PART 1—Breaking Down the 3 M’s of Health Insurance Options
This article is part of our new Summer Series lineup that will take you through the ins and outs of some common government benefits programs that many people utilize post-brain injury, including SSDI, SSI, Medicaid, Medicare, and more!
Note: The information presented in this article is not intended to be comprehensive and is not official legal advice. Its purpose is to provide you with insights and direction to help you access the resources most appropriate to your individual situation. You should consult a professional regarding documentation, additional questions, etc.
At the onset of a brain injury, survivors can experience loss of work, income, and even family support. If your health insurance was tied to your employment, it can also be a scary time if you now need new health insurance coverage.
In this installment of our summer series, we will get you up to speed on the big three government health care options: Medicaid, Medicare, and the Marketplace (a.k.a. “Obamacare” and The Affordable Care Act).
Applying for each of these programs can be a challenging process. Fortunately, you don’t have to do it alone. There are free Navigator services that can help you complete the applications, answer your questions, and provide further information and resources as needed. It is recommended that you utilize these resources if you are able.
This is Arizona’s income-based, state health insurance, better known as the Arizona Health Care Cost Containment System (AHCCCS, pronounced “Access”). In many states, it is commonly known as Medicaid.
To qualify for AHCCCS, various criteria such as the following are taken into consideration:
- Income — Income levels are based on the household structure (single, married, number of dependents) and household income. To determine your level, check out the 2020 Federal Poverty Limit (FPL) chart
- Arizona residency
Note: If you currently receive Supplemental Security Income (SSI), a needs-based program, you will automatically receive Medicaid coverage as well.
Information Needed to Apply
Whether you’re applying for AHCCCS for the first time, or renewing your benefits, be prepared to supply the following information for all applicants:
- Proof of citizenship and identity
- Alien Registration Cards, if non-U.S. citizens in your household are applying
- Social Security numbers, or proof that a Social Security number has been applied for
- Birth certificates
- Name, address, and daytime phone number of landlord or neighbor
- A statement verifying your address and the names of everyone living with you. This must be made by a non-relative who doesn’t live with you, be signed and dated, and include that person’s address and telephone number
- Proof of ALL money your household received from any sources last month and this month
- Proof that your employment ended, and last date paid
- Verification of any medical insurance other than AHCCCS
Submitting your Application
Once your application is received, it will be reviewed to determine if you qualify for AHCCCS benefits. Here are several ways you can apply:
- Complete and submit an online application through Health-e-Arizona
- Call 855-432-7587 to request a paper application. After receiving and completing the application, return it via mail or fax
- Utilize the free in-person application help service, Find an ASSISTOR, available through the Health-e-Arizona website.
*NOTE: In-person services may be currently limited or unavailable due to COVID-19
- For children 18 and under, download the KidsCare Application Addendum PDF form and turn it in by mail or fax
When will I Know if I’ve been Approved?
A decision will be made:
- Within seven days from the application date if you are hospitalized
- Within 20 days from the application date if you are pregnant
- At the latest, 45 calendar days from the original application date
- When a decision is made regarding your case, you will be notified by mail. You can also monitor the status of your application online at Health-e-Arizona Plus.
Freedom to Work Program
Since AHCCCS is an income-based program, there is often concern for a person with a brain injury that if they return to work, they will lose their benefits. Through Freedom to Work, you can be employed with a disability and still maintain your coverage. If eligible, you may be responsible for a small monthly premium of $35 or less. AHCCCS Freedom to Work includes the same care coverage as AHCCCS, including doctor visits, hospital stays, home care, mental health services, and medical equipment.
To qualify for Freedom to Work, you must be:
- A U.S. citizen or qualifying noncitizen
- Between the ages of 16-64
- Determined blind or disabled
- Working, and have $5,402 or less in monthly earned income
Remember, you don’t have to struggle through this process alone. BIAAZ is always available for guidance, as well as free resources for all survivors of brain injury, their families, caregivers, and professionals.
If you have any questions or would like additional information or resources regarding AHCCCS, you don’t have to wait for the next installment of this series. Just email your inquiries directly to firstname.lastname@example.org or email@example.com, or call the BIAAZ office at 1-888-500-9165.
AHCCS – 2020 Eligibility Requirements
ABOUT BRAIN INJURY ALLIANCE OF ARIZONA
The Brain Injury Alliance of Arizona (BIAAZ) is the only statewide nonprofit organization dedicated to improving the lives of adults and children with all types of brain injuries through prevention, advocacy, awareness, and education. BIAAZ also houses the Arizona Brain Health Resource Center, a collection of educational information and neuro-specific resources for brain injury survivors, caregivers, family members, and professionals.
What began in 1983 as a grassroots effort has grown into a strong statewide presence, providing valuable life-long resources and community support for individuals with all types of brain trauma at no charge.
The Brain Injury Alliance of Arizona:
- Works with the Congressional Brain Injury Task Force
- Houses Arizona Brain Health Resource Center
- Hosts the Statewide Opioid Use Disorder & Cognitive Impairment Workgroup
- Deploys a Statewide Opioid Use Disorder & Cognitive Impairment Response Team with peer support, training and family wraparound services
- Facilitates the Brain Health Advisory Council
- Manages a Statewide Neuro Info-Line 888-500-9165