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Medicaid Eligibility & Qualifications in Arizona

Medicaid is a heath program provided by the United States for individuals and families who are eligible and have low incomes and resources. They include low-income adults and their children, as well as people with disabilities. Some general requirements for eligibility include being in poverty or having HIV or AIDS. Other categories that may be considered are age, disability, blindness and pregnancy. However, falling under one of these categories does not necessarily qualify an individual for Medicaid.

  1. Eligibility

    • To qualify to receive services from Medicaid, applicants must meet certain criteria. They must be a resident of Arizona and a U.S. citizen or a qualified immigrant. If these are not met, the person may still be eligible for emergency services.

      Applicants must also have a Social Security number or apply for one. They must cooperate with the Division of Child Support Enforcement if necessary. Additionally, they must apply for potential income that may be available and have family income under the income limit.

    Programs

    • There are various programs of Medicaid in Arizona. They are separated by programs for adults and programs for families and children. Programs for adults include the Sixth Omnibus Reconciliation Act (or SOBRA), the Arizona Health Care Cost Containment System (AHCCCS), the Breast and Cervical Cancer Program, Family Planning Services and the Federal and State Emergency Services for Documented and Undocumented Aliens.

      Programs for families and children include SOBRA for children under the age of 1, SOBRA for children ages 1 to 5, SOBRA for children ages 6 through 18, AHCCCS for Families with Children and medical expense deduction.

    Qualifications

    • SOBRA qualifications limit adults to 133 percent of federal poverty level after allowed deductions. There is no resource limit, and the income limit increases for each additional child. For children younger than 1 and no older than 5, there is no resource limit and income cannot exceed 133 percent of FPL. For children 6 to 18, income cannot exceed 100 percent of FPL, and there is also no resource limit for this. This is the same for AHCCCS for both adults and children.

    Special Considerations

    • For the Breast and Cervical Cancer Program, women must be screened, diagnosed and referred to the AHCCCS by the National Breast and Cervical Cancer Early Detection Program. For SOBRA, some providers may assist in the application process, and the face-to-face or telephone interview may be waived. If AHCCCS is used, patients are ineligible for any other categorical Medicaid coverage.

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