What You Should Know About AHCCCS- Arizona Health Care Cost Containment System

What You Should Know About AHCCCS- Arizona Health Care Cost Containment System

Three Things You Should Know About AHCCCS-  Arizona Health Care Cost Containment System

As a personal injury lawyer who has represented thousands of clients injured in car accidents, I think it is necessary to discuss the importance of health insurance coverage when it comes to one’s medical treatment after being injured in an accident.



Especially in our current political environment where our President, Senators, and Representatives discuss repealing, replacing, or fixing “Obama” care (the Affordable Care Act aka ACA).   I have noticed in my law practice that since the passage of the ACA, I have far more injured clients who have health insurance.  In particular, I have a far greater number of clients who have AHCCCS as their health insurance coverage.

Below are three things that you need to know about AHCCCS

  1. First, you need to understand what AHCCCS is. AHCCCS is the Arizona Health Care Cost Containment System, which is a public program that helps pay medical expenses for Arizona residents that qualify for the program.  Whether or not you qualify for AHCCCS depends on your family’s situation, including things like whether you have a disability and how much you have in income.  If you qualify, AHCCCS will help pay for your visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services.
  2. What does a person need to pay for health insurance coverage through AHCCCS? The general answer is nothing. Most people who get AHCCCS don’t have to pay a monthly  If you are covered by AHCCCS, you only have to make payments when you need medical care.  Generally, if you are 19 years old or older, you may have to pay small co-payments that range from $2.30 to $3.40 each time you use certain medical services that AHCCCS covers.  You do not need to make co-payments if you are:
    • Less than 19 years old
    • A child eligible to get services from the Children’s Rehabilitative Services (CRS) program
    • A pregnant woman
    • Enrolled with American Indian Health Program (AIHP)
    • Diagnosed as Seriously Mentally Ill (SMI) by the Arizona Department of Health Services (ADHS)
    • An Acute Care AHCCCS member who is temporarily residing in a nursing home or residential facilities, if your medical condition would otherwise require hospitalization
    • In hospice care, or
    • Eligible for AHCCCS on a fee-for-service (FFS) basis
  3. Currently there are a number of proposed changes to AHCCCS. What are they?  The State of Arizona has submitted a proposal to the Federal Government requesting that eligibility for AHCCCS to include a work requirement and also have a lifetime limit on the medical benefits that an AHCCCS recipient can receive.  These proposed changes were spelled out in a state law — Senate Bill 1092 — that passed in 2015.  Among those changes is putting a five-year limit on enrollment for “able-bodied” Arizonans, and also imposing a requirement that would require able-bodied people enrolled in AHCCCS be employed, looking for work, in school or in job training.  The legislation also allows AHCCCS officials to ban enrollees for a year if they knowingly failed to report a change in family income or made false statements about their compliance with work requirements.

Zanes Law has both Phoenix personal injury lawyers and Phoenix car accident lawyers who have represented thousands of clients over the past fourteen years.  Zanes Law has offices in both Tucson and Phoenix, Arizona.  So if you have been injured in any way, please call us and we will do our best to help you just like we helped our many clients who have left us 5-Star Google reviews.