How to Get Health Insurance in Arizona: AHCCCS and Marketplace Plans

To get health insurance in Arizona, you take one of two paths based on your income. If you earn up to about 138% of the federal poverty level — roughly $1,769 a month for a single adult in 2026 — you apply to AHCCCS, Arizona’s Medicaid program, which accepts applications year-round. If you earn more, you shop for a private plan on the federal marketplace at HealthCare.gov during open enrollment, and you may qualify for a tax credit that lowers your monthly premium.¹

Arizona does not run its own state exchange, so marketplace plans are sold through the federal site. Every pathway requires that you live in Arizona and are a U.S. citizen or qualified immigrant.²

Which Pathway Fits You

Your household income relative to the federal poverty level decides where you apply. The 2026 poverty level is $15,960 for a single person and $33,000 for a family of four, and each additional household member raises the ceiling.³

AHCCCS (Adults)

Adults 19 to 64 with income at or below 133% of the poverty level qualify, and a 5% income disregard effectively raises the functional limit to about 138%. You cannot be entitled to Medicare or eligible under another Medicaid category. If you are a parent applying for yourself, your children must have their own health coverage as a condition of your enrollment.² The AHCCCS income table for 2026 allows up to $2,399 per month for a two-person household and $3,658 for a four-person household.⁴

KidsCare (Children 18 and Under)

KidsCare is Arizona’s children’s health program for families whose income is too high for standard AHCCCS but who still need affordable coverage for their kids. The limit is about 200% of the poverty level, with the same 5% disregard pushing the effective ceiling a bit higher. Enrollment is open year-round, and you use the same portal as AHCCCS.⁵

Marketplace Plans With Subsidies

If your household income is between 100% and 400% of the poverty level — up to $63,840 for a single person or $132,000 for a family of four in 2026 — you can buy a marketplace plan and receive a premium tax credit.⁶ These plans must cover the ten essential health benefits and cannot turn you away for a pre-existing condition.

One boundary matters here: if your employer offers health insurance, you generally cannot get marketplace subsidies. The exception is when the employer plan is unaffordable, meaning your share of the cheapest employee-only premium exceeds 9.96% of your household income for plan years beginning in 2026.⁷

What to Gather Before You Apply

Having your paperwork ready shortens the application and reduces the chance of a hold on your file.

Social Security numbers for every household member applying. If you have applied for one but not received it, proof of the application works.⁸
Proof of Arizona residency. A current lease is preferred; a utility bill or Arizona driver’s license also works.⁹
Immigration documents if applicable — Permanent Resident Card (I-551), Employment Authorization Card (I-766), Departure Record (I-94), or foreign passport, among others.¹⁰
Income verification. Recent pay stubs for employees; the most recent federal tax return for self-employed applicants.¹¹
Employer plan cost. If your employer offers coverage, know the cost of the lowest-priced employee-only plan.

List every person in your tax household on the application, even those not seeking coverage, because household size sets the income limit that determines your eligibility.

Applying for AHCCCS or KidsCare

Apply online through the Health-e-Arizona Plus (HEAplus) portal, in English or Spanish. You can also call 1-855-HEA-PLUS (1-855-432-7587) weekdays from 8 a.m. to 5 p.m., or get in-person help from one of more than 150 community partner organizations across the state.⁵¹²

The state will decide your AHCCCS application within one of the following windows:¹³

Seven days if you are currently hospitalized
Twenty days if you are pregnant
Forty-five days for all other applicants

Watch your mail. If the agency needs more documentation, the notice will include a deadline. Miss it and your application can be denied.

Applying on HealthCare.gov

For a private plan, create an account at HealthCare.gov and complete the application there. The site often gives an eligibility determination right away. You sign electronically, confirming under penalty of perjury that the information is truthful, and you should save your confirmation number.¹⁴

Open Enrollment

For 2026 coverage, open enrollment runs from November 1, 2025, through January 15, 2026.¹⁵

Special Enrollment Periods

If you miss open enrollment, you have 60 days from a qualifying life event to sign up.¹⁶ Qualifying events include:¹⁷

Losing job-based coverage, aging off a parent’s plan at 26, or losing Medicaid or CHIP eligibility
Getting married or divorced, having or adopting a child, or a death in the family
Moving to a new ZIP code or county, including a move to Arizona from another state
Becoming a U.S. citizen, leaving incarceration, or gaining tribal membership

Expect to submit proof — a letter from your former insurer, a COBRA notice, an employer letter, or documentation from Medicaid or CHIP.

What Coverage Costs

AHCCCS Cost-Sharing

AHCCCS is not entirely free for everyone. Arizona law authorizes the following amounts, though whether you pay them depends on your specific eligibility category and income:¹⁸

Monthly premium of $15 per person, capped at $60 per household
$5 office visit copay
$10 urgent care copay
$30 emergency room copay
Prescription copay of $2.30 per fill¹⁹

Marketplace Premium Tax Credits

The premium tax credit works on a sliding scale, so lower-income households pay a smaller percentage of income toward premiums. In 2026, a household under 133% of the poverty level would pay about 2.10% of income, while one between 300% and 400% would pay up to 9.96%.⁷

You can take the credit in advance to lower your monthly bill or claim it on your tax return. If you take it in advance, you have to reconcile the amount on IRS Form 8962. Skipping that form can affect your future eligibility for credits.²⁰

After You Enroll

Report changes in income, household size, or address as soon as they happen.²¹ For marketplace enrollees getting advance credits, a change you don’t report can mean owing money at tax time or missing savings you’re entitled to.

Marketplace plans do not automatically renew on the same terms. If you have coverage in December and take no action by December 15, you may be auto-enrolled in the same or a similar plan, but the premium and subsidy amounts can change. Reviewing your options every year is the way to avoid surprises.²²

AHCCCS members go through an annual redetermination. The state tries to verify continued eligibility using data on hand and contacts you if it needs more information. Respond promptly to any renewal notice; ignoring it can create a gap in coverage.

If You’re Denied

You have appeal rights on both pathways.

For a marketplace decision, you have 90 days from the date of your eligibility notice to request an appeal through HealthCare.gov.²³ If the marketplace asked for documents to confirm information, sending them in can resolve the issue without a formal appeal. Miss the 90-day window and you can explain why when you file; extensions are possible.

For AHCCCS, federal Medicaid rules require states to give applicants and members at least 90 days from the mailing date of the notice of action to request a fair hearing.²⁴ Your denial notice will explain how to request a hearing and describe your right to continued benefits while the appeal is pending. For help, call AHCCCS at 602-417-4000 or 1-800-654-8713.¹²

No State Penalty for Being Uninsured

Arizona does not impose a penalty for going without health insurance, and the federal individual mandate penalty has been $0 since 2019. The reason to enroll is practical: an uninsured hospital stay or emergency can produce debt that lasts for years.

1
DIFI. 2026 Health Insurance Marketplace Open Enrollment
2
AHCCCS. AHCCCS Eligibility Requirements February 1, 2026
3
U.S. Department of Health and Human Services. 2026 Poverty Guidelines – 48 Contiguous States
4
AHCCCS. 615 Income Standards
5
AHCCCS. Apply for AHCCCS Health Insurance/KidsCare
6
Internal Revenue Service. Eligibility for the Premium Tax Credit
7
Internal Revenue Service. Revenue Procedure 2025-25
8
AHCCCS. 532 Social Security Number
9
Arizona Department of Health Services. Attachment B – Proof of Residency
10
AHCCCS. 524 Noncitizen Status – A Overview
11
AHCCCS. 605 Verifying Income
12
AHCCCS. AHCCCS Contacts
13
Arizona Department of Economic Security. How to Apply for Medical Assistance
14
Centers for Medicare & Medicaid Services. Reporting a Move
15
eCFR. 45 CFR 155.410 – Initial and Annual Open Enrollment Periods
16
eCFR. 45 CFR 155.420 – Special Enrollment Periods
17
HealthCare.gov. Qualifying Life Event (QLE)
18
Arizona Legislature. Arizona Revised Statutes 36-2903.01 – Additional Powers and Duties
19
AHCCCS. Copayments
20
Internal Revenue Service. About Form 8962, Premium Tax Credit
21
HealthCare.gov. Reporting Income, Household, and Other Changes
22
HealthCare.gov. Renew, Change, Update, or Cancel Your Plan
23
HealthCare.gov. What Can I Appeal?
24
eCFR. 42 CFR Part 431 Subpart E – Fair Hearings for Applicants and Beneficiaries