B Premium Billing and Payment

 

 

Revised 11/06/2020

Policy

The AHCCCS Division of Business and Finance (DBF) sends a bill for the premium to the customer on the first day of each month. If the first day of the month is a weekend or holiday, the bills are mailed on the first workday of the month.

The billing statement notifies the customer of:

 

1) When Are Premium Payments Due?

Premiums are prospective. This means:

If a payment is not received by the 15th of the month, it is considered late.

 

2) How Can Payments be Made?

The customer or anyone else may pay the premium by:

Payments can be made online using AHCCCS’ Online Premium Payment service or can be mailed to the following address:

STATE OF ARIZONA AHCCCS

File 749228

Los Angeles, CA 90074-9228

Important! When mailing a payment, it may take five to seven days to be processed and credited.

Payments may be made in advance. For example, the customer may pay quarterly, bi-annually or annually.

If you receive a premium payment in the mail, immediately bring it to the Division of Business and Finance (DBF) in the 701 building.

See How to Locate Household Account Balances for information on the household’s account balance or last payment received.

 

3) Premium Payment During an Appeal Process

When an AHCCCS FTW customer with a premium wants to have AHCCCS Medical Assistance continued during the appeal process, the customer must:

Premium Payment During an Appeal Process Example

 

4) Appeal of the Premium Amount

If the customer appeals the amount of the premium for an FTW approval, the customer must pay the assessed premium throughout the hearing process.

If a customer appeals an increase in the AHCCCS FTW premium and the appeal request is received prior to the effective date of the premium increase, the premium amount is decreased to the lower amount until a hearing decision is made.

 

5) When Are Changes in the Premium Amount Effective?

A decrease in a customer’s premium is effective the month after proof of the income or Impairment Related Work Expenses (IRWE) change is provided.

An increase in a customer’s premium is effective the first month after a 10-day advance notice is sent to the customer. When there are less than 10 days before the first day of the next month, the premium is increased the first day of the month after that.

See Freedom to Work (FTW) Premium Begin Date Examples for examples of when a change in premium begins.

See How to Do a Premium Adjustment Due to Untimely Processing for instructions on adjusting the premium when the change is processed untimely.

 

Definitions

Term

Definition

Impairment Related Work Expenses (IRWE)

The cost of services and items that a person needs in order to work because of a physical or mental impairment.

 

Legal Authority

Program

Legal Authorities

AHCCCS FTW

FTW-ALTCS HCBS

42 USC 1396a(a)(10)(A)(ii)(XV) and 42 USC 1396a(a)(10)(A)(ii)(XVI)

ARS 36-2929 and ARS 36-2950

AAC R9-22-1909