Elder Law

Long Term Care

What is ALTCS?

Arizona Long Term Care System (ALTCS) is one of the Medicaid programs under the AHCCCS (Arizona Health Care Cost Containment System) umbrella. It is an insurance that covers the cost of long term care and medical expenses for those that qualify. It is intended for the poor and may enable married couples to avoid complete impoverishment.

ALTCS Eligibility

Pre-Admission Screening (PAS)

  • Performed in person by a representative of ALTCS
  • Factors considered (Elderly and Physically Disabled):

Review of medical information

Functional Assessment

  • Activities of Daily Living: Dressing, Bathing, Grooming, Feeding, Mobility, Transfer, Toileting
    Continence
  • Sensory limitations (vision/hearing)
  • Orientation (time and place)
  • Emotional/Cognitive Behaviors: Aggression, Self-injury, Wandering, Resistive, Disruptive

Income

Relationship Status Gross Monthly Income Limit
Single $2,250
Married $2,250 (applicant only)
Married $4,500 (both spouses)

WHAT IS AN INCOME ONLY TRUST?

Resources

Relationship Status Application Resource Limits
Single NA <$2,250
Married Applicant <$2,250 (applicant only)
Married Spouse
1⁄2 of the countable Married resources spouse (at least $24,720, up to $123,600)

Exempt Resources

  • The Arizona primary residence (not in trust)
  • One vehicle
  • Pre-paid burial arrangements
  • Life insurance, up to $1500 face value
  • Household goods and personal effects
  • Special Needs Trust (established before age
  • 65 pursuant to 42 U.S.C. §1396p(d)(4)(A))
  • ABLE account, if applicable

NOTE: ALTCS Policies and related laws are complex and extensive. Eligibility is determined by evaluating many factors. This webpage provides only basic information and is not a substitute for the advice of an experienced attorney intended for any specific situation. Furthermore, consulting with an attorney before applying for ALTCS may improve the likelihood of application approval and maximize planning options.

ALTCS FAQs

What ALTCS may cover?

  • in home care (medical and non-medical); up to 30-40 hours per week
  • respite care, up to 600 hours per year
    adult day programs
  • long term care facilities (assisted living/memory care/skilled nursing, group homes)
  • durable medical equipment (walker, wheelchair, Hoyer lift, etc.)
  • adult briefs
  • home modifications to accommodate the disabled
  • Medical expenses not covered by Medicare, including Rx, doctor visits, tests, etc.
  • DDD services: attendant care, day programs, respite, habilitation services

NOTE: NOT AN EXHAUSTIVE LIST AND SUBJECT TO CHANGE; COVERAGE FOR EACH INDIVIDUAL CUSTOMER MAY VARY.

What will ALTCS cost me?

  • ALTCS is insurance coverage for long term care and medical expenses.
  • Once approved by ALTCS, benefits are administered by private insurance companies, called Program Contractors. (e.g.,
  • Mercy Care, United Health Care, Banner/University Family Care, Care 1st )
  • Services are only covered by ALTCS if the service providers are “in-network” with the customer’s Program Contractor.
  • Each month, customers pay one single “co-pay”, referred to as Share of Cost, to their care provider or facility for the services that the Program Contractor agrees to cover. The Share of Cost is never greater than the customer’s gross income, and may include deductions that reduce the cost. (e.g., Personal Needs Allowance, out-of-pocket medical expenses, and spouse/family allowances)

What documentation do I need to provide for an ALTCS application?

View List

How We Can Help?

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Eligibility counseling for ALTCS and Veterans’ Aid & Attendance benefits

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Work with you and ALTCS to process the ALTCS application and execute any planning steps

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Asset Protection Planning

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Assist with Income Only Trusts (“Miller Trusts”)

What is Elder Law?

Elder Law focuses on the needs of a particular type of client, that being the aging and disabled, rather than a type of service, such as a Will or Trust. We counsel with those clients, or their loved ones, about legal options and resources that can help protect and care for those who cannot do so for themselves, if and when that time comes.

Long Term Care Payment Options

Pay the full rate of the care provider out of pocket.

Coverage (type of services, payout amount, and duration) may vary with the policy purchased.

Limited cash reimbursement for unreimbursed medical and care expenses available to US veterans of war of lower net worth.

(i.e., Medicaid for long term care services) Insurance that covers the cost of long term care and medical expenses, intended for the impoverished and to help married couples avoid complete impoverishment.

Medicare and hospice will NOT cover the cost of ongoing long term care expenses, or at least the coverage and services are extremely limited.

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