Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 22 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ADMINISTRATION › Article 14 - AHCCCS MEDICAL COVERAGE FOR HOUSEHOLDS › Section R9-22-1401 - General Information

Current through Register Vol. 30, No. 28, July 12, 2024
A. Scope.
				This Article contains eligibility criteria to determine whether a household or
				individual is eligible for AHC-CCS medical coverage. Eligibility criteria
				described under Article 3 applies to this Article.
B. Definitions. In addition to definitions
				contained in
				R9-22-101
				and A.R.S. §
									36-2901,
				the words and phrases in this Article, Article 3 and Article 15 have the
				following meanings unless the context explicitly requires another meaning:
"Burial plot" means a space reserved in a cemetery, crypt,
				  vault, or mausoleum for the remains of a deceased person.
Caretaker relative" means:
A parent of a dependent child with whom the child is
				  living;
When the dependent child does not live with a parent or the
				  parent in the home is incapacitated, another relative of the child by blood,
				  adoption, or marriage in the home who assumes primary responsibility for the
				  child's care;
or
A woman in her third trimester of pregnancy with no other
				  dependent children.
"Cash assistance" means a program administered by the
				  Department that provides assistance to needy families with dependent children
				  under 42
				  U.S.C. 601 et seq.
"Dependent child" means a child under the age of 18, or if
				  age 18 is a full-time student in secondary school or equivalent vocational or
				  technical training, if reasonably expected to complete such school or training
				  before turning age 19.
"MAGI - based income" means Modified Adjusted Gross Income as
				  defined under
				  42 CFR
				  435.603(e).
"Medical expense deduction" or "MED" means the cost of the
				  following expenses if incurred in the United States:
A medical service or supply that would be covered if provided
				  to an AHCCCS member of any age under Articles 2 and 12 of this Chapter;
A medical service or supply that would be covered if provided
				  to an Arizona Long-term Care System member under 9 A.A.C. 28, Articles 2 and
				  11;
Other necessary medical services provided by a licensed
				  practitioner or physician;
Assistance with daily living if the assistance is documented
				  in an individual plan of care by a nurse, social service worker, registered
				  therapist, or dietitian under the supervision of a physician except when
				  provided by the spouse of an applicant or the parent of a minor child;
Medical services provided in a licensed nursing home or in an
				  alternative HCBS setting under
				  R9-28-101;
Purchasing and maintaining an animal guide or service animal
				  for the assistance of a member of the MED family unit under
				  R9-22-1436;
				  and
Health insurance premiums, deductibles, and coinsurance, if
				  the insured is a member of the MED family unit.
"Monthly income" means the gross countable income received or
				  projected to be received during the month or the monthly equivalent.
"Monthly equivalent" means a monthly countable income amount
				  established by averaging, prorating, or converting a person's income.
"Spendthrift restriction" means a legal restriction on the
				  use of a resource that prevents a payee or beneficiary from alienating the
				  resource.
"Tax dependent" is described under
				  42 CFR
				  435.4.
"Taxpayer" means a person who expects to file a tax return,
				  and does not expect to be claimed as a tax dependent by another person.
"Title IV-D" means Title IV-D of the Social Security Act,
				  42 U.S.C.
				  651 -
				  669,
				  the statutes establishing the child support enforcement and paternity
				  program.
"Title IV-E" means Title IV-E of the Social Security Act
				  42
				  U.S.C. 670 -
				  679,
				  the statutes establishing the foster care and adoption assistance
				  programs.