What You Pay

If you get Programa de Libertad para Trabajar de AHCCCS, you may need to pay a monthly premium and copayments for certain services.

Premiums

The monthly premium for Programa de Libertad para Trabajar de AHCCCS coverage is based on your countable earned income. The higher your income is, the higher your premium will be. The maximum premium is $35.

Use this tool to see your countable income and then check the table below to see how much your premium will be.

Sus ingresos contables:
Programa de Libertad para Trabajar de AHCCCS Premiums by Countable Income

If Your Countable Monthly Income Is:

Then Your Monthly Premium Is:

$0.00 - $500.00

0

$500.01 - $750.00

$10

$750.01 - $1,000.00

$15

$1,000.01 -$1,250.00

$20

$1,250.01 - $1,500.00

$25

$1,500.01 - $1,750.00

$30

$1,750.01 - $2,269.00

$35

Note: American Indians who verify their tribal enrollment are not charged a premium, regardless of their income.

To get a better idea of whether you qualify for Programa de Libertad para Trabajar de AHCCCS and how much your premium might be, use the Calculadora del programa de Libertad para Trabajar de AHCCCS.

When Can My Premium Change?

If your income changes, your premium may also change. Programa de Libertad para Trabajar de AHCCCS will review your eligibility and premium at least every 12 months. Depending on your situation, your premium could go up or down.

Be sure to report any changes in income to the Programa de Libertad para Trabajar de AHCCCS office within 10 days of when the change occurs. You can call them at 1-855-432-7587 or 1-602-417-5010.

Billing

If you have to pay a monthly premium to get Programa de Libertad para Trabajar de AHCCCS, the state will send you a bill on the first workday of every month. If you have questions about billing, contact the Programa de Libertad para Trabajar de AHCCCS office for help at 1-855-432-7587 or 1-602-417-5010. If you prefer, you can pay your premium online.

If you miss a payment, you get a letter, called a “notice of adverse action,” that lets you know what you need to do to get back into good standing. If AHCCCS gets full payment from you by the due date shown in that letter, then your coverage will be reinstated. If not, then you will lose your coverage for not paying the premium.

Copayments When You Get Services

Generally, if you are 19 years old or older, you may have to pay small copayments as low as $2.30 when you use certain medical services that AHCCCS covers.

You do not need to make copayments if you are:

  • Less than 19 years old
  • A child eligible to get services from the Children's Rehabilitative Services (CRS) program
  • A pregnant woman
  • Enrolled with American Indian Health Program (AIHP)
  • Diagnosed as Seriously Mentally Ill (SMI) by the Arizona Department of Health Services (ADHS)
  • An Acute Care AHCCCS member who is temporarily residing in a nursing home or residential facilities, if your medical condition would otherwise require hospitalization, or
  • In hospice care.