E Guaranteed Enrollment Periods
Click here to see this page in full context

 

  1. Home >
  2. Policy >
  3. Chapter 1100 Enrollment >
  4. 1102 Enrollment with a Health Plan >
  5. E Guaranteed Enrollment Periods

E Guaranteed Enrollment Periods

 

 

Revised 04/15/2025

Policy

The guarantee period is calculated at the time the discontinuance is received by PMMIS. Eligibility for the guaranteed enrollment period is based on the reason the customer became ineligible for the AHCCCS program.

NOTE     Customers receiving Medicare Savings Program (MSP) or Federal Emergency Services (FES) only, do not have guaranteed enrollment periods.

Guaranteed enrollment periods apply as follows:

If...

The guaranteed enrollment period is...

Unless the customer...

It is the first time the customer has ever been enrolled with an AHCCCS Complete Care (ACC) plan

Six months

  • Dies

  • Moves out of state;

  • Cannot be located and mail is returned to the agency as undeliverable;

  • Is incarcerated;

  • Is adopted;

  • Was ineligible at the time of initial enrollment; or

  • Voluntarily withdraws from the program.

The customer is under age 19 when approved or renewed.

12 months

  • Dies;

  • Reaches age 19;

  • Moves out of state;

  • Cannot be located and mail is returned to the agency as undeliverable;

  • Becomes eligible for SSI Cash or ALTCS and approved in error [manual process];

  • Was approved or renewed in error; or

  • Voluntarily withdraws from the program.

The customer is under age 19, currently in KidsCare, and cascading into a higher medical eligibility program 

12 months. The effective start date and the renewal date will be reset and align the Medicaid Renewal date for all household members.

NOTE     This does not apply to MSP programs, Medicaid programs where the customer does not meet the age requirement, SSI-MAO and Specialty Categories (DAC, PICKLE), YATI, and TMA 
 

  • Dies

  • Reaches age 19;

  • Moves out of state;

  • Was approved or renewed in error;

  • Voluntarily withdraws from the program; or

  • Is a DCS customer.

 

See How to Disenroll A Customer During a Guaranteed Enrollment Period (Continuous Eligibility Period or CE)

 

Definitions

Term

Definition

Guaranteed Enrollment Period

A period of enrollment that continues even when the customer no longer qualifies for AHCCCS or KidsCare for certain reasons.

 

Legal Authority

Program

Legal Authorities

All Programs (except MSP and KidsCare)

42 USC 1396a(e)(12)

AAC R9-22-1705

KidsCare

42 USC 1397gg(e)(1)

AAC R9-31-307