FAA-0001A - Application for Benefits 2026

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The document is an application for benefits provided by the Arizona Department of Economic Security, specifically for programs under the Arizona Health Care Cost Containment System (AHCCCS). It outlines eligibility criteria and application procedures for various assistance programs, including health insurance, Medicare cost assistance, Nutrition Assistance (SNAP), Cash Assistance, and Tuberculosis Control. The document also provides information on how to apply online or in person, the importance of providing accurate information, and the rights and responsibilities of applicants. Additionally, it includes details about potential penalties for fraud and discrimination policies.

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Click 'Get Form' to open the FAA-0001A application in our platform.
Begin by filling out your contact information, including your name, address, and preferred language. Ensure all details are accurate.
In the 'Household Information' section, list all members of your household who are applying for benefits. Include their names, dates of birth, and Social Security numbers where applicable.
Proceed to the 'Income' section. Provide details about your household's income sources and amounts. Use our editor's features to easily input figures and make adjustments as needed.
Complete the 'Citizenship Information' section for each applicant. If necessary, attach proof of citizenship using our document upload feature.
Review all sections for completeness and accuracy before signing the application electronically within our platform.
Submit your completed application via email or print it out to send by mail or fax as instructed on the last page.

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Versions	Form popularity	Fillable & printable
2023	4.4 Satisfied (56 Votes)
2022	4.3 Satisfied (61 Votes)
2022	4.8 Satisfied (157 Votes)
2021	4.3 Satisfied (105 Votes)
2019	3.8 Satisfied (39 Votes)
2017	4.2 Satisfied (55 Votes)
2017	4.4 Satisfied (47 Votes)
2016	4.2 Satisfied (38 Votes)
2015	4.3 Satisfied (40 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I apply for Arizona Department of Economic Security Services?

The easiest way to apply for benefits is online through Health-e-Arizona Plus. You may also begin the application process by phone by calling 1-855-432-7587.

How to get cash assistance in AZ?

Complete and submit an online application through Health-e-Arizona Plus. Download the Application for Benefits - English (FAA-0001A) or Application for Benefits - Spanish (FAA-0001A-S) and turn it in by mail or fax. Call (855) 432-7587 to request a paper application be mailed to you.

Does Arizona have a medical assistance program?

The Arizona Health Care Cost Containment System (AHCCCS) is Arizonas Medicaid agency that offers health care programs to serve Arizona residents.

Do FAA employees get a pension?

How much does a Faa make in California? As of Sep 10, 2025, the average annual pay for a Faa in California is $34,298 a year. Just in case you need a simple salary calculator, that works out to be approximately $16.49 an hour. This is the equivalent of $659/week or $2,858/month.

What are the benefits of working for the FAA?

Federal Benefits It includes a variety of insurance, retirement, leave and flexible spending options for employees and their families. The comprehensive package is designed to provide employees with the tools and care they need to be happy and healthy at work and at home.

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What benefits do FAA employees get?

As a new employee of the FAA, you may be eligible to enroll in: Health Insurance. Dental and Vision Insurance. Flexible Spending Accounts. Life Insurance. Long Term Disability Insurance.

FAA-0001A - Application for Benefits 2026

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See more FAA-0001A - Application for Benefits versions

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Got questions?

How do I apply for Arizona Department of Economic Security Services?

How to get cash assistance in AZ?

Does Arizona have a medical assistance program?

Do FAA employees get a pension?

What are the benefits of working for the FAA?

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What benefits do FAA employees get?

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