Prescription Drug Coverage

AHCCCS

AHCCCS is Arizona's Medicaid program. It helps pay medical expenses for people with low income. If you meet eligibility requirements, AHCCCS will help pay for your visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services.

AHCCCS Prescription Benefits

Most AHCCCS beneficiaries pay a small $2.30 copayment for their prescription drugs.

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.

To learn more about AHCCCS copayments, click here.

AHCCCS and Medicare Part D

If you are a senior or the Social Security Administration says you have a disability, you may be able to get AHCCCS and Medicare at the same time.

It will help you to have AHCCCS and Medicare Part D at the same time because:

  • With AHCCCS, you will automatically be enrolled in a Part D benchmark plan and 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 the Part D Low Income Subsidy.

KidsCare

KidsCare is Arizona’s Children’s Health Insurance Program (CHIP). If you are on KidsCare already, it offers very good drug coverage — there will be no copayments for your medications! Just make sure to pay your monthly premium and complete all renewal paperwork on time. If you do not, you could lose your KidsCare coverage and not be able to get it back, because it is not accepting new enrollments due to lack of funding.

To read more about KidsCare, click here.

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