Mercy Care is a managed care organization that serves individuals across Arizona.
As part of Arizona’s Medicaid program, AHCCCS (Arizona Health Care Cost Containment System), Mercy Care coordinates physical, mental, and behavioral health services for eligible members.1
They aid diverse populations, like low-income individuals, seniors, and those with disabilities, to get access to medical treatment, mental health support, and substance abuse programs.
If you’re an Arizona resident looking for affordable healthcare, you might ask, “What is Mercy Care?” Here’s what you need to know.
Who is Eligible for Mercy Care?
Before you can take advantage of the services available through Mercy Care, you must enroll in Arizona’s Medicaid program, AHCCCS.
Mercy Care serves primarily low-income individuals, including children, seniors, and people with disabilities who need long-term care.
Eligibility is based on income, residency in Arizona, and specific health needs.
If you need help with physical, mental, or behavioral health services or long-term care support, you may be eligible for Mercy Care.
If you meet AHCCCS eligibility requirements, you can access a range of services tailored to your needs.
Find Treatment Covered by Mercy Care
Explore residential, outpatient, and virtual pathways to addiction treatment and mental health recovery in Arizona.
Eligibility Based on Age
Mercy Care serves all ages, with programs specific to children, adults, and the elderly.
For children, Medicaid programs like KidsCare provide medical services to low-income families so their children receive preventive care, immunizations, and treatment for illnesses.
Adults with disabilities or chronic conditions may qualify for AHCCCS and get comprehensive care that includes mental health and substance abuse services.
The elderly may qualify for long-term care and get support to manage chronic health conditions, receive home-based services, or live in assisted living facilities.
Through Mercy Care, each age group has options to fit their needs.
Eligibility Based on Income
Income is a factor in determining eligibility for Mercy Care services as they are provided through Arizona’s Medicaid program, AHCCCS.
To qualify for Medicaid or state health programs, you must meet income guidelines, which vary based on family size and other factors.
Your household income must fall within specific income levels based on federal poverty level (FPL) guidelines.
- For adults: The income limit is 138% of the FPL. In 2024, that’s an individual earning less than $20,783 a year or a family of four earning less than $41,400.2
- For children: Programs like KidsCare cover children from families earning up to 200% of the FPL. That’s a maximum income of $60,000 for a family of four.
- For elderly and disabled: Those requiring long-term care may have slightly different thresholds but must still meet income limits based on AHCCCS guidelines.
These income brackets ensure that those with the greatest financial need can access healthcare services through Mercy Care.
Other Eligibility Factors
In addition to income and age, other factors can qualify you for Mercy Care services.
For example, pregnant women qualify for coverage for prenatal and postpartum care.3
People with chronic health conditions like diabetes, heart disease, or asthma may also qualify for specialty care and ongoing management through Mercy Care.
Mercy Care offers long-term support services to help people with disabilities or special needs manage daily living and health needs.
Mental health and substance abuse treatment are also part of Mercy Care.
So, if you’re struggling with behavioral health conditions, you have access to full care, including counseling, medication management, and rehabilitation services.
These factors, along with income and residency criteria, ensure that disadvantaged Arizonans’ health care needs are covered.
Check your Eligibility
If you think you may be eligible for Mercy Care, check your eligibility through Arizona’s AHCCCS system. Keep your documents up to date and communicate with your healthcare provider to make sure you’re getting the coverage you need. Mercy Care offers many services, so feel free to explore all of them.
Is Mercy Care Part of AHCCCS?
Yes, Mercy Care is a contracted health plan in Arizona’s Medicaid system known as AHCCCS.
Mercy Care is one of several health plans available to AHCCCS members.
It provides access to services covering various aspects of healthcare, including physical health, mental health, and long-term care.
Individuals applying for health insurance through AHCCCS can choose Mercy Care as their health plan, and through this managed care organization, they can receive covered services.
At Mercy Care, members are given a doctor network, specialists, hospitals, and other healthcare providers to ensure their best interests and clinical needs have been considered.
Since Mercy Care is thoroughly integrated with AHCCCS, the healthcare service provided to the members is complete and fully serves each individual’s needs.
Is Mercy Care Medicaid?
Mercy Care is not Medicaid itself but a health plan in the Medicaid system through Arizona’s state program, AHCCCS.
In essence, while Medicaid is a federal government program (subsidized at the same time by the states to provide healthcare to low-income people), every state operates its own different Medicaid system.
Mercy Care is one of the several managed care providers for AHCCCS that covers doctor visits, hospital care, mental health, and long-term care for those eligible for membership.
In other words, Mercy Care offers Medicaid benefits for Arizona residents but is not the program itself.
What Does Mercy Care Cover?
Mercy Care covers a wide range of healthcare services, including:
- Primary care services, such as routine doctor visits, preventive care, and vaccinations
- Behavioral health services, including counseling, therapy, and medication management
- Addiction treatment services, including substance abuse treatment programs, rehabilitation, and ongoing support
Mercy Care Coverage: At a Glance
Mercy Care covers many essentials.
Here’s a quick list of their main services available:
- Routine and preventive doctor visits
- Prescription medications for various conditions
- Behavioral health services like therapy, counseling, and medication management
- Hospital care (inpatient and outpatient)
Substance abuse treatment (detox and rehab) - Long-term care for seniors and individuals with disabilities (home care and assisted living)
- Transportation to medical appointments for those who need help with that
- Case management for complex health needs
- Rehabilitation (physical and occupational therapy)
This coverage means that Mercy Care members get the support they need for both short-term and long-term health issues.
Frequently Asked Questions
What is Mercy Care and how does it work?
Mercy Care is a managed care organization that serves AHCCCS members in Arizona. It provides physical health, mental health, and behavioral health services to eligible individuals. Members choose Mercy Care as their health plan to see a network of providers.
Who is eligible for Mercy Care?
To be eligible for Mercy Care you must be an AHCCCS member and meet the income, residency, and other eligibility requirements set by the state. Mercy Care serves low income families, pregnant women, children, the elderly, and people with disabilities. Eligible AHCCCS members can choose Mercy Care as their provider.
What services are covered?
Mercy Care covers primary care, behavioral health services, addiction treatment, hospital care, prescription medications, and long-term care. It also covers specialty care for mental health and substance use disorders. Coverage varies by individual and program, so be sure to check your plan for a full list of services.
Key Takeaways
- Key Takeaways
- Mercy Care is a managed care organization with AHCCCS, Arizona’s Medicaid program.
- Eligibility is based on age, income and health status, with different programs for children, adults and the elderly.
- Physical health coverage, behavioral health coverage, long-term care and more.
- Professional help through Cornerstone Healing Center’s programs covered by Mercy Care.
Comprehensive Care Through Mercy Care
Mercy Care is a lifeline for Arizonans who need access to medical and behavioral health services.
From routine doctor visits to long-term care and mental health support, Mercy Care makes sure its members get the healthcare they need to live healthier lives.
Cornerstone Healing Center is a provider under Mercy Care and offers specialized mental health and addiction treatment services.
Our programs are designed to support individuals on their recovery journey with personalized care in a safe and supportive environment.
If you or a loved one are seeking treatment under Mercy Care, contact us to learn more about the programs we offer.
Let’s get you started on the healing process.
