Ariz. Admin. Code § R9-22-314 - Withdrawal from AHCCCS Medical Coverage
A. A member may withdraw from AHCCCS medical
coverage at any time by giving oral or written notice of withdrawal to the
Administration or its designee. The member or the member's legal or authorized
representative shall provide the Administration or its designee with:
1. The reason for the withdrawal,
2. The date the notice is effective,
and
3. The name of the member for
whom AHCCCS medical coverage is being withdrawn.
B. If a notice of withdrawal does not
identify specific members the Administration or its designee shall discontinue
eligibility for any members that the person submitting the withdrawal has legal
authority to act on behalf of.
C.
The Administration or its designee shall notify the member of the
discontinuance as required by
R9-22-312.
Notes
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