Apply for AHCCCS Health Insurance/KidsCare
You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). You can apply for yourself, your family, or someone close to you.
Note: Health-e-Arizona Plus is offered in both English and Spanish.
Print an Application
Click on the link to DES below if you (or the person you are applying for) are one or more of the following:
- An adult without children
- A pregnant woman
- A family with children
- A child only
You can use one application to apply for AHCCCS Medical Assistance for everyone in your household. Applications for AHCCCS Health Insurance are available on the Department of Economic Security (DES) Application page:
Click on the link to the application below if you (or the person you are applying for) are one or more of the following:
- 65 years of age or older
- An individual who is blind or disabled
- A working individual with a disability (Freedom to Work)
- An individual that wants help with Medicare costs only
The application below is to apply for AHCCCS Health Insurance and/or Medicare Costs Sharing programs. To open the form so you can print it, click on the link below.
Note: This application process does not apply for individuals who are in need of Arizona Long Term Care System (ALTCS) services, such as in home healthcare, nursing facility, or assisted living. To apply for Long Term Care, contact one of our ALTCS offices .
Adobe Acrobat Reader is required to view PDF files. This is a free program available from the Adobe web site . Follow the download directions on the Adobe web site to get your copy of Adobe Acrobat Reader.