Health Care

Arizona Long Term Care System (ALTCS)

The Arizona Long Term Care System (ALTCS) is Arizona’s Medicaid funded program to provide long term care for elderly and disabled Arizona residents. While some people can afford to fund the costs of a nursing home or attendant care, many cannot. ALTCS is meant to help families who would otherwise be hard pressed to find ways to keep loved ones safe and cared for.

What are the Eligibility Requirements for the ALTCS? 

There are medical, residential, and financial eligibility requirements. The individual must be an Arizona resident. Applicants must be blind, aged, disabled or have developmental disabilities that prevent independent living. They must need nursing home level of care - this means they need assistance with meals, medications, bathing, dressing, and navigating their environment.

What are the Financial Eligibility Requirements? 

If the applicant is a single person, they can have “countable revenue sources” of no more than $2000. If the applicant is married, it is a bit more complicated. The spouse should review a Community Spouse Information Sheet. Countable revenue sources are:

  • Funds in checking, savings, and credit union accounts
  • Real Estate the applicant owns but does not live in (Rental property, vacation homes, commercial property etc.)
  • Cash value of whole life and universal life insurance policies. Term insurance has no cash value and would be unaffected.
  • Cash, stocks, bonds, bitcoin, certificates of deposit
  • Non-exempt vehicles

In addition to the type of assets listed above, ALTCS considers the applicant’s monthly income. Income includes, wages, Social Security Disability, Social Security Retirement, SSI, pensions from former employment, 401K income and the like. As of January 1, 2021, the allowable monthly income is $2,382. A disabled spouse is allowed to transfer up to $3216 per month in income to the healthy spouse to bring his or her income within the permitted limit.

Resources that are not “countable” and do not pose obstacles to eligibility include:

  • The house the applicant (and spouse) own and live in unless it is held in a trust.
  • One vehicle
  • Burial plots and irrevocable burial plans
  • The allowed sum of $1500 designated for burial
  • Household and personal belongings

How is Medical Eligibility Determined? 

Once ALTCS has determined the applicant is financially eligible for the ALTCS program, either a social worker or a registered nurse will meet the applicant and family in a face-to-face interview. Their goal is to determine if the applicant’s safety and well-being require immediate institutionalization in a nursing home setting. If the applicant has good mobility but requires care because of dementia or other intellectual disabilities, the interviewer will need to decide whether nursing home level care or intermediate levels are required for the patient. While the goal is to decide if the applicant needs nursing home or assisted living care, that does not mean the family will be forced to institutionalize their loved one. There are options for home care.

The social worker or nurse will ask questions in the interview designed to assess the applicant’s level of disability. If elderly, applicants must be over the age of 65 and either physically or mentally disabled and unable to care for themselves. The applicant is required to release relevant medical records to ALTCS to aid in the eligibility decision. The medical records are also needed to develop a care plan for the individual.

How do I apply for ALTCS? 

You can call the toll-free number for applications, information, and with questions: 888-621-6880. The first step in the application process after collecting your financial documents is filling out a Request for Application for Arizona Long Term Care and submitting it to AHCCCS. You can email the form to This email address is being protected from spambots. You need JavaScript enabled to view it. or fill the form out by hand and take it to any local ALTCS office. The addresses of all the offices are included with the Request for Application form. Once you have submitted the Request for Application, an intake interview will be arranged.

When evaluating eligibility for the program, ALTCS does a detailed analysis of the applicant’s financial and medical information. Be prepared to supply information on income, bank accounts, brokerage accounts, real estate, automobiles, insurance policies and other financial assets. ALTCS will also need information on your age, medical history, and any disabling medical conditions you may have. If able, you can apply on your own. However, many applications are made by family members. These family members may hold a power of attorney, guardianship or conservatorship covering the applicant.

What Happens After I Qualify? 

Once you qualify for the program, ALTCS will do the calculations based on your financial information to determine your share of the costs for nursing home or for home- based health care. Your “share of costs” will be calculated with certain eligible deductions that you may be allowed. Allowable deductions include:

  • A community spouse allowance for the other spouse who is living in the family home.
  • A family allowance for any dependents living in the family home.
  • Sometimes, an ALTCS patient is placed in a nursing home but, the expectation is that the nursing home placement will last 6 months or less, and the applicant will return home. In that event, a home maintenance allowance may be granted.
  • Medical insurance premiums
  • Medical expenses not covered by ALTCS. Those include things like dental care, vision, hearing aids, eyeglasses, etc.

After eligibility is established, you will be enrolled with a program contractor and assigned to a case manager. The case manager will meet with you and your family to decide on a service plan. Covered services include:

  • Institutional care
  • Home and community-based care that is a combination of home care and outpatient community care.
  • Medical services and prescriptions
  • Behavioral health services
  • Preventive care
  • Hospice

Other benefits include: 

  • Adult day care
  • Durable medical equipment
  • Home health care
  • Home modifications for wheelchair and disability issues
  • Home nursing
  • Housekeeping
  • Meal delivery
  • Attendant care to assist with activities of daily living like bathing, dressing, and feeding.
  • Respite care
  • Transportation

If you or your loved one need long-term care, look into assistance from ALTCS.

 

 

 

This website has been prepared for general information purposes only. The information on this website is not legal advice. Legal advice is dependent upon the specific circumstances of each situation. Also, the law may vary from state-to-state or county-to-county, so that some information in this website may not be correct for your situation. Finally, the information contained on this website is not guaranteed to be up to date. Therefore, the information contained in this website cannot replace the advice of competent legal counsel licensed in your jurisdiction.

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