AHCCCS NOTICE: Continuity of Care for Members Who Lose AHCCCS Coverage
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Governs limited continuity of care rights for members who lose AHCCCS coverage and enroll in a new health plan in Arizona; explains eligibility (life‑threatening condition or third trimester pregnancy), required member/provider actions, and duration limits.
No material clinical or coverage changes in this revision.
Continuity of Care Eligibility and Requirements
Eligibility and requirements for continuity of care
Continuity of care is available to new members who meet one of the following conditions at the effective date of enrollment and who submit a written request:
ANY of the following
Life‑threatening disease or condition (ELIGIBLE)
- Member submits a written request to the new health insurance plan to continue an active course of treatment.
- Previous provider agrees in writing to accept payment at the rates of the new health insurance plan.
- Previous provider agrees in writing to the new health insurance plan's other requirements for continuity of care.
Member is in the third trimester of pregnancy on the effective date of enrollment (ELIGIBLE)
- Member submits a written request to the new health insurance plan to continue an active course of treatment.
- Previous provider agrees in writing to accept payment at the rates of the new health insurance plan.
- Previous provider agrees in writing to the new health insurance plan's other requirements for continuity of care.
Provider Acceptance and Agreement Requirements
Provider must agree in writing to accept new plan rates and requirements
Continuity of care will only be provided if the previous provider signs a written agreement to accept payment at the new health plan’s rates and to comply with the new plan’s other requirements for continuity of care.
- Provider must agree in writing to accept payment at the rates of the new health insurance plan.
- Provider must agree in writing to the new health insurance plan’s other requirements for continuity of care.
Key Definitions
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