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What is Mercy Care ACC‑RBHA with SMI?
What is Mercy Care ACC‑RBHA with SMI?
This is short for Arizona Health Care Cost Containment System (AHCCCS) Complete Care Regional Behavioral Health Agreement. This plan provides physical and behavioral health care coverage. We serve people with a serious mental illness (SMI) designation (PDF). Our service area includes Maricopa, Pinal and Gila counties. It doesn’t include ZIP codes 85542, 85192 and 85550.
What is AHCCCS?
AHCCCS is short for Arizona Health Care Cost Containment System. It’s the Medicaid agency that serves people who live in Arizona. You’ll see it written as “AHCCCS.” And people call it “access.” AHCCCS offers health services to people who meet certain income and other requirements.
How to qualify
To get services from Mercy Care ACC-RBHA with SMI, a person must have both:
- An SMI designation (PDF)
- A functional impairment as a result of the SMI designation
A functional impairment means a person:
- Can’t live in an independent or family setting without supervision
- Is seriously disruptive to their family or community
- Can’t function well at work or in school
- Is at risk of getting worse
Behavioral health providers must screen people for SMI. Adults must get screening for SMI regularly if they receive:
- General mental health services
- Substance use services
People must be at least 17 and a half years old to have an SMI screening.
A person’s guardian or legal representative can ask for SMI screening.
A hospital can also ask for a screening. This is an urgent referral and the contracted provider must screen for SMI within 24 hours.
- A primary care physician (PCP) for a referral
- A behavioral health home
- Providers must screen within 7 business days of the SMI determination referral request.
- Providers send their SMI evaluation packets to one of the groups that determines SMI for the final SMI determination.
- People receive written notice of the decision within 3 business days of the first screening. The notice has info about the right to appeal the decision.
Apply for benefits
You must be a member of the Arizona Health Care Cost Containment Health System (AHCCCS) to get benefits and coverage from Mercy Care ACC-RBHA with SMI. You can apply for AHCCCS for yourself, your family or someone close to you:
Online: Visit at Health-e-Arizona Plus (English and Español). Choose “APPLY ONLINE.”
By mail: Visit the AHCCCS website, download and print the form. See the steps under “Print an Application.” Then, mail it to:
Arizona Department of Economic Security
Family Assistance Administration
PO Box 19009
Phoenix, AZ 85005-9009
Learn more about Mercy Care ACC-RBHA with SMI.
If you don’t qualify for AHCCCS
You may still be able to get treatment. Learn about the mental health block grant (MHBG).
- Indian Health Services Facilities
- Tribally Operated 638 Health Care Facilities
- Urban clinics: Urban Indian Health Programs
Need to switch health plans? Visit the AIHP.
Need help with general questions? You can also email Tribal Relations.
Check your status
The decision on your health coverage can take up to 90 days. You’ll get a letter from AHCCCS with either:
- Approval of your application and next steps
- Denial of your application and info about how to appeal the decision
You can check the status of your application:
Online: Creating an account at Health-e-Arizona Plus (English and Español) allows you to:
- Apply for coverage online (faster than printing and mailing the form)
- Check your eligibility status
- See letters and messages
- Print forms
- Manage your benefits
Watch your mail
Your coverage starts as soon as the state approves your application. You’ll get a Mercy Care welcome packet and member ID card in the mail.
No longer qualify for health benefits?
You may still qualify to get treatment for mental health, drugs or alcohol use. Certain state and federal grants cover treatment. To learn more, call us at 602-586-1841 or 1-800-564-5465 (TTY 711). You can also check “grants for treatment” under the health and wellness tab at the top of this page.
Need language help?
You can get all our printed materials in other formats. You pay nothing for these materials. This includes your member handbook and provider directory. You can also get info in languages other than English. Call us at 602-586-1841 or 1-800-564-5465 (TTY 711).
Learn more about language help.