What to bring
With you to HFINAZ
You will need to provide the following proof for yourself and all other people living with you.
- Wages: Copies of check stubs or statement from employer showing your gross earnings.
- Self-Employment: 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.
- Other Income: Proof of any other income or money received from any source or for any reason.
- Health Insurance: A copy of insurance ID cards for persons who are applying for medical benefits but who are currently covered by health insurance.
- Citizenship: Original citizenship documents for persons who want medical coverage. All applicants declaring U.S. citizenship must provide proof of citizenship and identity.
- Immigration Status: Documents from the United States Citizenship and Immigration Service (USCIS), formerly INS, for all persons with a legal immigration status. You may apply even if you do not have a USCIS/INS document, but if you are eligible for AHCCCS, coverage will be limited to emergency services.
- Daycare: Proof of amount billed for the care of a child or incapacitated adult so an adult in the household can work.
- Child Support: Proof of court ordered support expenses paid by an adult in the household. Proof of child support income received for children.
- Shelter and Utility: Proof of shelter and utility expenses (example: rent, mortgage, homeowner’s fees, property taxes, home insurance when separate from mortgage, gas used for heating, propane, other fuel, electric, water, garbage, sewer, telephone, etc).
- Medical Expenses: Proof of recurring medical expenses for anyone in the household age 60 and older, blind, or disabled. Social Security Number: Immigrants who are not legally able to obtain a Social Security Number are not required to provide one. All other applicants must either:
- Provide a verified Social Security number (SSN)
- Provide proof that an application for a number or a replacement card has been submitted to the Social Security Administration (SSA)
- Neither AHCCCS nor the DES office use the Social Security number as the ID number. AHCCCS and the DES offices use your Social Security number:
- For computer matching with other state and federal agencies
- To find out about income and Medicare coverage
- To assure that a person is not approved for benefits more than once at the same time
What if an applicant needs help obtaining documentation?
For Birth Certificates (born in Arizona): AHCCCS and DES can help verify Arizona births with specific information. Contact the local office for further information.
For Birth Certificates (born outside Arizona): Contact Vital Records in the state of birth. For state contact information go to http://www.cdc.gov/nchs/w2w.htm.
For Naturalization Documents: Contact the USCIS on the web at http://www.uscis.gov, or by phone at 1-800-375-5283.