Glossary: AHCCCS

Rules that allow Supplemental Security Income (SSI) recipients to keep their SSI benefit at a lower level when they return to work.

A rule that lets people who stop getting Supplemental Security Income (SSI) benefits due to work income keep their AHCCCS health coverage while earning up to $53,159 per year. 1619(b) also makes it easier to get SSI benefits started up again if your countable income goes below SSI's income limit. For 1619(b), you must continue to meet other SSI eligibility rules, such as the resource limit.

Note: If your earnings are over this limit and you have high medical expenses, you might still qualify for 1619(b). Ask your local Social Security office about the 1619(b) Individualized Earnings Threshold.

A program that provides health coverage to working people with disabilities in Arizona who are not otherwise eligible for AHCCCS. People in the Freedom to Work program get full AHCCCS coverage in exchange for a monthly premium.

For benefits eligibility, a person who is recognized as an American Indian by a federally recognized tribe, or is recognized by the United States as an Indian and has a Certificate Degree of Indian Blood (CDIB) from the Bureau of Indian Affairs. For a list of the federally recognized tribes, check the U.S. Department of the Interior Indian Affairs website.

AHCCCS is Arizona's Medicaid program. AHCCCS is a state-run health care program that pays medical expenses for people who are disabled, young, elderly, poor, or pregnant. If you meet program requirements, AHCCCS will help pay for a variety of medical services including visits to the doctor, hospital stays, medical equipment, home care services, and prescription drugs. You can apply for AHCCCS online.

A program that provides AHCCCS benefits to people of any age who are blind or disabled and need ongoing services at a nursing home level of care.

A person who is currently living in Arizona with the intention of remaining in the state permanently or for an indefinite time period. Or a person who is currently living in Arizona to obtain or pursue employment or who entered Arizona with a job commitment.

Assuming they meet all other eligibility criteria, U.S. citizens and Qualified Aliens (inlcuding those who meet I-551 or I-94 status) are eligible for both Social Security and state public benefits programs.

Legal residents who don't have I-551 or I-94 status may be eligible for some state programs, but not for Social Security programs. This could include Legal Permanent Residents (LPRs), refugees, asylees, conditional entrants, people certified as victims of trafficking, certain people whose immigration status is pending, people under Temporary Protected or Family Unity Beneficiary Status, Lawful Temporary Residents, applicants for asylum, people who have been granted or are applying for withholding of removal, and all other people with a lawfully residing immigrant status.

People who are undocumented or non-immigrants are eligible for fewer programs.

The amount of income that Social Security or the state counts when figuring out if you qualify for benefits and, if so, the level of benefits you should get. Not all of your income counts.

Example: Supplemental Security Income (SSI) counts most unearned income, but a bit less than half of earned income. So, if you have $500 in unearned income and $500 in earned income, your countable income for SSI would be just $697.50, even though your total income would be $1,000. Other programs, such as disability-based AHCCCS and Medicare Savings Programs often use calculations similar to SSI's.

An agency ruling that your disability meets the standards set by the Social Security Administration's definition of disability. Your disability must be reviewed and determined to match the SSA definition before you can get certain public benefits. If you're on SSI, SSDI, or any Arizona disability benefits program, you've already been determined disabled.

A division within Arizona’s Department of Economic Stability (DES) that decides whether or not you meet the state criteria for blind or disabled status. The Disability Determination Services Administration uses a standard process to make disability determinations for people with disabilities who either aren't eligible for Social Security benefits such as SSI or SSDI, have an application pending for Social Security benefits, or are in their 5-month waiting period for SSDI.

Contact your local DES/Family Assistance Administration office for more information.

AHCCCS health coverage that you get at no cost to you (though there may be copays for certain services.)

KidsCare is Arizona's Children's Health Insurance Program (CHIP). KidsCare provides health coverage for qualifying Arizona residents who are 18 years old or younger, have limited family income, and are not eligible for AHCCCS health coverage.

An organization that administers health care and long-term care services for the Arizona Health Care Cost Containment System (AHCCCS) and the Arizona Long-Term Care System (ALTCS). Most people who get AHCCCS or ALTCS are assigned a case manager at an MCO. The MCO may decide which doctors a patient may see and which services a patient may use.

A joint federal and state program that provides assistance with medical costs to low income individuals and families. Medicaid programs vary from state to state. The federal Medicaid program is called AHCCCS in Arizona.

Medicare Savings Programs are programs that help people with low income and low resources pay for their Medicare expenses, such as Medicare Part A and Medicare Part B premiums, coinsurance, and deductibles. There are three main Medicare Savings Programs:

  • The Qualified Medicare Beneficiary (QMB) program helps people with countable income that’s 100% of FPG or less ($1,255 per month or less if you live alone).
    • If you have Original Medicare, QMB helps pay for your Part B and Part A premiums, copayments, and deductibles.
    • If you have a Medicare Advantage plan, QMB helps pay your premium, copayments, and deductibles.
    • Note: If you qualify for QMB, you also qualify for AHCCCS coverage.
  • The Specified Low-Income Beneficiary (SLMB) program helps people with countable income that’s more than 100% of FPG, but at or below 120% of FPG ($1,506 per month or less if you live alone).
    • If you have Original Medicare, SLMB helps pay for the Part B premium.
    • If you have a Medicare Advantage plan, SLMB helps with the premium.
  • The Qualified Individual-1 (QI-1) program helps people with countable income that’s more than 120% of FPG, but at or below 135% of FPG ($1,695 per month or less if you live alone).
    • If you have Original Medicare, QI-1 helps pay for the Part B premium.
    • If you have a Medicare Advantage plan, QI-1 helps with the premium.

Medicare Savings Programs are managed by the Arizona Health Care Cost Containment System (AHCCCS). AHCCCS determines if you are eligible and will help you manage your care. You can apply for an MSP online using Health-e-Arizona or complete the paper MSP application and submit it to your DES/Family Assistance Administration office.

A review done to figure out whether a person qualifies for a benefit.

There are several categories of noncitizens who are considered “qualified aliens.” These people include:

  • Afghan and Iraqi special immigrants
  • Aliens with deportation or removal withheld
  • Amerasian refugees
  • American Indians born in Canada
  • Asylees
  • Battered aliens
  • Conditional entrants
  • Cuban-Haitian entrants
  • Foreign-born members of U.S. Indian Tribes
  • Hmong or Laotian Highlanders
  • Lawful permanent residents
  • Parolees for at least one year
  • Victims of trafficking

Note that not all qualified aliens can get full AHCCCS coverage.

Most nonqualified aliens are people who were admitted to the United States for a limited period of time, such as foreign students, visitors for business or pleasure, and temporary workers. They do not qualify for any form of AHCCCS coverage.

Undocumented aliens are people in the U.S. without the permission of the U.S. government. They cannot get full AHCCCS coverage, but may qualify for emergency services.

Agencies to which you need to report any changes in your income or living situation, if you get public benefits.

If you're on Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY), or visit your local Social Security office, and ask what's the best way for you to report. Note: Reporting rules for SSI and SSDI are different and if you get both benefits, you must report income for them separately.

If you're on AHCCCS or any other state program, like TANF Cash Assistance or Nutrition Assistance, report online or contact your local DES/Family Assistance Administration office.

This is the Arizona Health Care Cost Containment System (AHCCCS) office that handles health care for people with disabilities who do not get Supplemental Security Income (SSI) cash benefits.

If you have a disability and don’t get SSI cash benefits, you can apply for AHCCCS coverage at your local DES/Family Assistance Administration office. If you do not qualify for one of the AHCCCS programs through DES, your application may be referred to SSI-MAO, who will contact you in order to complete your application. You can also choose to apply for AHCCCS directly through the SSI-MAO office. For more information, call SSI-MAO at 1-602-417-5010.

If you have a disability and get SSI benefits, you will get AHCCCS benefits automatically and do not need to apply separately.

A person who is:

  • Born in one of the 50 states, Washington D.C., Puerto Rico, Guam, Northern Mariana Islands, U.S. Virgin Islands, American Samoa, or Swain’s Island
  • Born outside of the U.S. to at least one parent who is a U.S. citizen
  • Granted citizenship status by U.S. Citizenship and Immigration Services (USCIS)

When applying for benefits, contact the agency you are applying to to find out what documents are acceptable for proving citizenship.

A Work Incentive Consultant is a trained expert who can help you understand Social Security work incentives, disability benefit programs, and how they are impacted by work. Their goal is to help you avoid complications while developing a sustainable financial plan for your future.

You can contact Benefits 2 Work Arizona to find a Work Incentive Consultant serving your community. They specialize in working with employed or soon to be employed people who get Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), and related programs.