Arizona Medicaid Income Eligibility Overview
Arizona's Medicaid program, the Arizona Health Care Cost Containment System, offers coverage to various eligible groups, including parents, children, pregnant women, and individuals with disabilities. Income eligibility ranges from 120% to 160% of the federal poverty level and is funded through assessments, tobacco taxes, and state funds. The program follows ACA guidelines for expansion, with specific eligibility criteria for different categories. Benefit calculations and trend analyses provide insights into program spending and utilization trends.
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Arizona Medicaid Income Eligibility 1 160% 140% 120% Funded Through Assessment Funded Partially Through Tob. Tax and Tob. Settlement, Partially Through Assessment 100% Funded Through Tob. Tax and Tob. Settlement 80% Funded Through State Funds 60% 40% 1/ Excluding ALTCS 2/ Under the Affordable Care Act (ACA), "Parents" with incomes between 100 and 138% qualify under the new "Adults" category, along with Childless Adults. Only those who are under age 65 and not eligible for Medicare qualify for the expansion. 3/ Individuals who have Medicare coverage do not qualify for expanded coverage under the ACA. Individuals with disabilities under age 65 may qualify for ACA expanded coverage in the new "Adults" category before they become eligible for Medicare. 20% 0% Infants (0-1) Children (1-5) Children (6-18) Pregnant Women Parents 2/ Aged or w/ disabilities 3/ Childless Adults 1 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System Reaching across Arizona to provide comprehensive quality health care for those in need
Benefit Calculations Pulled FY 2011 IP and OP spend by hospital Prop 204 TANF Childless Adults TANF + CA between 19 and 64 w/o Medicare (to approximate Newly Eligibles) Total Spend converted to PMPM and adjusted for program changes, trended forward to State FY 14 and 15 2 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System Reaching across Arizona to provide comprehensive quality health care for those in need
Trend Analysis PMPM Trend from FFY11 to FFY14 FFY15 Trend IP OP IP OP Prop 204 TANF (8.82)% 2.38% 1.00% 3.00% Childless Adults (12.96)% 2.44% 1.00% 3.00% Newly Eligible (10.84)% 2.33% 1.00% 3.00% 3 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System Reaching across Arizona to provide comprehensive quality health care for those in need
Trend Analysis, ctd. Used budget assumptions for member months to apply monthly PMPM for: Prop 204 TANF CA Newly Eligibles Calculated estimated total IP & OP spend for FY 14 and FY 15 Applied per hospital proportions, by population 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System 4 Reaching across Arizona to provide comprehensive quality health care for those in need
