American Indian Health Plan (AIHP) in AHCCCS: Enrollment and Coverage

The American Indian Health Program, known as AIHP, is a fee-for-service health coverage option inside AHCCCS (Arizona’s Medicaid program) built for American Indian and Alaska Native members. Instead of being placed in a managed care plan with a fixed network, AIHP members can see any AHCCCS-registered provider, including Indian Health Service facilities, tribally operated 638 programs, and urban Indian health clinics, without a referral.¹²

Who Qualifies

You must be American Indian or Alaska Native and already enrolled in AHCCCS or KidsCare. There is no separate AIHP application; the initial AHCCCS application works the same as it does for any other Arizonan.³ Once you have AHCCCS, choosing AIHP over a managed care plan requires proof of tribal membership or enrollment in a federally recognized tribe. The list of acceptable documents is on page two of the AIHP-002 form, and AHCCCS asks that you send copies rather than originals.¹

One income note matters at the AHCCCS application stage. Tribal gaming per capita payments count as taxable income under the Modified Adjusted Gross Income rules used to decide Medicaid eligibility. Non-gaming per capita payments, income from trust lands, and Bureau of Indian Affairs scholarships are excluded from the MAGI calculation.⁴ For KidsCare, Indian Trust income does not count toward household income at all.⁵

How to Enroll in AIHP

Two paths get you into AIHP. You can submit the AIHP-002 member change request yourself along with your tribal documentation. Or an IHS Benefit Coordinator or Patient Enrollment Specialist at an Indian health facility can submit the AIHP-001 form on your behalf. Changes usually process within 24 to 48 business hours.¹

You can also request enrollment changes through Health-e-Arizona Plus online, or by calling AHCCCS at 602-417-7000 in Maricopa County or 1-800-962-6690 statewide.⁶

AIHP or an AHCCCS Complete Care Plan

American Indian and Alaska Native members have a choice most AHCCCS members do not: AIHP’s fee-for-service model, or an AHCCCS Complete Care (ACC) managed care plan. You can switch between the two at any point in the year. Members in an ACC plan who want to move to a different ACC plan can only do that once a year.⁷

Under AIHP, the AHCCCS Division of Fee-For-Service Management functions as the health plan and pays providers directly. You can see any AHCCCS-registered provider that has not opted out of fee-for-service, no referral required.² Under an ACC plan, your care runs through that plan’s contracted network, but you still keep the right to walk into any IHS or tribal 638 facility for care.⁷

Both options provide integrated physical and behavioral health care, including Children’s Rehabilitative Services. If you have a Serious Mental Illness designation, your behavioral health care comes through a Regional Behavioral Health Authority no matter which option you pick; the AIHP/ACC choice only affects your physical health coverage.⁷

What AIHP Covers

AIHP covers medically necessary preventive, acute, and behavioral health care, on the same scope as AHCCCS generally, with features specific to the American Indian population.

Preventive Care and Screenings

Covered services include annual physicals; mammograms, Pap tests, colonoscopies, and PSA tests; and screening for heart disease, high blood pressure, high cholesterol, HIV and other sexually transmitted infections, and tuberculosis. Immunizations covered range from routine childhood vaccines to influenza, COVID-19, pneumococcal, hepatitis A and B, HPV (ages 9 to 26), and shingles vaccines for adults 50 and older.⁸

Dental, Vision, and Pharmacy

Children under 21 receive dental checkups, screenings, and follow-up care under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, which also covers vision screening. For adults, medically necessary eyeglasses require prior authorization. Pharmacy covers medications for family planning, prenatal care, and general treatment of illness.⁸ The 2022–2027 Section 1115 waiver renewal removed a prior cap on adult dental services for AI/AN members served by IHS and tribal 638 facilities.⁹

Behavioral Health and Crisis Services

AIHP members can receive mental health and substance use services at any IHS or tribal 638 facility. If you live in an area served by a Tribal Regional Behavioral Health Authority (TRBHA), you can route your behavioral health care through that authority. Five TRBHAs operate in Arizona under intergovernmental agreements with AHCCCS: the White Mountain Apache Tribe, the Colorado River Indian Tribe, the Pascua Yaqui Tribe, the Navajo Nation, and the Gila River Indian Community.¹⁰ TRBHA services include individual, group, and family counseling, inpatient and crisis services, medication monitoring, psychosocial rehabilitation, and respite care. No physician referral is needed.¹¹

Crisis services are open to anyone in Arizona, 24 hours a day, regardless of insurance. Tribal-specific crisis lines include the Tohono O’Odham Nation (1-844-423-8759), Gila River and Ak-Chin Indian Communities (1-800-259-3449), Salt River Pima Maricopa Indian Community (1-480-850-9230), and northern Arizona tribal communities (1-833-990-6400). A Tribal Warm Line is available at 1-855-728-8630.¹²

Transportation

AIHP covers non-emergency medical transportation when you have no other way to get to appointments. You call your health plan’s member services line to arrange a ride. For trips to IHS or tribal 638 providers, roundtrip ground transportation of 100 miles or less does not require prior authorization, and IHS/638 facilities are exempt from the authorization rules that apply to longer trips.¹³

Traditional Healing

Starting October 1, 2025, Arizona began reimbursing traditional healing practices through Medicaid, joining California, Oregon, and New Mexico. CMS approved the coverage through a Section 1115 waiver amendment in October 2024.¹⁴ Covered services can include ceremonial consultations, traditional counseling, and sweat lodge sessions. Practitioners must be employed by or contracted with an IHS or tribal 638 facility, and each facility, working with its tribal community, decides which specific practices are eligible for reimbursement.¹⁵

What You Pay

Nothing, in almost every case. American Indian members who are active or prior users of IHS, tribal 638 health programs, or urban Indian health programs are exempt from all AHCCCS copayments. No mandatory or optional copays apply.¹⁶ Enrolled tribal members also pay nothing for KidsCare and are exempt from KidsCare waiting periods when they receive care at IHS or tribal facilities.⁵

When You Still Need Prior Authorization

AIHP members don’t need referrals, but some services need prior authorization. Under AHCCCS Medical Policy Manual Chapter 820, services from IHS and 638 facilities are generally exempt, and so are emergency services. For non-IHS providers, authorization is required for categories including elective hospital admissions, behavioral health inpatient stays, cochlear implants, home health beyond the first five post-discharge visits, hysterectomies, genetic and biomarker testing, and orthotic or prosthetic devices costing more than $300.¹⁷

The American Indian Medical Home

AIHP members can also opt into the American Indian Medical Home (AIMH), a voluntary primary care case management program at participating IHS and tribal 638 facilities. AIMH adds diabetes education, care coordination, and a 24-hour call line. Enrollment is free and does not change your AIHP coverage or provider options, and you can join, leave, or switch sites at any time.¹⁸

Nine facilities participate: Chinle Comprehensive Health Care Facility, Fort Yuma Health Center, Gila River Health Care, Parker Indian Health Center, Phoenix Indian Medical Center, San Carlos Apache Healthcare Corporation, Tuba City Regional Health Care Corporation, Whiteriver Indian Hospital, and Winslow Indian Health Care Center.¹⁸

If You Need Long-Term Care

AIHP is an acute care program. AI/AN members who need long-term care are served separately through the Tribal Arizona Long Term Care System if they live on a reservation, with case management handled under intergovernmental agreements between AHCCCS and individual tribes. Seven tribes run their own case management programs: Gila River Indian Community, Hopi, Navajo Nation, Pascua Yaqui, San Carlos Apache, Tohono O’Odham Nation, and White Mountain Apache. Members from 13 other tribes get case management through the Native American Community Health Center.¹⁹ AI/AN members in ALTCS, the foster care program (CMDP), and the developmental disabilities program do not switch between AIHP and ACC the way acute care members do.⁷

What H.R. 1 Changes for AI/AN Members

The One Big Beautiful Bill Act (H.R. 1), signed July 4, 2025, made broad Medicaid changes nationwide but preserved key protections for American Indian and Alaska Native populations.²⁰

Work and community engagement requirements for able-bodied Medicaid expansion adults without dependents take effect after December 31, 2026. AI/AN beneficiaries are explicitly exempt.
Most Medicaid expansion adults will face eligibility redetermination every six months instead of annually, but AI/AN members keep the standard 12-month schedule.
New cost-sharing rules for expansion adults with incomes above 100% of the federal poverty level begin in October 2028, but the existing federal prohibition on charging AI/AN members premiums, deductions, or similar fees stays in place.

Arizona had earlier sought its own work requirements through the “AHCCCS Works” 1115 waiver amendment, which would have exempted AI/AN members from community engagement conditions. That request was withdrawn after CMS issued a withdrawal approval letter in June 2021.⁹

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AHCCCS. AHCCCS Complete Care – American Indian
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AHCCCS. AHCCCS AIHP Guide
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AHCCCS. Section 1115 Waiver
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Gila River Health Care. TRBHA Member Handbook 2025
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Arizona Complete Health. Crisis Intervention Services
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AHCCCS. Non-Emergency Medical Transportation
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AHCCCS. AHCCCS Launches Traditional Healing Services
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AHCCCS. Traditional Healing FAQs
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AHCCCS. Copayments
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AHCCCS. AMPM Chapter 820 – Prior Authorization
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AHCCCS. American Indian Medical Home
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National Council of Urban Indian Health. Overview of the One Big Beautiful Bill Act Exemptions for AI/AN People