Form DE-103 Application for Ahcccs Health Insurance and Medicare Savings Programs - Arizona

What Is Form DE-103?

This is a legal form that was released by the Arizona Health Care Cost Containment System - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is form DE-103?
A: Form DE-103 is the application for Ahcccs Health Insurance and Medicare Savings Programs in Arizona.

Q: What is Ahcccs?
A: Ahcccs stands for Arizona Health Care Cost Containment System, which is Arizona's Medicaid program.

Q: What are the Medicare Savings Programs?
A: The Medicare Savings Programs help eligible individuals pay for their Medicare premiums, deductibles, and co-insurance.

Q: Who can apply for Ahcccs Health Insurance and Medicare Savings Programs?
A: Residents of Arizona who meet the eligibility requirements can apply for Ahcccs Health Insurance and Medicare Savings Programs.

Q: What information do I need to provide on Form DE-103?
A: Form DE-103 requires information about your household, income, assets, medical expenses, and other relevant details.

Q: How do I submit the completed Form DE-103?
A: You can either mail the completed form to the address provided on the form or submit it in person to your local Ahcccs office.

Q: What happens after I submit Form DE-103?
A: After you submit Form DE-103, Ahcccs will review your application and determine your eligibility for the Health Insurance and Medicare Savings Programs.

Q: How long does it take to hear back from Ahcccs after submitting Form DE-103?
A: The processing time for Form DE-103 may vary, but Ahcccs will notify you of their decision within 45 days of receiving your application.