AHCCCS Member Resources

Additional information for AHCCCS members can be found on this page.

Policy Manual

The purpose of the Eligibility Policy Manualis to provide detailed documentation that supports eligibility decisions for the various health insurance programs offered through AHCCCS.

Notice to the Public | Rich Text Version

Arizona’s Eligibility Policy Manual for Medical, Nutrition, and Cash Assistance

Reference Documents

Eligibility Standards Desk Aid | Rich Text Version

AHCCCS has almost 100 different one-page guides about various aspects of the health care system. Topics include: behavioral health care; various member services; foster care, kinship and adoptive families; and the grievance and appeal processes.

See all the one-page Empowerment Tools at www.azahcccs.gov/OIFATools

ALTCS Member-Directed Options

Member directed models or options allow members to have more control over how certain services are provided, including services like attendant care, personal care and homemaker services. The models are not a service, but rather define the way in which services are delivered. Member-directed options are available to most Arizona Long Term Care System (ALTCS) members who live in their own home. The options are not available to members who live in an alternative residential setting or nursing facility. ALTCS members or their representatives are encouraged to contact their case manager to learn more about and consider member-directed options.

Agency with Choice Resources

Agency with Choice a member-directed option available to ALTCS members living in their own home. Under the Agency with Choice option, the provider agency and the member enter into a relationship and share employer-based responsibilities for the paid caregiver. The provider agency maintains the authority to hire and fire the caregiver and provide or arrange for the required minimum standardized training for the caregiver. The member, or their individual representative, may choose to assume one or more of the following employer-based responsibilities:

  • Recruit and select caregivers, including specifying the qualifications of the caregiver over and above the standard qualifications required by AHCCCS
  • Dismiss caregivers
  • Manage caregivers, including determining duties and schedules
  • Supervise caregivers
  • Training caregivers, including identifying special training needs

AHCCCS Member Communication

Click on "Member Notice" for the latest communication regarding the new Agency with Choice, member-directed option. Click on "FAQs" for answers to common questions pertaining to Agency with Choice.

Self Directed Attendant Care (SDAC) Resources

Self Directed Attendant Care (SDAC) is a member-directed option that has been available to members since 2008. Under the SDAC option, the member or member’s legal guardian serves as the legal employer of the paid caregiver and assumes all employer-based responsibilities. The member or member’s legal guardian is supported by a Fiscal Employer Agent that takes care of the taxes, payroll withholding and paychecks for the caregiver.

Policy

Additional Information & Brochure

SDAC Brochure | Rich Text Version

American Indians and Alaska Natives (AI/AN) enrolled in AHCCCS or Children's Health Insurance Program (KidsCare) may choose to receive their coverage through the AHCCCS American Indian Health Program (AIHP) or one of the AHCCCS-contracted managed health plans.

Information About the AHCCCS American Indian Health Program

AHCCCS American Indian Health Program (AIHP) provides medically necessary services for enrolled members. The program also provides coverage for preventive and behavioral health care services.

Member Guide | Rich Text Version

Obtaining Services

AIHP members may receive health care services from Indian Health Facilities (the Indian Health Service, tribally-operated "638" health programs, urban Indian health clinics) and other AHCCCS-registered doctors.

Unique Program Choices

AI/AN members can switch their enrollment between AHCCCS AIHP and an AHCCCS managed health care plan and back again at any time. However, a member can change from one managed health care plan to another (for example, Mercy Care Plan to Maricopa Health Plan) only once a year.

American Indian AHCCCS Member Enrollment Choices | Rich Text Version

Contact

There are two ways for AHCCCS members to change their AHCCCS enrollment:

Background

On April 6, 2020, AHCCCS received temporary authority from the Centers for Medicare and Medicaid Services (CMS) to permit parents of minor children with disabilities to be paid caregivers during the federal COVID-19 Public Health Emergency (PHE). This temporary authority allowed parents and caregivers a way to ensure their children continued to receive health care services during the pandemic, and to have a choice in whether or not to allow direct care workers into their homes. It also ensured continuity of services in the event direct care workers became ill or decided not to work as the result of COVID-19. On Sept. 27, 2023, AHCCCS sent to CMS an 1115 Waiver amendment requesting this authority on a permanent basis. On Feb. 16, 2024, AHCCCS received approval from CMS to make the Parents as Paid Caregivers (PPCG) a permanent service model option of the Arizona Long Term Care System (ALTCS) program under the 1115 Waiver. More details are available on the Parents as Paid Caregivers 1115 Waiver web page. On April 24, 2025, HB2945 was signed into law that requires specific safeguards and guardrails for the PPCG service model in addition to waiver/program requirements of AHCCCS and DES/DDD.

Frequently Asked Questions

Parents as Paid Caregiver for Minor Children FAQ

Policies and Public Comment Process (May - July, 2025)

AHCCCS and DES/DDD are proposing revisions to their policies that impact the Parents as Paid Caregiver (PPCG) service model. These revisions include commitments made to CMS in the 1115 Waiver proposal. They also include terms and conditions of the state’s authority approval and recent legislation (HB 2945).

AHCCCS policies will be open for public comment beginning May 9, 2025. The DES/DDD policies will be open for public comment on June 9, 2025. Both agencies are collecting public comments to streamline the process for stakeholders. AHCCCS and DES/DDD will also host two public forums during the public comment period.

The document AHCCCS and DDD Joint Agency Communication, provides details on how to submit public comments and the public forums. It also has guidance for how to streamline your review of the proposed policy changes and share your feedback with both agencies.

Contact AHCCCS

You may send PPCG inquiries to PPCG@azahcccs.gov.

Please note: Do not use this email address to share feedback or comments on the policies open for public comment. Please follow the specific instructions, provided above, for engagement in the public comment process to help ensure your comments are documented and recorded with other stakeholders interested in the parents as paid caregiver service model.