Medicaid Costs and Coverage in Arizona


The question “How much is Medicaid in Arizona?” can have different answers, depending on circumstances. Medicaid cost estimates are determined by a number of factors, including the size of your household and your household’s annual income. This is due to the fact that Medicaid, also called Medical Assistance, is for low-income households. In addition to Medicaid costs, it is important to know the Medicaid coverage that you can expect to receive under your Medicaid insurance plan. For information about Medical Assistance cost estimates and coverages, continue reading the following sections.

What services are covered by Medicaid in Arizona?

While you may be wondering, “How much is Medicaid in Arizona?” it is important to first review the coverage you may receive with Medicaid health insurance in Arizona. When determining Medicaid coverage, it is important to understand that while some medical procedures and expenses are mandated by the federal government and require state Medicaid programs to provide such coverage, other forms of AZ Medical Assistance coverage are determined by the state itself. That means that one state’s Medicaid covered services are not likely to be exactly like what would be found in another state, making it crucial that you understand the coverage that is provided within Arizona.

While there are a few types of Medicaid insurance programs available within Arizona, Medicaid will cover services including, but not limited to, the following:

  • Doctor’s visits

  • Immunizations

  • Laboratory services and X-rays

  • Pregnancy care

  • Surgery services

  • Physical exams

  • Behavioral health services

  • Emergency care

  • Specialist care

  • Emergency dental services

Additionally, beneficiaries who are younger than 21 years of age will receive additional Medical Assistance covered services, which include, but are not limited to, the following:

  • Vision exams and glasses

  • Hearing exams

  • Dental screening

For a comprehensive list of services covered by Medicaid, download our complimentary guide today.

When will Arizona Medicaid coverage begin?

In addition to asking, “How much does Medicaid cost in Arizona?” it is important to know when coverage will generally begin if you are approved for Medicaid health insurance. In most cases, AZ Medicaid coverage will begin the first day of the month that you are determined to be eligible to receive Medicaid. This means that Medicaid will backdate your coverage, but what if you have medical expenses prior to applying for Medicaid?

It is possible that your Medical Assistance coverage could cover medical bills and expenses from up to three months before you applied for Medicaid, but this must be indicated on your application or you must contact your Medicaid office as soon as possible. The office will determine if you are eligible for this backdated Medicaid coverage, referred to as Prior Quarter Coverage. Any medical expenses that occurred more than three months prior to your application will be excluded.

What does Medicaid not cover in Arizona?

It is critical to understand services not covered by Medicaid, as there are a variety of differences between Arizona Medicaid and what might be found in another state. Some medical procedures not covered by Arizona Medicaid include, but are not limited to, the following:

  • Cosmetic surgery

  • Surgical procedures in which Medicaid has not provided prior authorization

  • Vision exams and glasses for those who are 21 years of age or older

  • Hearing exams and hearing aids for those who are 21 years of age or older

How much does Medicaid cost in Arizona?

When determining the cost of Medicaid in AZ, it is worth knowing that not everyone will have the same fees, or even a fee at all. Most types of Medicaid insurance do not include a premium that must be paid on a monthly basis, with the exception of Arizona’s KidsCare CHIP program.

However, although Arizona Medicaid costs do not usually include a premium, that does not mean you will avoid paying any fees with Medicaid health insurance. Depending on the size of your household, income level and other factors – you may be required to provide a Medicaid copayment each time you receive a medical service in which your Arizona Medicaid covers expenses.

It is worth knowing, however, that copays are not charged for a variety of services even if you would normally accrue a copayment. Medicaid services that do not require a copay include, but are not limited to, the following:

  • Family planning services and supplies

  • Pregnancy related health care services

  • Emergency services

  • Preventative visits

  • Provider preventable servicers

Additionally, certain Medicaid beneficiaries, including beneficiaries younger than 19 years of age, pregnant women and several other groups do not have to pay copays. For more details about copayments and other AZ Medicaid costs, you can download our comprehensive guide today.

Who Is Eligible to Get Health Services in Arizona?

Residents must meet the eligibility requirements established by the Arizona Health Services Department in order to quality for programs such as Medicaid and Medicare. Your income and age might be significant factors regarding your eligibility, but requirements vary. To learn more about AZ medical assistance, download our guide today.

What Kinds of Health Care Services Can I Receive in Arizona?

Arizona health care services differ significantly in regards to price and coverage. A resident’s eligibility might also play a role in the cost of each service. To learn about how you can apply for these health services, please download our guide now.