Application Requirements

To qualify for KidsCare you must:

• Be a resident of Arizona
• Be 18 years old or younger
• Be a U.S. citizen or a qualified eligible immigrant - regardless of the status of the parents
• Not currently be covered by other health insurance
• Not qualify for coverage through a state agency employee
• Be a member of a household that meets the KidsCare income guidelines
• Be a member of a household that is willing to pay a premium

Income Limits

Depending on your family size and income, you may qualify for KidsCare or AHCCCS (Medicaid). KidsCare applications are screened first for AHCCCS and then KidsCare. If you or your child qualifies for AHCCCS, your application will be sent to the Department of Economic Security and they may ask you for more information.

Family Income Limits

May Qualify for AHCCCS (Medicaid, with no monthly premium)			May Qualify for KidsCare
Family Size	Monthly Family Income	Annual Family Income	Monthly Family Income	Annual Family Income
1	$867	$10,400	$1,734	$20,800
2	$1,167	$14,000	$2,334	$28,000
3	$1,467	$17,600	$2,934	$35,200
4	$1,767	$21,200	$3,534	$42,400
5	$2,067	$24,800	$4,134	$49,600
6	$2,367	$28,400	$4,734	$56,800

This chart shows how much your family can make in gross monthly income, which is all the money your family gets during a calendar month, before any taxes or deductions. If you are paid weekly, KidsCare counts 4.3 times your gross weekly pay. If you are paid every other week, KidsCare counts 2.15 times your gross biweekly pay.

Proof

All applicants must provide proof of information given on the application.

To speed up the processing of your application, send the information listed below with your application:

• If you are working for someone other than yourself, include copies of check stubs or a letter from employer showing your gross earnings last month and this month. If someone listed on the application lost a job within the last two months, send proof of the last day worked and the gross amount of the last check received.
• If you are self-employed, include copies of current Federal tax forms: 1040, SE and applicable schedule C, C-EZ, E, F, K-1, etc. or proof of business income and expenses for the last calendar month.
• Other Income: Include proof of any other income or money your family got from anyone for any reason, this month and last. This includes award letters from the Division of Child Support Enforcement, Social Security Administration, Unemployment Insurance, Veterans Administration, Railroad Retirement, or other retirement or disability pension.
• Health Insurance: Include copies of insurance cards for persons who are applying but who already have health insurance, or attach a piece of paper that lists the company name and policy number.
• Citizenship: KidsCare will need to see the original document for persons applying who are U.S. citizens, such as a birth certificate, U.S. passport, etc.
• Immigration Status: Copies of both sides of immigration documents for persons who are applying. Receiving KidsCare/AHCCCS will not affect anyone's immigrant status.
• Daycare: Proof of the amount of money paid for the care of a child or an incapacitated adult.

Health Plan

When you fill out the application for KidsCare you must choose a health plan.