What You Pay

Most people who get AHCCCS don’t have to pay a monthly premium. If you are covered by AHCCCS, you only have to make payments when you need medical care.

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
  • In hospice care, or
  • Eligible for AHCCCS on a fee-for-service (FFS) basis.
Example

Dahlia is on AHCCCS and never has to pay a monthly premium. One hot day in early July, she feels sick and goes to the doctor. When she gets there, the doctor tells Dahlia that she has allergies and prescribes her a medication that will help her feel better.

Since AHCCCS has no copayments when you are sick and go to the doctor, the only thing Dahlia pays is a $2.30 copayment for her medication.

Compared to Private Insurance

AHCCCS’s copayments are usually much lower than the copayments required by private insurance plans. For example, many private insurance plans can have annual deductibles that require you to pay thousands of dollars before the plan will cover most services and even after the deductible is paid, many private insurance plans require $50 or more copayments for services.