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 The name of the member for whom AHCCCS medical coverage is being withdrawn.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.