NOTICE: Marketplace Plan Enrollment Without Patient Permission
Do you have AHCCCS? Are having issues regarding your Non-Emergent Transport? Are you being told you have another insurance?
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The Health Insurance Marketplace is seeing an increase in suspicious activity by some agents and brokers selling Marketplace coverage. This may include signing you up for coverage without your knowledge or switching you out of a plan you already have and into a new one.
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What you need to know to protect yourself
What to do if you suspect changes were made on your account
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How Marketplace can help?
If the Marketplace representatives determine you have been enrolled or had your plan switched without your knowledge, our representatives can work with your insurer and the Internal Revenue Service (IRS) to:
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If you have any questions or concerns please contact WIHCC or DMC PBC
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Dilkon Medical Center
South: 928-657-1141 North: 928-657-1142 |
Winslow Indian Health Care Center
South: 928-289-8032 North: 928-289-6183 |
Leupp Clinic
928-686-6556 |
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Patient Benefits CoordinatorThe Patient Benefits Coordinator is the advocate for the patient in the search of and utilization for alternate resources such as AHCCCS, Medicare, Medicaid, Department of Veterans Affairs (VA), Private Insurance Billing, etc. and helping with their enrollment.
Our Patient Benefits Coordinator meets patients daily and knows firsthand that educating the individual about their health care choices is key to building healthy families and healthy communities. Our goal is to ensure that all patients who are eligible for alternate resources are identified, contacted and encouraged to apply for and maintain eligibility for available benefits. Just a Reminder.....
If you have any medical bill or referral pending; patients are required to either apply for AHCCCS or complete an AHCCCS Screening every 6 months before Purchase Referred Care (PRC), formerly known as Contract Health, payment can be authorized or appointment can be scheduled. |
AHCCCS ADULTS
Arizona Health Care Cost Containment System (AHCCCS)
Eligibility Income Guidelines Effective 02/01/2022:
Special Requirements: must be 19 years of age or older; Under age 65; not entitled to Medicare; and Ineligible for any other categorical Medicaid coverage; and limited income. Come see a PBC to see if you qualify for AHCCCS. PBC can do your application online through Health-E-Arizona Plus.
Eligibility Income Guidelines Effective 02/01/2022:
- Household 1: $1,507.00
- Household 2: $2,030.00
- Household 3: $2,553.00
- Household 4: $3,076.00 (add $524 per additional person).
Special Requirements: must be 19 years of age or older; Under age 65; not entitled to Medicare; and Ineligible for any other categorical Medicaid coverage; and limited income. Come see a PBC to see if you qualify for AHCCCS. PBC can do your application online through Health-E-Arizona Plus.
ARIZONA BREAST & CERVICAL CANCER TREATMENT PROGRAM (BCCTP)
If you are uninsured, under 65 years of age, and have been diagnosed with breast or cervical cancer or pre-cancerous cervical lesion; you may be able to received treatment through the BCCTP. To qualify for the BCCTP; come see a PBC to check on eligibility requirements.
ARIZONA LONG TERM CARE SYSTEM (ALTCS)
ALTCS program is for individuals who are 65 or older, blind, or disabled and need ongoing services at a nursing home level of care. However, program participants do not have to reside in a nursing home. Many ALTCS participants live in their own home or an assisted living facility and receive needed in-home services.
Come see a PBC to start an application.
Come see a PBC to start an application.
HEALTH INSURANCE MARKETPLACE
Open Enrollment for 2023 coverage begins on November 1, 2022, and ends January 15, 2023.
If you don't have health insurance through a job, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another source that provides qualifying health coverage, the Marketplace can help you get coverage. If you are a member of a federal recognized tribe, you can apply for Insurance through the Marketplace ANYTIME. You may qualify for a premium tax credit that lowers your monthly insurance bill, and for extra savings on out-of-pocket costs like deductibles and copayments. The plans are offered by private insurance companies with a range of prices and features.
You can apply online at www.healthcare.gov or come see a PBC to set up an account and enroll in a health plan.
If you don't have health insurance through a job, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another source that provides qualifying health coverage, the Marketplace can help you get coverage. If you are a member of a federal recognized tribe, you can apply for Insurance through the Marketplace ANYTIME. You may qualify for a premium tax credit that lowers your monthly insurance bill, and for extra savings on out-of-pocket costs like deductibles and copayments. The plans are offered by private insurance companies with a range of prices and features.
You can apply online at www.healthcare.gov or come see a PBC to set up an account and enroll in a health plan.
KidsCare
If the child's income is too high for AHCCCS Health Insurance, the child may qualify for KidsCare at a low monthly premium. Per federal law, Native American enrolled with a federally recognized tribe, you do not have to pay a PREMIUM.
WHO IS ELIGIBLE:
Eligibility Income Guidelines Effective 02/01/2022:
Application will be done online at Health-E-Arizona Plus. Come see a PBC to see if your child(ren) qualify.
WHO IS ELIGIBLE:
- Is not eligible to receive AHCCCS (Medicaid) coverage.
- No health insurance coverage within the last 3 months.
- Not available to State employees, their children, or spouses
Eligibility Income Guidelines Effective 02/01/2022:
- Household 1: $2,265.00
- Household 2: $3,052.00
- Household 3: $3,839.00
- Household 4: $4,625.00 (add $787 per additional person).
Application will be done online at Health-E-Arizona Plus. Come see a PBC to see if your child(ren) qualify.
MEDICARE COST SHARING PROGRAM
KIDSCARE
If the child's income is too high for AHCCCS Health Insurance, the child may qualify for KidsCare at a low monthly premium. Per federal law, Native American enrolled with a federally recognized tribe, you do not have to pay a PREMIUM.
If the child's income is too high for AHCCCS Health Insurance, the child may qualify for KidsCare at a low monthly premium. Per federal law, Native American enrolled with a federally recognized tribe, you do not have to pay a PREMIUM.
MEDICARE ENROLLMENT
- Part A/B: You can also enroll during the annual Medicare open enrollment period from October 15 to December 7 each year.
- Part B: If you don’t enroll in Medicare Part B during your Initial Enrollment Period, you have another chance each year to sign up during a General Enrollment Period from January 1 to March 31.
- Part D: Starts October 15 to December 7 of each year. Some people with limited resources and income may also be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan.
PREGNANT ?
Are you a Veteran?
You may be eligible for medical benefits. Bring the following information, so we may assist you in applying for benefits online:
You may be eligible for medical benefits. Bring the following information, so we may assist you in applying for benefits online:
- Personal Information
- Spouse/Dependent Information
- Insurance Information
- Military Service Information (DD 214)
- Financial Information
Click on the VA button for more information.
SOCIAL SECURITY BENEFITS
You can apply for early retirement benefits at age 62 or until full retirement age. PBC can help you apply using Social Security Administration's online services or make an appointment for you to visit the local Social Security Office.
SOCIAL SECURITY DISABILITY
For adults/children with chronic illness or disease, you may be eligible for Disability. If you are approved, you can receive monthly benefits and you may qualify for other health care programs such as Medicare or Medicaid. PBC can assist you to apply for benefits online or schedule an appointment for you to visit the local Social Security Office.
VETERANS
Are you a Veteran?
You may be eligible for medical benefits. Bring the following information, so we may assist you in applying for benefits online:
You may be eligible for medical benefits. Bring the following information, so we may assist you in applying for benefits online:
- Personal Information
- Spouse/Dependent Information
- Insurance Information
- Military Service Information (DD 214)
- Financial Information
Click on the VA button for more information.
Date Last Reviewed: Sept 2022
Are you a worker being affected by the COVID-19 outbreak? You may be eligible for Unemployment Insurance. Visit Arizona DES online to apply.
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Apply for programs like AHCCCS/KidsCare, Medicare Cost Sharing and Nutrition Assistance (SNAP) through Health-e-Arizona PLUS. |
Introducing Health-e-Arizona Plus. AHCCCS and DES collaboration for a new one site system to apply for AHCCCS Health Insurance, KidsCare, Nutrition Assistance and Cash Assistance benefits and to connect to the Federal Insurance Marketplace.
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New Medicare cards, protect your health and your identity. (Navajo translation)
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HIV/AIDS RYAN WHITE PROGRAMCome see a PBC representative to pick up an application. |
RADIATION EXPOSURE SCREENING & EDUCATION PROGRAM (RESEP)Come see a PBC representative to pick up an application. |
Other Resources
Some Important Links Below: *
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* Links above will redirect you out of the this website
To Contact a Patient Benefits Coordinator:
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Vanessa F. Begay
PBC Support Assistant (928) 289 - 8041 |
Winslow Medical Building
(928) 289 - 6183 (North MOB) (928) 289 - 8032 (South MOB) Fax : (928) 289 - 8093 |
Dilkon Clinic PBC Office
(928) 289 - 3826 Leupp Clinic PBC Office
(928) 686 - 6556 |
Alutha Yellowhair
Patient Benefits Supervisor (928) 289 - 6298 |
