Is it Right for You?

Almost everyone should be able to get health coverage. The question is, which plan is right for you and your family?

This page looks at whether you might qualify for AHCCCS Freedom to Work, and if you do, how you can have AHCCCS Freedom to Work and other health coverage at the same time. If you don’t qualify for AHCCCS Freedom to Work, you may still qualify for AHCCCS based on other rules and you should consider other options we will introduce, including Medicare and private health insurance.

AHCCCS Freedom to Work Basic Eligibility Requirements

To qualify for AHCCCS Freedom to Work, you must:

• Be age 16 – 64
• Have been determined to be blind or have a disability according to Social Security Administration rules
• Be a U.S. citizen or meet specific noncitizen requirements
• Be working and paying Social Security and Medicare taxes, and
• Meet certain income requirements.

Note: If you’re on Supplemental Security Income (SSI) or SSI’s 1619(b) provision, you will automatically qualify for AHCCCS and do not need to apply for AHCCCS Freedom to Work separately. You will not need to pay a premium and you do not need to worry about the qualifying rules discussed on this page. Read more in DB101’s AHCCCS for People with Disabilities article.

Disability Determination

To get AHCCCS due to your disability, you must be determined disabled by the Disability Determination Services Administration (DDSA), which handles disability determination for SSA and AHCCCS. To get a disability determination, you will have to get medical documentation specified by DDSA.

They’ll say you have a disability if:

• You have a physical or mental impairment or combination of impairments, and
• Your condition has lasted or is expected to last for at least 12 months.

For AHCCCS Freedom to Work, SSA’s disability rules related to earned income do not apply.

Note: If you get Social Security Disability Insurance (SSDI) benefits, you automatically meet this requirement.

Citizenship and Noncitizen Requirements

You must be a U.S. citizen or meet specific noncitizen requirements to be eligible for AHCCCS Freedom to Work.

If you are legally in the United States, but do not qualify for AHCCCS, you may qualify for subsidized private insurance through HealthCare.gov.

If you are an undocumented immigrant, you may qualify for AHCCCS coverage for emergencies only. To learn more about this, contact your local DES/Family Assistance Administration office.

Income

AHCCCS Freedom to Work is for people with disabilities who have moderate incomes from work. If you are in this situation, you may qualify if your countable monthly income is at or below an income limit.

To see whether your income would qualify for AHCCCS Freedom to Work due to your disability, AHCCCS will look at your countable earned income and compare it to the Federal Poverty Guidelines (FPG). For eligibility, only your earned income is counted, not the income of other household members.

If your countable monthly income is below 250% of FPG ($3,138 for an individual), you may qualify for AHCCCS Freedom to Work.

Figuring Out Your Countable Income

Follow these steps to find out your countable income:

1. Add up your gross monthly earned income (income from work before taxes are deducted), including wages, tips, bonuses, and self-employment earnings.
2. Subtract a $65 Earned Income Exclusion and a $20 General Exclusion.
3. Then divide the result by 2. The result is your countable earned income.

AHCCCS Freedom to Work Countable Income

Earned Income

Minus the $20 General Exclusion

Minus the $65 Earned Income Exclusion

= Subtotal

Divide by two

= Countable Income (Freedom to Work)

**Depending on your situation, Impairment Related Work Expenses (IRWEs), if you have them, may be subtracted before or after dividing by 2. Talk to a Work Incentive Consultant if you have any questions about this.

Your AHCCCS Freedom to Work Countable Income (compared to FPG):

Your Monthly Earned Income	$
	20.00
	65.00
Your Monthly Countable Income
Federal Poverty Guidelines	$1,255.00
Your Countable Income as a Percent of FPG

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If you are working, paying taxes and have countable monthly income that is 250% of FPG or less, you may qualify for AHCCCS Freedom to Work.

AHCCCS Freedom to Work, Private Health Coverage, and Medicare

Here we will look at what signing up for AHCCCS Freedom to Work might mean if you also have or want private coverage or Medicare.

AHCCCS Freedom to Work and Private Health Coverage

You can be enrolled in both AHCCCS Freedom to Work and private coverage at the same time. There are 2 main advantages to this:

• Private insurance may cover some benefits that AHCCCS Freedom to Work doesn’t or the other way around.
• Private coverage may let you choose from more doctors.

The disadvantage is that you would have to pay premiums for both programs and private coverage usually has higher copayments than AHCCCS Freedom to Work, so it might not be worth the expense.

AHCCCS Freedom to Work and Medicare

If you are eligible for both AHCCCS Freedom to Work and Medicare, it will help you to have both because:

• If your income is low enough, AHCCCS Freedom to Work may pay your Part B premium (and your Part A premium, if you have one). In some cases it may even pay for Medicare deductibles, co-insurance, and copayments.
• You will automatically qualify for the Part D Low Income Subsidy. The Low Income Subsidy means you may not have to pay a premium for your Part D or any deductibles. All you would pay for prescription drugs are Part D’s copayments, which range from $1.55 to $11.20.

To learn more, read DB101’s detailed information on Medicare Savings Programs for Parts A and B and the Part D Low Income Subsidy.