AHCCCS Complete Care

Nothing is more important than the health and well-being of you and your baby. That’s why our plan benefits include: 

• Choice of Doctor. Find a doctor you trust in our network. 
• Prenatal Visits. Care for you before your baby is born.
• Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.

If you have asthma, diabetes or another long-term condition, you can depend on us. Our plan makes sure you get the care and services you need. Benefits include:

• Care Management. Personal support from an experienced professional as needed.
• Asthma Support. Individual care to help you control asthma or COPD as needed.
• Behavioral Health. Counseling, substance abuse counseling, and other treatments are covered.
  
• Medication Management
• Special Health Care Needs Care Coordination

We make sure the sight, smile and hearing of our members up to age 21 are at their best:

• Vision. Eye exams, frames and lenses including replacement and repair are covered. 
• Dental. We pay for cleanings, checkups and dental work for members through age 20*.
  
• Hearing. Tests, checkups and hearing aids are included.

*Members 21 and older have $1,000/year for emergency dental services. This benefit has limitations. Please refer to your Member Handbook for details.

Members recovering from a serious illness or surgery often need extra support. Our plan includes the care and equipment needed to recover safely at home. Benefits include:

• Equipment and Supplies. In-home medical and safety equipment are covered.
• Personal Care. Services to aid healing after illness or injury.

Sometimes you might need a little extra help using your health plan. For those times, you can rely on:

• Transportation. Our plan provides trips to and from medical and behavioral health visits or the pharmacy.
• Interpreters. An interpreter can go with you to medical and behavioral health visits.
• Language Help. Translated materials are available at no cost.
  
• Social Services. Sometimes a person's health and safety requires help from community programs. We help members connect to community services. Here they can get information about a variety of programs like:
  • Food and housing assistance.
  • Community child care.
• They can help members get much needed relief in many ways.
• Member Services. Our member services team can help answer questions. They are available Monday - Friday from 8a.m. - 5p.m.

Do you or your child have trouble managing COPD or asthma symptoms? A nurse who specializes in breathing issues can really help. Benefits include a customized treatment plan and medicine to: 

• Manage flare-ups.
• Reduce symptoms.
• Help you stay active.

Do you or a loved one have a serious health problem, a behavioral health issue, a substance abuse issue or a high-risk pregnancy? If so, our care managers are in your corner. They will:

• Explain medical terms in plain language. 
• Coordinate your doctor appointments.
• Provide your care team with your medical records. 

Your care manager will stay with you on your medical journey. He or she will:

• Think beyond your medical and behavioral health needs.
• Make sure you have support at home.

So you can focus on getting better.

Every member gets to choose a primary care physician (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.

If you don’t have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

• Preventive care.
• Treatment if you are sick or injured.
• Referrals to specialists for certain conditions.

Where you have your baby is an important choice. That’s why you can pick from nearly 100 in-network hospitals across Arizona. 

We encourage you to tour the hospital’s birthing center. This way you will be familiar with it. And you’ll be more relaxed when you have your baby.

We pay for cleanings, checkups and dental work for members through age 20. 

Exams and cleanings every six months help teeth and gums stay strong and healthy. If there is a dental problem that needs to be fixed, that’s covered as well.

Members 21 and older have $1,000/year for emergency dental services*.

*This benefit has limitations. Please refer to your Member Handbook for details.

Our plan covers medical equipment ordered by your doctor. This can include supplies like:

• Hospital beds.
• Oxygen tanks.
• Walkers or wheelchairs.

Trouble hearing can affect everyday life in many ways. Our plan includes services and support to help protect the hearing of members up to age 21.

We cover:

• Exams, therapy and tests.
• Hearing aids.

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

We will help you:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
• Get supplies, including breast pumps for nursing moms.
• Connect with community resources such as Women, Infants and Children (WIC) services.

Our plan covers:

• Nursing care.
• Supplies and equipment
• Treatments.
• Diagnostic tests and exams.

And after leaving the hospital, we make sure each member gets follow-up care, if needed, to continue healing at home.

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointment.

We also have people at member services who speak more than one language. Chances are, we have someone who speaks your language.

If your child is enrolled in the KidsCare program, they will have a monthly premium to pay. It is crucial to make this payment every month to ensure that your child continues to have their KidsCare health insurance coverage.

If you have any questions about premiums, please call the AHCCCS Premium Billing Center:

• Maricopa County: 1-866-771-2722
• Statewide:  1-844-846-7633

You can get information in your preferred language. Just ask. Then anything we write to you will only be in that language. This service is provided at no cost to you.  

Our plan includes prescription drugs and refills.

We also cover over-the-counter medicines with a written order from your doctor.

And we make getting your medicine easy. You can fill your prescriptions at:

• Local network pharmacies.
• Services that deliver right to your door.

Health insurance is complex. We can answer your questions simply and completely.

We help you find:

• Doctors.
• Pharmacies.
• Hospitals or other health facilities.
• Local resources.

We are concerned about how you feel. Behavioral health services can help you with personal problems that may affect you and/or your family. These problems may be stress, depression, anxiety or using drugs or alcohol.

AHCCCS Complete Care members assigned to UnitedHealthcare Community Plan will receive all of their health care from UnitedHealthcare Community Plan with the exception of the first 23 hours of crisis care. If you are experiencing a behavioral health crisis call one of the phone numbers below that matches the county you live in.

Crisis Hotlines by County:

Maricopa County: 602-222-9444 or 1800-631-1314

Cochise, Graham, Greenlee, La Paz, Pima, Pinal, Santa Cruz and Yuma Counties: 1-866-495-6735

Apache, Coconino, Gila, Mohave, Navajo and Yavapai Counties: 1-877-756-4090

Gila River and Ak-Chin Indian Communities: 1-800-259-3449

You may self-refer to a behavioral health provider.

Call the Nurse Line at 1-877-440-0255, TTY/TDD  711 anytime, 24 hours a day, 7 days a week.

A pregnancy is an incredible journey. It’s a journey you want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

At these visits, the clinic will:

• Make sure both you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

Members accessing behavioral health services can receive up to 600 hours per benefit year (October 1st through September 30th).

We help members connect to community services. Here they can get information about a variety of programs, like:  

• Food and housing assistance.
• Community child care.

They can help members get much needed relief in many ways.

If you need a ride to an appointment, ask a friend, a family member or neighbor first. If you cannot get a ride UnitedHealthcare Community Plan will help you. AHCCCS Complete Care members may receive non-emergency transportation services through UnitedHealthcare Community Plan for a physical or behavioral health AHCCCS covered service.

Children in the plan receive vision coverage up to age 21. This coverage includes:

• Regular exams.
• Frames and lenses.

This benefit is offered by Nationwide Vision.

Well visits with your doctor can help keep you healthy. These visits can catch health problems early so they can be treated. Preventive services include: 

• Checkups for adults and children.
• Well-baby care.
• Care for women expecting a baby.
• Routine shots and tests.
• Mammograms.

You will not have a copayment for preventive care.