Arizona End User Online Services Terms and Conditions

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Multi-State
Control #:
US-CP0829-AM
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Word; 
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This sample form, a detailed End User Online Services Terms and Conditions document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

Timeframes When the customer is applying for:Then the processing period is...SSI-MAO or FTW based on disability90 calendar days from the application dateKidsCare30 calendar days from the application dateBCCTP7 calendar days from the date a complete application is received by AHCCCS.1 more row ?

At the latest, 45 calendar days from the application date.

AHCCCS uses electronic sources to obtain income information. These sources do not identify income from providing attendant or personal care to an ALTCS member living with the caregiver as difficulty of care payments.

- Fee-for-Service claims are considered timely if the initial claim is received by AHCCCS no later than 6 months from the date of service. - IHS/638 claims should be submitted within 12 months from the date of service.

Income. If your family's income is at or below 138% of the Federal Poverty Guidelines (FPG) ($20,120 per year for an individual in 2023, $41,400 for a family of four), you may qualify for AHCCCS.

You will get an AHCCCS ID card from your health plan. Keep your AHCCCS ID card with you. If you do not have your AHCCCS ID card with you, you can give the provider your AHCCCS ID number or Social Security number so they can look up your AHCCCS information.

The participating medical provider (doctor or pharmacy) will be able to verify your enrollment in a medical assistance program. You should receive your AHCCCS insurance card in the mail from your health plan 7-14 days after you are approved.

Income Limits Household SizeGross Monthly Income Limit Effective 02/01/20233$2,7564$3,5255$3,895Each additional person $570*2 more rows

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Arizona End User Online Services Terms and Conditions