KidsCare - Arizona's Children's Health Insurance Program (CHIP) 3/19/10 10:08 AM

AHCCCS

KidsCare - Arizona's Children's Health Insurance Program (CHIP)

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Note: An enrollment cap is in place for the KidsCare Program due to a lack of funding. This means that we cannot
approve applications for KidsCare. However, you can still apply and be placed on a waiting list, and we will contact
you if funding becomes available.
If the child's income is too high for AHCCCS Health Insurance, the child may qualify for KidsCare at a low monthly
premium.

Who Can Receive Services

Income Limits
Premiums
Application Help
Additional Information

Who Can Receive Services

The applicant may qualify for this program if the applicant:

Is an Arizona resident
Is 18 years old or younger
Is an United States citizen or a qualified immigrant
Has a Social Security number or applies for one
To apply for a Social Security number visit the U.S. Social Security Administration
Make a copy of the form submitted as confirmation of applying for a Social Security Number
Is under the income limit
Is not currently covered by other health insurance
Does not qualify for coverage through a state agency employee
Is not eligible to receive AHCCCS (Medicaid) coverage
Is a member of a household that is willing to pay a premium

Income Limits
This chart shows how much money a person can receive each month before taxes (gross monthly income) and
other deductions are subtracted.
KidsCare Income Limits
May Qualify for AHCCCS
May Qualify for KidsCare
(Medicaid, with no monthly premium)
Family Size Monthly Family Income Annual Family Income Monthly Family Income Annual Family Income
1 $903 $10,830 $1,805 $21,660
2 $1,215 $14,570 $2,429 $29,140
3 $1,526 $18,310 $3,052 $36,620
4 $1,838 $22,050 $3,675 $44,100
5 $2,150 $25,790 $4,299 $51,580
6 $2,461 $29,530 $4,922 $59,060
Income limits change every April 1.
Premiums
KidsCare will cost no more than $50 a month for one child or no more than $70 a month no matter how many
children are in the household. Per federal law, Native Americans enrolled with a federally recognized tribe and
certain Alaskan Natives do not have to pay a premium. To get KidsCare at no cost, you must give us proof of tribal
enrollment.
KidsCare Premium Amounts
Monthly Income Less Monthly Income Greater Monthly Income Greater
Household
Than or Equal Than 150% But Less Than 175% But Less
Size
to 150% FPL Than or Equal to 175% Than or Equal to 200%
1 $0.00 - $1354.00 $1354.01 - $1580.00 $1580.01 - $1805.00

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KidsCare - Arizona's Children's Health Insurance Program (CHIP) 3/19/10 10:08 AM

2 $0.00 - $1822.00 $1822.01 - $2125.00 $2125.01 - $2429.00

3 $0.00 - $2289.00 $2289.01 - $2671.00 $2671.01 - $3052.00
4 $0.00 - $2757.00 $2757.01 - $3216.00 $3216.01 - $3675.00
5 $0.00 - $3224.00 $3224.01 - $3762.00 $3762.01 - $4299.00
6 $0.00 - $3692.00 $3692.01 - $4307.00 $4307.01 - $4922.00
Each Additional Add $467.00 Add $545.00 Add $623.00
Member
Monthly
One Child $10.00, More Than One Child $40.00, More Than One Child $50.00, More Than
Premium
One Child $15.00 One Child $60.00 One Child $70.00
Amount

Application Help
Many community organizations and clinics are willing to help with the AHCCCS application process. Help can
include answering your questions about the application, how your household information should be filled in, or what
proof is necessary to go along with the application.
Some organizations will help you with paper applications and some will use a web-based application tool called
Health-e-Arizona.
KidsCare Application Help by County [PDF, 154KB]
Additional Information
Please use the Applicants Menu on the left for information about how to apply, covered services, available health
plans, and additional resources. For other questions, please contact us.

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