The Basics
The Arizona Health Care Cost Containment System (AHCCCS) is a public program that helps pay medical expenses for people with low income. How you may qualify depends on your family’s situation, including things like whether you have a disability and how much you have in income.
This article focuses on a way of qualifying that is for adults under the age of 65 who make 138% of the Federal Poverty Guidelines (FPG) or less (that's $21,597 per year or less for a person who lives on their own) and for children who qualify for KidsCare because their families earn 230% of FPG or less ($73,945 per year for a family of four). DB101 has other articles that discuss how people with disabilities can qualify for AHCCCS and AHCCCS Freedom to Work.
If you qualify, AHCCCS will help pay for your visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. Some people worry that if their income goes up, they’ll lose their AHCCCS. In 2025, if you get AHCCCS and your income goes up, you will have more options that may let you stay with AHCCCS or get help paying for a private health plan.
This article is about AHCCCS and will help you understand:
- If AHCCCS is right for you
- What services it covers
- How much you will have to pay, and
- How to sign up.
If, after reading this article, you need more help in understanding AHCCCS, we recommend you talk to trained experts who can help you. Here are some good resources:
- Visit or call your local DES/Family Assistance Administration office.
- Talk to a Federally Qualified Health Center.
- Get local help from HealthCare.gov.
- If you have a disability, talk to a Work Incentive Consultant to learn more about health programs for people with disabilities.
- You can get AHCCCS no matter how much you have in resources.
- If you have a disability, you may qualify for disability-based AHCCCS or AHCCCS Freedom to Work if your income is too high for income-based AHCCCS.
- If you make more than 138% of the Federal Poverty Guidelines (FPG) and can’t get affordable health coverage through your job, you may be able to get help paying for private health coverage.
- There is a single marketplace called HealthCare.gov where you can compare and sign up for plans, including AHCCCS and private health coverage.
Note: DB101 keeps track of changes to health coverage and related laws. DB101 has been and will continue to be updated to reflect any changes. Visit KFF for news related to health coverage.
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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. If you do, it is your best choice and you won’t qualify for subsidized individual coverage. You can see if you qualify for AHCCCS at Health-e-Arizona or HealthCare.gov.
If you don’t qualify for AHCCCS, consider other options we will introduce, including Medicare and private health insurance.
If the Social Security Administration (SSA) says you are disabled, you may have additional ways of qualifying for AHCCCS, depending on your situation. Read DB101’s AHCCCS for People with Disabilities article.
AHCCCS Basic Eligibility Requirements
To qualify for AHCCCS, most people must meet several basic requirements:
-
Be under 65 years old
- You can be 65 or older if you are the parent or caretaker of a child
-
Not be eligible for Medicare
- You can be on Medicare if you are the parent or caretaker of a child or are pregnant
- Be a U.S. citizen or meet specific noncitizen requirements, and
- Have income below certain limits
Under Age 65
There are different ways to get AHCCCS and the way described here is usually for people under age 65. If you are 65 years old or older, read DB101’s Medicare article and talk to your local DES/Family Assistance Administration office about whether you qualify for AHCCCS.
Exception: If you are 65 or older and are the parent or caretaker of a child, you may be able to get AHCCCS through the rules discussed in this article.
If you are under 65, continue reading this article.
Not Eligible for or Enrolled in Medicare
AHCCCS’s eligibility rules are different for most people who are eligible for or enrolled in Medicare. If you are eligible for or getting Medicare, read DB101’s Medicare article or contact your local DES/Family Assistance Administration office.
Exception: If you are enrolled in Medicare and are the parent or caretaker of a child or are pregnant, you may be able to get AHCCCS through the rules discussed in this article.
If you are not on Medicare, keep reading this article.
Citizenship or Residency
You must be a U.S. citizen or meet specific noncitizen requirements to be eligible for AHCCCS.
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.
If you are a U.S. citizen or meet the noncitizen requirements for AHCCCS, continue reading this article.
Income
If your family’s income is at or below 138% of the Federal Poverty Guidelines (FPG) ($21,597 per year for an individual in 2025, $44,367 for a family of four), you may qualify for AHCCCS. Children who are 18 or younger can get AHCCCS KidsCare coverage if their family's income is 230% of FPG or less ($73,945 per year or less for a family of four).
Income-based AHCCCS counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based AHCCCS eligibility.
You may see the income limit for AHCCCS listed as 133% of FPL in some places. However, when AHCCCS counts your income, they’ll knock 5% of FPL off your income if you make more than 133% of FPL. That's why we show the limit as 138% of FPL, because it more accurately shows how much you could make and still get AHCCCS.
If you cannot get AHCCCS because your income is too high, consider buying an individual plan through HealthCare.gov. See DB101’s article about Buying Health Coverage on HealthCare.gov.
| Your family size: | |
Annual income limits for your family: | |
| Income-based AHCCCS (138% FPG) | |
| AHCCCS KidsCare (230% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
The bottom line: If you meet the 4 main requirements described here, AHCCCS is a great program that you should sign up for. We explain how to sign up later in this article.
If you have a disability, you may qualify for AHCCCS in more than one way. The good thing is that when you apply for AHCCCS, the people reviewing your application will automatically figure out which AHCCCS eligibility rules are right for you.
Reasons you might qualify for AHCCCS under disability rules instead of the rules described in this article:
- Your income is higher than the 138% of FPL limit. AHCCCS’s eligibility rules for people with disabilities don’t count all of your earned income, so you may make more than that and qualify by disability rules. Furthermore, people with disabilities who work and have higher income may qualify through AHCCCS Freedom to Work.
- You also get Medicare. Usually, AHCCCS isn’t available to most people getting Medicare, but AHCCCS for people with disabilities is. It may even help pay your monthly Medicare premiums.
Reasons you might qualify for AHCCCS under the rules described in this article, even if you have a disability:
- Your disability does not meet Social Security’s definition of disability. AHCCCS for people with disabilities is only for people who have disabilities meeting this standard.
- You make enough money that you would have to pay a monthly premium for AHCCCS Freedom to Work.
To learn more, read DB101’s articles about AHCCCS for people with disabilities and AHCCCS Freedom to Work, or contact your local DES/Family Assistance Administration office.
AHCCCS and Private Health Coverage
If you qualify for AHCCCS, you should sign up for it. Here we will look at what signing up for AHCCCS might mean if you have or want private coverage.
AHCCCS and Employer-Sponsored Health Coverage
If you qualify for AHCCCS, it will always be your best choice, even if your employer offers health insurance. That’s because AHCCCS has no monthly premium and the copayments for services are usually much lower than copayments required by employer-sponsored plans. Also, AHCCCS may cover some services that your employer-sponsored coverage does not pay for.
However, there are a couple of advantages to having both AHCCCS and employer-sponsored coverage at the same time:
- Private insurance may cover some benefits that AHCCCS doesn’t or the other way around.
- Private coverage may let you choose from more doctors.
Nelson is a single father living on his own with his two daughters. He makes $20 an hour repairing shoes and works 30 hours a week, so he makes a total of about $2,600 a month. Because he works 30 hours a week, his employer offers him and his daughters health insurance, but to get it, he would have to pay a $400 premium each month.
Nelson decides to go to his local DES/Family Assistance Administration office to see if his family would qualify for AHCCCS, because he doesn’t have enough money to pay the monthly premium for health coverage offered through his job. The case worker looks at his income and explains that he does qualify for AHCCCS, because his income is less than 138% of FPG for a family of three. Nelson signs up for AHCCCS and does not sign up for the plan his job offered.
AHCCCS and Individual Plans
If you are eligible for AHCCCS, then you will not be eligible to get government help to pay for a private insurance plan. That means the private insurance plan would be expensive for you. If you qualify for AHCCCS, it will always be a better option for you than paying for an individual plan.
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What it Covers
If you get AHCCCS, it will pay for a broad range of medical services. If you’re not sure if a particular service is covered by AHCCCS, or if it requires prior authorization, ask your doctor or your AHCCCS managed care program.
Here is a list of the main services that AHCCCS provides:
- Doctor's Visits
- Immunizations (shots)
- Prescriptions (not covered if you have Medicare)
- Lab and X-rays
- Specialist Care
- Hospital Services
- Transportation to Doctor
- Emergency Care
- Pregnancy Care
- Surgery Services
- Physical Exams
- Behavioral Health
- Family Planning Services
- Dialysis
For children under age 21, AHCCCS also provides:
- Early and Periodic Screening Diagnosis and Treatment (EPSDT) Services
- Glasses
- Vision Exams
- Dental Screening
- Dental Treatment
- Hearing Exams
- Hearing Aids
Coverage for some long-term care services, including nursing homes, may require a separate application for a program called the Arizona Long Term Care System (ALTCS). It has different eligibility requirements and most people who get AHCCCS coverage do not qualify for ALTCS. To learn more, see DB101’s information about ALTCS in the Personal Assistance Services article or contact your local DES/Family Assistance Administration office.
- Dental services that are cosmetic or not medically necessary
- Cosmetic surgery
- Autopsy
- Vocational/educational services
- Gender-reassignment surgery
- Artificial insemination, including in vitro fertilization
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What You Pay
Most people who get AHCCCS don’t have to pay a monthly premium. 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 copayments as low as $2.30 when you use certain medical services that AHCCCS covers.
You do not need to make copayments 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.
Dahlia is on AHCCCS and never has to pay a monthly premium. One hot day in early July, she feels sick and goes to the doctor. When she gets there, the doctor tells Dahlia that she has allergies and prescribes her a medication that will help her feel better.
Since AHCCCS has no copayments when you are sick and go to the doctor, the only thing Dahlia pays is a $2.30 copayment for her medication.
Compared to Private Insurance
AHCCCS’s copayments are much lower than the copayments required by private insurance plans. For example, many private insurance plans can have annual deductibles that require you to pay thousands of dollars before the plan will cover most services and even after the deductible is paid, many private insurance plans require $50 or more copayments for services.
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How to Sign Up
Application
There are different ways to apply for AHCCCS:
- Online using Health-e-Arizona. Health-e-Arizona lets you apply for other programs, like Nutrition Assistance or TANF Cash Assistance, at the same time.
- Online using HealthCare.gov, an online one-stop shop where you can learn about your public and private coverage options.
- In person at your local DES/Family Assistance Administration office.
- Using a paper application and faxing or mailing in to your local DES/Family Assistance Administration office.
No matter how you apply, it is important to know that if you are not eligible for AHCCCS, you may be able to get private insurance subsidized by the government.
Health-e-Arizona is the easiest way to apply for AHCCCS if you think you might qualify. Health-e-Arizona also lets you apply for other benefits, like Nutrition Assistance (formerly Food Stamps), at the same time.
HealthCare.gov is a good option if you don’t think you will qualify for AHCCCS, because it will also check and see if you can get private coverage with subsidies.
The bottom line: Both systems will help you find the benefits you need. The big difference is that, depending on your situation, one might be a bit faster than the other.
Staying on AHCCCS
Usually, once you are approved for AHCCCS, you will continue to get it for 12 months if your situation does not change. If your income, immigration status, residency, or household size changes, update your information on Health-e-Arizona or let your DES/Family Assistance Administration office know. When you report your changes, the eligibility system will tell you whether you will continue getting AHCCCS or if you have new health coverage options. There should always be at least one health coverage option for your family.
If you need help applying for AHCCCS, try the following options:
- Visit or call your local DES/Family Assistance Administration office.
- Talk to a Federally Qualified Health Center.
- Get local help from HealthCare.gov.
- If you have a disability, talk to a Work Incentive Consultant to learn more about health programs for people with disabilities.
Learn more
Frequently Asked Questions
This is really confusing. Where can I get help?
- Visit or call your local DES/Family Assistance Administration office.
- Talk to a Federally Qualified Health Center.
- Get local help from HealthCare.gov.
- If you have a disability, talk to a Work Incentive Consultant to learn more about health programs for people with disabilities.
To qualify for AHCCCS, is there a limit on the amount of resources my family can have?
No. AHCCCS has no resource limit.
If my job offers me health coverage, am I allowed to sign up for AHCCCS?
Yes. If your family’s income is low enough for you to qualify for AHCCCS, you may do so even if your job offers insurance.
Note: If your job offers you affordable insurance, you cannot get subsidies for purchasing an individual health plan through HealthCare.gov.
Isn’t AHCCCS just for people with disabilities?
No. AHCCCS is available to many people. To get AHCCCS, most people must:
-
Be under 65 years old
- You can be 65 or older if you are the parent or caretaker of a child
-
Not be eligible for Medicare
- You can be on Medicare if you are the parent or caretaker of a child or are pregnant
- Be a U.S. citizen or meet specific noncitizen requirements, and
- Have income below certain limits
There are additional ways to get AHCCCS if you have a disability or are a senior. When you apply for AHCCCS, the person reviewing your application will figure out which type of AHCCCS is best for you.
Note: Some people who do not qualify for most AHCCCS benefits, such as undocumented immigrants, may qualify for coverage in emergencies only.
What is the most money I can make and still get AHCCCS? Why have I seen different amounts listed in different articles?
You and your family can usually get AHCCCS if your family’s income is at or below 138% of the Federal Poverty Guidelines (FPG) ($21,597 for an individual in 2025, $44,367 for a family of four). Children 18 years old or young can get AHCCCS KidsCare coverage if their family's income is 230% of FPG or less ($73,945 per year or less for a family of four).
You may see the income limit for AHCCCS listed as 133% of FPL in some places. However, when AHCCCS counts your income, they’ll knock 5% of FPL off your income if you make more than 133% of FPL. That's why we show the limit as 138% of FPL, because it more accurately shows how much you could make and still get AHCCCS.
Income-based AHCCCS counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based AHCCCS eligibility.
Note: The income limits may be different if you have a disability. Read DB101’s article about AHCCCS for People with Disabilities.
| Your family size: | |
Annual income limits for your family: | |
| Income-based AHCCCS (138% FPG) | |
| AHCCCS KidsCare (230% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
I make too much money for AHCCCS, but not enough to afford private coverage. What are my options?
If you make more than the income limit for AHCCCS, the government may help you pay for a private insurance plan though HealthCare.gov. This option is only available if you can’t get affordable health coverage through your job.
You can read more about this option in DB101’s article about Buying Coverage on HealthCare.gov.
Where can I sign up?
- Online using Health-e-Arizona. Health-e-Arizona lets you apply for other programs like Nutrition Assistance or TANF Cash Assistance at the same time.
- Online using HealthCare.gov, an online one-stop shop where you can learn about your public and private coverage options.
- In person at your local DES/Family Assistance Administration office.
- Using a paper application and faxing or mailing it in to your local DES/Family Assistance Administration office.
Note: If you get Supplemental Security Income (SSI) or used to and now are on SSI 1619(b), you automatically get AHCCCS coverage. You do not need to apply for AHCCCS.
Which is better, Health-e-Arizona or HealthCare.gov?
Health-e-Arizona is the easiest way to apply for AHCCCS if you think you might qualify. Health-e-Arizona also lets you apply for other benefits, like Nutrition Assistance (formerly Food Stamps), at the same time.
HealthCare.gov is a good option if you don’t think you will qualify for AHCCCS, because it will also check and see if you can get private coverage with subsidies.
The bottom line: Both systems will help you find the benefits you need. The big difference is that, depending on your situation, one might be a bit faster than the other.
Does it matter how I qualify for AHCCCS?
In most cases, no. The actual medical coverage you get from AHCCCS will be the same, no matter how you qualified. Generally speaking, the big difference is that people with disabilities get extra ways to qualify and if you have a disability and start working, you can earn more while still getting AHCCCS coverage.
DB101 has four articles about different ways to get AHCCCS:
- The AHCCCS article explains the most common way to qualify, which does not require you to have a disability.
- The AHCCCS for People with Disabilities article explains a common way for people with disabilities who have low incomes to qualify.
- The AHCCCS Freedom to Work article explains a way that people with disabilities who work can get AHCCCS coverage by paying a premium.
- The SSI article explains how people with disabilities may qualify for AHCCCS automatically if they qualify for SSI.
If you are not sure how you qualified for AHCCCS, you can ask your local DES/Family Assistance Administration office.
I’m an immigrant. Can I get AHCCCS?
- Undocumented immigrants do not qualify for full AHCCCS coverage, but they may qualify for AHCCCS coverage for emergency services.
- Most immigrants who have been legal residents for less than 5 years do not qualify for full AHCCCS coverage. However, they may qualify to get private coverage subsidized by the government.
- Immigrants who have been legal residents for 5 years or longer and some other noncitizens who meet specific noncitizen requirements qualify for all of the same programs that citizens can get.
Learn more
Common Pitfalls
Not getting health coverage because you think it will be too expensive
In the past, some people found it impossible to find health coverage that was affordable and met their needs. Now, there should be an option for almost everybody, regardless of whether you have a disability. The exact health coverage that will be right for you will depend on things like your family’s income, whether you have access to employer-sponsored coverage, your age, where you live, and whether you have a disability.
If you do not have the option of employer-sponsored coverage, you may be able to get government help to pay for an individual plan on HealthCare.gov. If you cannot afford private individual coverage, your best options will be public programs, like AHCCCS or Medicare, if you qualify.
Note: It is very important to have health coverage, but starting in 2019 there is no tax penalty if you don't have coverage.
Not looking into AHCCCS because you think there’s no way you can qualify
AHCCCS used to be mainly for people with disabilities, seniors, children, and pregnant women. Starting in 2014, it is for anybody with low income (at or below 138% of the Federal Poverty Guidelines (FPG), $21,597 for an individual in 2025 ($44,367 for a family of four). No matter how much money you have in the bank or what your health situation is, you could qualify.
It is easy to check if you can get AHCCCS: just go to Health-e-Arizona and fill out an application. They’ll let you know whether you qualify and help you sign up.
If you can’t get AHCCCS, you can get health coverage through your employer or through HealthCare.gov, depending on your situation.
Not going back to work because you fear losing your AHCCCS coverage
In the past, people feared that if they got a job while they were on AHCCCS, they’d lose their AHCCCS, because they would no longer have low enough income to qualify.
Starting in 2014, if you lose one health coverage option, there will be another one you can get. If you lose your AHCCCS coverage, you will either become eligible for employer-sponsored coverage or private individual coverage. And, if you can’t afford the individual coverage, the government may help you pay for it.
The bottom line: There is a coverage option for everybody. Do not worry that getting a job will leave you without health coverage.
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Next Steps
Learn more about AHCCCS
To learn more about AHCCCS:
- Visit the AHCCCS website.
- Visit or call your local DES/Family Assistance Administration office.
- Talk to a Federally Qualified Health Center.
- Get local help from HealthCare.gov.
- If you have a disability, talk to a Work Incentive Consultant to learn more about health programs for people with disabilities.
Apply for AHCCCS
There are different ways to apply for AHCCCS:
- Online using Health-e-Arizona. Health-e-Arizona lets you apply for other programs like Nutrition Assistance or TANF Cash Assistance at the same time.
- Online using HealthCare.gov, an online one-stop shop where you can learn about your public and private coverage options.
- In person at your local DES/Family Assistance Administration office.
- Using a paper application and mailing it in to your local DES/Family Assistance Administration office.
Benefits and Work Incentives Consulting Services
If you're currently on SSI, SSDI, or CDB benefits, and you're looking for a job, you should qualify for free benefits consulting services. Trained Work Incentive Counsultants at Benefits 2 Work Arizona 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 at 1-866-304-WORK (9675) toll-free to find a Work Incentive Consultant serving your community.
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The AZ Links – Aging and Disability Resource Center (ADRC) helps seniors, people with disabilities, and their family members and caregivers find resources and services that meet their independent living, disability, housing, financial, legal, and health needs. |
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