AHCCCS Eligibility for Young People

The Arizona Health Care Cost Containment System (AHCCCS) helps people with low income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. If you qualify for Supplemental Security Income (SSI), you also qualify automatically for AHCCCS and don't need to worry about the rules on this page.

To get AHCCCS, you have to meet certain rules. These rules can seem confusing at first, but they are actually pretty simple. First we will present the rules for young people under the age of 19, then we’ll present them for anybody 19 or older. Read the section that is appropriate for you.

If you have any questions, talk to a Work Incentive Consultant.

How to Apply for AHCCCS

After you learn about eligibility, you can apply for AHCCCS:

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.

AHCCCS If You Are 18 or Younger

If you are 18 or under, you may qualify for AHCCCS if:

  1. You get Supplemental Security Income (SSI)
  2. Your family has low income, regardless of whether you have a disability, or
  3. Your family has low income and qualifies for AHCCCS KidsCare.

If you get SSI, you will automatically qualify for AHCCCS and will not have to fill out an additional application. You can read more about how to qualify for SSI in the SSI Eligibility page of this article. If you have more questions about how this works, talk to a Work Incentive Consultant.

Income-Based AHCCCS

If you don’t get SSI, you can still qualify for AHCCCS if:

The key here is that you and your family must not exceed the income limit for your family situation. Depending on the number of people in your family and your age, the income limit varies. To see the income limit for your family’s situation, click here.

AHCCCS may not count all of your income, so you should apply even if you think you won’t qualify. It may turn out that you do qualify. Depending on your family situation, your parents may also qualify. To read more about how parents or other guardians may qualify for AHCCCS, click here.

KidsCare

If you don't get SSI and don't qualify for income-based AHCCCS, AHCCCS will check to see if you qualify for KidsCare based on your family's income. If you are 18 or younger and your family’s income is 205% of the Federal Poverty Guidelines (FPG) or less ($52,788 per year or less for a family of four), you may qualify for KidsCare. It doesn't matter how much your family has in resources.

There is a monthly premium for KidsCare coverage. The amount of the premium depends on your family's income. Get more information about the KidsCare premium.

Check whether your family's income is low enough for you to get KidsCare coverage:

Health Coverage Income Limits for Your Family
Is the income limit for KidsCare 200% or 205% of FPG?

You may see the children's income limit for KidsCare listed as 200% of the Federal Poverty Guidelines (FPG). However, when AHCCCS counts your income, they’ll knock 5% of FPG off your household income if you make more than 200% of FPG. That's why we say that you can make up to 205% of FPG, because it more accurately shows how much income you could have and still get KidsCare coverage if you are under 19.

If you are or have been enrolled in the Department of Economic Security’s (DES) Foster Care Program

If you are 17 or younger and in DES Foster Care, you qualify for AHCCCS no matter how much money you make. If you are 18 to 25 years old and were in DES Foster Care or Tribal Foster Care and on AHCCCS on your 18th birthday, you also may qualify for AHCCCS no matter how much money you make.

AHCCCS if You Are 19 or Older

The rules for AHCCCS when you turn 19 are very similar to the rules before you turned 19. There are two common ways to get AHCCCS. You can qualify:

  1. If you get Supplemental Security Income (SSI)
  2. If you have low income, regardless of whether or not you have a disability

If you get SSI, you will automatically qualify for AHCCCS and will not have to fill out an additional application. You can read more about how to qualify for SSI in the SSI Eligibility page of this article. If you have more questions about how this works, talk to a Work Incentive Consultant.

Notes for people on SSI

If you’re on SSI, there is a special rule that allows you to keep your AHCCCS coverage even when your earned income is too high to get any SSI cash benefits. This rule is called 1619(b). Thanks to 1619(b), you can make up to $36,819 per year without losing your AHCCCS.

While 1619(b) means that you can get AHCCCS while earning way more than the program’s normal income limit, your resources have to remain below SSI’s $2,000 resource limit. If your resources go above that limit, you should consider AHCCCS Freedom to Work. To learn more about AHCCCS Freedom to Work, click here.

If you don’t get SSI, you can still qualify for AHCCCS if:

Your income will be counted, but your parents’ income will not be counted. The exact income limit will depend on your situation, such as whether you are single or married, whether you have children or are pregnant, and whether you have a disability. To get more information about income limits in different situations, click here.

If you meet the Social Security Administration’s definition of disability, there are 2 ways in which you may be able to get AHCCCS even if your paycheck is higher than the AHCCCS income limit states:

  1. When AHCCCS calculates your income, it will reduce the amount stated on your paycheck by the amount you spend on any Impairment Related Work Expenses (IRWEs) or Blind Work Expenses (BWEs). That means that if you pay for certain things that you need in order to do your job, such as medications or accommodations, you should tell AHCCCS about them, because it might help you qualify for AHCCCS health coverage. DB101’s SSI and Work page explains IRWEs and BWEs in greater detail.
  2. If you make more than the AHCCCS income limit even when IRWEs are taken into account, you may still qualify for AHCCCS Freedom to Work, which has higher income limits. AHCCCS Freedom to Work is described in detail here.