|
Please call 873-5042 to schedule an
appointment. Walk-in enrollment assistance is available every
Wednesday from 1 to 4 pm.
| Family Size |
Count each child, their parent(s) and/or
step-parent(s) living in the home. If someone is
pregnant, count each unborn child |
Each Added Person |
Gross Monthly
Income |
1 |
2 |
3 |
4 |
5 |
6 |
| $1,805 |
$2,428 |
$3,052 |
$3,675 |
$4,298 |
$4,922 |
$600 |
INCOME LIMITS GOOD THROUGH APRIL 1, 2010
You must bring all required
documents to process your application:
- Proof of child care expenses
- Proof of address-one utility bill
- All household income for last month and current month.
Such as wages, child support, social security,
self-employment
- Original birth certificates and Social Security cards
for children and adults applying
- Proof of citizenship/immigrant status for all applicants
- A copy of current health insurance ID cards
- State issued ID’s, children’s vaccine records or school
ID’s
- Proof of pregnancy (if applicable)
If interested in applying online:
https://www.healthearizona.org
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