Example

Melanie’s Story

Melanie is 35 years old and has cerebral palsy. She hasn’t been able to work for the past 6 months due to her disability and been living on the $850 in Social Security Disability Insurance (SSDI) benefits she gets every month. AHCCCS covers her health care expenses.

She’s been feeling better recently and wants to go back to work. So she talks to some friends and passes her resume around. Soon enough, a former coworker offers her a part-time job at his new start-up company. Unfortunately, the job does not come with health insurance and she’d be earning too much money to keep her AHCCCS. She really wants to take this job but she cannot risk going without health insurance. Between her prescription drugs, physical therapy, and Personal Assistance Services (PAS), her total medical cost is several thousand dollars per month.

Melanie looks at getting an individual plan on HealthCare.gov. She knows that starting in 2014, nobody can be turned down for a plan, but she doesn’t know how good the available plans really are. After filling out her information, it turns out that she could sign up for a plan that would cost her about $150 a month for the premium. The problem is that the plan has a deductible and also has copayments that are way higher than her AHCCCS copayments were. Furthermore, it wouldn’t pay for the PAS she needs like AHCCCS does. She hopes to find another option.

She talks about the problem with her personal assistant, Samantha, who mentions the AHCCCS Freedom to Work program.

“It’s designed for people like you,” Samantha says. “You can go back to work and earn up to $6,360 per month, while still keeping your health coverage.”

“But what about my savings? Can I keep them?” Melanie asks.

“I think so,” says Samantha, “but you should talk to a Work Incentive Consultant to find out more.”

Together, Melanie and Samantha find the local Center for Independent Living and set up an appointment with a Work Incentive Consultant. They learn that Melanie can have any amount of resources and still qualify for AHCCCS Freedom to Work.

The Work Incentive Consultant tells them, “AHCCCS Freedom to Work pays for all the same services that your AHCCCS coverage has been paying for. You may have to pay a monthly premium, but that wouldn’t be more than $35 each month. You’ll also be responsible for small copayments for some services.”

“Plus,” the Work Incentive Consultant tells her, “if your condition gets worse and you have to take some time off work, you won’t necessarily lose your coverage as long as you are an employee.”

“This all sounds great,” says Melanie. “I can go back to work! So what do I do now?”

“Take that job,” says the Work Incentive Consultant, “and when you get your first check, call your AHCCCS caseworker within 10 days to report your earnings and ask about AHCCCS Freedom to Work coverage. Then we’ll go from there.”

Melanie is ecstatic. She’ll be able to go back to work, doing something she really enjoys. And she’ll be able to keep her health coverage for a reasonable monthly cost.