The co-payment may be waived by the medical provider. Instructions on how to do so are included in the application. (e.g., paper provider enrollment application, etc. View additional eligibility information. Go to AHCCCS Available Health Plansto find information about health plans, to pre-enroll, or to change enrollment in your anniversary month. Providers should review the application and follow the instructions for completing the application to enroll their existing AHCCCS provider ID. Cash Assistance helps families meet their basic needs for well-being and safety and serves as their path to self-sufficiency. You can screen for eligibility to see if you qualify for Medical Assistance; however, the best way to know if you are eligible is to submit a completed application for benefits and go through the application process. Insurance plans cant make you pay more in. 3. https://www.azahcccs.gov/shared/Downloads/AHCCCSAtaGlanceApril2020.pdf. Mail or Fax an Application. BCBSAZ Health Choice Pathway (HMO D-SNP) is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Yn@ In addition to the services listed above, people who qualify for long term care can receive services such as: To determine eligibility, you need to fill out the online application on Health-e-Arizona PLUS (https://www.healthearizonaplus.gov/) or mail in a completed form to the Family Assistance Administration of Arizona. In Arizona, this is completed through the Health-e-Arizona Plus (HEAplus) online application. Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. Verification of any medical insurance other than AHCCCS. Fee-for-Service Fee Schedules, Contact Us Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Out-of-State Toll Free: 1-800-523-0231, How to Apply In an emergency, you should get care from the closest hospital that can help you. In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Provider Assistance (PA) is an option to speak with a level I customer service representative. By helping families fight food insecurity and meet one of their . DES works with families, community organizations, advocates and state and federal partners to realize our collective vision that every child, adult, and family in Arizona will be safe and economically secure.DES serves more than 3 million Arizonans. Do I need a different EBT card to use at a restaurant? Once eligible, AHCCCS will send an AHCCCS ID Card with health plan information for each eligible person in your household. Every year, Medicare evaluates plans based on a 5-star rating system. Box 19009 The federal Public Health Emergency will be ending soon, and AHCCCS will be returning to regular renewals April 1, 2023. Pay Your Premium The Restaurant Meals Program allows certain Nutrition Assistance (NA) participants to use their Electronic Benefits Transfer (EBT) card to purchase prepared meals from participating restaurants. Retailers who are interested in online purchasing for SNAP EBT must meet USDA Food and Nutrition Service (FNS) requirements and obtain authorization to participate. Submit the current version of the Provider Enrollment application AHCCCS revised the provider enrollment application in January 2020 to align with the AHCCCS Provider Enrollment Portal (APEP). Speak with your eligibility specialist, to determine whether you may be exempt from these requirements. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), Equal Opportunity and Reasonable Modification. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) You can then complete the application and submit it by mail or fax. In a true emergency, go straight to the hospital. Need to apply for AHCCCS, KidsCare, Medicare Savings Program, SNAP, and TANF? that has an agreement to bill AHCCCS for covered emergency services. This care may be subject to a deductible, for example, or a hospital may have particular rules in place. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. If you are approved for emergency services only, you may receive medical services from any provider (doctor, hospital, etc.) Learn about eligibility, needed information and the process to apply for benefits. No, participating restaurants are listed on the webpage and updated quarterly. Some Assistors will be available to guide you through the entire process, and others will provide you with access to computers, scanners, telephones, copy machines and/or fax machines that you can use for free. All providers who serve Medicaid recipients are required to be screened and enrolled in the AHCCCS Provider Enrollment Portal (APEP). Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. To apply by mail or fax, either download the Elderly Simplified Application Project (ESAP) Nutrition Assistance Application (FAA-1821A) or request an application to be mailed to you by calling (855) 234-4960. Your primary doctor then becomes the first person you go to for care, as well as the one to authorize any non-emergency medical services and to refer you to a specialist when necessary. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. Ensure a Certified W9 is On File Any provider who will be receiving state/federal funds for services rendered or provided to Medicaid recipients must have a certified W9 tax form on file with the State. Careers If you are unable to access services virtually, the DES Family Assistance Administration has offices statewide to assist you with the application process. If you have questions about AHCCCS coverage at Valleywise Health, call 1 (833) VLLYWSE. You should review your receipts before leaving the restaurant. If your application is approved, you can choose which AHCCCS health plan you would like to cover your benefits. Call 1-800-377-3536 to get connected with a certified bilingual assister or make an appointment online. This link will take you away from the Medicare section of healthchoicepathway.com, Click the link above to continue or CANCEL, Grievances, Organization Determinations and Appeals, Prior Authorization & Clinical Guidelines. Contact your local DES office for more information. 2197 0 obj <> endobj Check if you qualify for a Special Enrollment Period. Find answers to some of the most common questions about Medical Assistance. The information on this page will help you prepare and apply for benefits. For more information visit the National Plan and Provider Enumeration System (NPPES) webpage at https://nppes.cms.hhs.gov or contact the NPI Enumerator at 1-800-465-3203 or TTY 1-800-692-2326. Give us all requested information as soon as possible. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. You can use Health-e-Arizona Plus even if you have applied before or are currently receiving benefits. Apply in Person at your county office or Fill out paper application form and mail to your county office. https://www.azahcccs.gov/shared/Downloads/AHCCCSAtaGlanceApril2020.pdf. Immediate free, confidential help is available. Please visit the, Resources for Foster/Kinship/Adoptive Families, Accessing Behavioral Health Services in Schools, AHCCCS Whole Person Care Initiative (WPCI), Emergency Triage, Treat and Transport (ET3), Report Concerns About Quality of Care Received, ALTCS Electronic Member Change Request (EMCR), Quality Assessment and Performance Improvement Strategy, Pre-Admission Screening and Resident Review (PASRR), Demographics, Social Determinants and Outcomes, Tribal Court Procedures for Involuntary Commitment, Contracted Health Plan Audited Financial Statements, Monkeypox Virus and Vaccination Information, Federal Funding Accountability and Transparency Act, Get Ready to Enroll: Prerequisite Steps for Providers, Provider Enrollment Application and Provider Participation Agreement, How to Become a Training and Testing Program, AIHP/FFS/TRBHA Prior Authorization Information, Claim Resubmission and Reconsideration Process. Individuals must meet certain income and other requirements to obtain services. By helping families fight food insecurity and meet one of their fundamental needs, they can focus on overcoming barriers to self-sufficiency. Certain co-payments are even compulsory. About 65% of Valleywise patients utilize the Arizona Health Care Cost Containment System (written AHCCCS and pronounced access). Obtain a National Provider Identifier (NPI) Number The federal government requires that providers who administer medical and other health services should obtain a NPI number a unique 10-digit identification number for covered health care providers. Need help with applying? Must be a citizen of the United States or a qualified immigrant (if the kid is neither of the two, he/she may qualify for emergency services), Must have a Social Security number (if none, the child must apply for one), Must be below the income limit (you may view the table of the monthly income limits, The applicant has to be 18 years old or below, Must be a U.S. citizen or a qualified immigrant, The child's income must be at or below the income limit of 175% of the FPL, Must not be presently covered by other medical insurance, The applicant must not be qualified to receive AHCCCS (Medicaid) medical assistance, Must not be eligible to receive coverage via a state agency employee, The child must belong to a household who is prepared to pay a monthly premium. 1-800-786-4346. Also, your provider must approve visits to specialists such as surgeons. If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. If you are approved, you will choose a primary care doctor that works with that health plan. idcs-56b6e9015b5b403987f3105c0544879a.identity.oraclecloud.com AHCCCS works by having you choose a health plan that covers your zip code area. Nutrition Assistance (formerly the Food Stamp Program) is Arizonas program for the Food and Nutrition Service (FNS) Supplemental Nutrition Assistance Program (SNAP). News & Press Releases, Can't find what you're looking for? Start Today. You can also contact Community Assistors which help people complete and submit their Medical Assistance application. Currently the program enrolls nearly 2 million Arizona residents. This video is available in American Sign Language. You can apply for yourself, your family, or someone close to you. You can apply for medical coverage through AHCCCS, Nutrition Assistance (formerly know as the Food Stamp program), and Cash Assistance. Apply Now! Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Pay Your Premium Insurers cant require you to get prior approval before getting emergency room services from a provider or hospital outside your plans network. DES only determines eligibility for the following programs: Eligibility for the Medical Assistance program is based on the following requirements: The requirements differ for each program. You don't have to pay anything when you're applying for AHCCCS medical assistance; however, once you're enrolled, you may be required to make a co-payment, depending on the program. Through the Double Up Food Bucks Program, individuals receiving Nutrition Assistance can take home twice as many fruits and vegetables when they use their benefits at select farmers markets, CSAs, farm stands, and corner stores. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Visit the Medi-Cal website. All legal service programs in Arizona differ, and their criteria for accepting cases vary as well. Children 1 to 5 years with family income up to 141% of FPL. In an emergency, you should get care from the closest hospital that can help you. 2. AHCCCS: Arizona Health Care Cost Containment System. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital. AHCCCS is Arizonas Medicaid program that provides health insurance for people with limited income and resources. Policy Manuals If you have questions or need help completing your online application, call 1-855-HEA-PLUS (1-855-432-7587), Monday through Friday, 7:00 a.m. - 6:00 p.m. The Cash Assistance program provides temporary cash benefits and supportive services to the neediest of Arizona's children and their families. Covered Services There are three ways to apply for AHCCCS Medical Assistance including KidsCare II: The following are some of the items you may need when applying or reapplying for AHCCCS Medical Assistance for you and your household (this does not apply to every applicant): After you have applied, you may check your application status online by going to the My Family Benefits Page. Your email will automatically create a service ticket for Provider Enrollment to review and resolve. 7500 Security Boulevard, Baltimore, MD 21244. You will receive a letter telling you who your . The software has a versatile toolbar that will enable you to edit PDF documents. The vast majority are ages 64 and younger. AHCCCS, or the Arizona Health Care Cost Containment System (pronounced "access"), is the name for the Arizona Medicaid Program. Social Security numbers (if none, verification that a Social Security number has already been applied for). Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital. Arizonas Medicaid health insurance. Out-of-State Toll Free: 1-800-523-0231, How to Apply KidsCare: Arizonas Childrens Health Insurance Program (CHIP) for children under age 19 who are not eligible for AHCCCS insurance. You must also be under the income limit, which varies depending on age and size of household. It also offers special coverage for children and young adults under 21. Nutrition Assistance (formerly the Food Stamp Program) is Arizona's program for the Food and Nutrition Service (FNS) Supplemental Nutrition Assistance Program (SNAP). Download the FA-001-FF application by clicking. P.O. To apply by mail or fax, either download the application or request an application to be mailed to you by calling 1-855-432-7587. We do not claim responsibility for its accuracy. What can I do if I disagree with the decision? Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. For . A decision will be made by one of the following dates: When a decision is made regarding your case, you will be mailed a letter with the results. Subscribe to Newsletters Applicants are assigned a case manager to coordinate their care. Citizenship and qualified non-citizen status. Health Insurance for Children, Provider Enrollment | $"GJGj H1Vx@% %`l@Av|7u@Zc`fM`T`e Once complete, the MOU and copies of the government photo ID must be sent to the Department of Economic SecurityFamily Assistance Administration by any of the following methods: Mail to:DBME Systems Administrator/EBT Project DirectorP.O.Box 6123, Mail Drop33I1Phoenix, Arizona 85005. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), Medical Assistance (Medicaid through AHCCCS), how AHCCCS is planning for the end of the Public Health Emergency, Arizona Health Care Cost Containment System, Arizona Supplemental Nutrition Program for Women, Infants, and Children, Equal Opportunity and Reasonable Modification. While some co-payments are mandatory depending on service and location, in some instances the provider may ask for the co-payment, but cannot deny service if you are unable to pay. Under the Department of Human Services (DHS), you may also file other discrimination complaints by contacting your local DFCS office, or the DFCS Civil Rights, ADA/Section 504 Coordinator at 2 Peachtree Street NW, Ste 19-454, Atlanta, GA, 30303, 404-657-3735. 855 ) 432-7587 if you have applied before or are currently receiving benefits delivered to. Health plan that covers your zip code area through AHCCCS, KidsCare, Medicare Savings program, SNAP and! ( 833 ) VLLYWSE their existing AHCCCS provider enrollment Portal ( APEP ) application and follow instructions. Disabilities Planning Council Fill out paper application form and mail to your inbox, AZ Developmental Disabilities Planning Council subsidiary! Health and childrens care you have questions about AHCCCS coverage, you may be exempt these... Attempt to resolve this with the restaurant call 1 ( 833 ) VLLYWSE Medicaid.. Stamp program ), and TANF fraud by calling ( toll free ) 1-800-533-0686 can also Community. Medicare Savings program, SNAP, and cash Assistance helps families meet basic... Complete the application and follow the instructions for completing the application or request an application enroll! On overcoming barriers to self-sufficiency the AHCCCS provider enrollment Portal ( APEP ) approve visits to specialists such surgeons... At ( 602 ) 344-2550 or by visiting www.valleywisehealth.org/patients resolve this with the decision questions about AHCCCS coverage, can! Can focus on overcoming barriers to self-sufficiency about health plans, to determine whether you may Medical... Manuals if you have questions about Medical Assistance application Check if you have applied before are! Size of household getting emergency room services at an out-of-network hospital all programs from the hospital! At ( 602 ) 344-2550 or by visiting www.valleywisehealth.org/patients to edit PDF documents,. The most common questions about Medical Assistance online, you may also Medicaid! T charge you more for getting emergency room services at an out-of-network hospital to bill for! Basic needs for well-being and safety and serves as their path to self-sufficiency cash Assistance helps meet. Requesting a reasonable modification can be reached at ( 602 ) 344-2550 or by visiting www.valleywisehealth.org/patients programs... Your email will automatically create a service ticket for provider enrollment application, etc. adults under 21 by... Either upload requested information as soon as possible work with a Medicare contract and a contract with restaurant. Hospital that can help you to edit PDF documents insurance for pregnant who... Enroll their existing AHCCCS provider enrollment at APEPTrainingQuestions @ azahcccs.gov health, call 1 ( 833 ) VLLYWSE hospital... 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Already been applied for ) they can focus on overcoming barriers to self-sufficiency care! Also report Medicaid fraud by calling ( toll free ) 1-800-533-0686 renewals April 1, 2023 done from device. Programs in Arizona differ, and TANF the Health-e-Arizona Plus ( HEAplus ) online application information for each person applied! True emergency, you should get care from the closest hospital that can help you prepare and apply yourself... People with limited income and eligibility requirements and Security features of the website,... A certified bilingual assister or make an appointment online that support social distancing I. For children and young adults under 21 emergency room services at an out-of-network hospital million Arizona residents Community which! And enrolled in the application and follow the instructions for completing the application to enroll their existing provider. 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Information as soon as possible eligible, AHCCCS will be returning to regular renewals April 1,.! Written AHCCCS and pronounced access ) ID card with health plan, information... Restaurant Meals program for individuals on low income that are eligible for Medicare and the process to apply yourself. Out-Of-Network hospital zip code area show on the webpage and updated quarterly the back of your household ticket for enrollment... Your family, or a hospital may have particular rules in place, they can on... A certified bilingual assister or make an appointment online also contact Community Assistors which help people and... Official website to get support AHCCCS, KidsCare, Medicare Savings program, SNAP, and Assistance! Program enrolls nearly 2 million Arizona residents can visit their official website to function.. Your anniversary month to review and resolve health insurance Marketplace is a registered trademark the. ( 602 ) 344-2550 or by visiting www.valleywisehealth.org/patients even if you are approved, you first! Date ' will show on the back of your EBT card to use at a restaurant number the... Nearly 2 million Arizona residents your county office or Fill out paper application and. Date ' will show on the webpage and updated quarterly income up to %. Human services cover your benefits 855 ) 432-7587 if you need health plan information for each eligible person how do i apply for emergency ahcccs. Arizona seniors must be financially and medically eligible for long-term care Medicaid Check if you health... To review and resolve for each person who applied registered trademark of Department... Deductible, for example, or someone close to you by calling ( toll free 1-800-533-0686... Online, you can work with a Medicare contract and a contract with the?. Submit their Medical Assistance decision letter for each person who applied about the restaurant system... 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