No, ALTCS will generally not take your home to recover for expenses it paid for your care. ALTCS has certain limited rights to recover against the applicant’s home property: (1) TEFRA lien, and (2) the Estate Recovery program.


What is a TEFRA lien?

AHCCCS may place a lien on the customer’s interest in real property during their lifetime for expenses it paid towards the customer’s care. AHCCCS shall seek to recover the lien upon the sale or transfer of the real property subject to the lien.

When does it apply?

ALTCS customers who are:

  • Age 55 or older, and
  • Permanently institutionalized (i.e., residing in a skilled nursing facility, not assisted living or memory care facilities) for at least 90 days.

However, there are a number of exceptions or potential planning options to avoid this risk. We recommend you discuss these with an experienced attorney.

How can I protect my home from TEFRA liens?

This is very difficult to do.  Transfers may result in a long transfer penalty, if done within five years of filing the ALTCS application.  The policies are complicated, we recommend you consult with an experienced Arizona attorney familiar with ALTCS policies to explore these options.

Note, most people in need of long term care do not reside in skilled nursing facilities, but assisted living of some form, which is not subject to TEFRA liens.  If skilled nursing care is needed, we recommend putting the customer’s safety before the desire to avoid TEFRA liens.

Estate Recovery

What is Estate Recovery?

AHCCCS may have a claim against the estate of a deceased ALTCS customer to recover expenses it paid for the customer’s medical or long term care.

When does it apply?

  • Deceased ALTCS customers who are age 55 or older.
  • Typically during the probate of the ALTCS customer’s estate.

Again, there are a number of exceptions and potential planning options to avoid estate recovery. 

In short, AHCCCS will not take an ALTCS customer’s home while he/she is still living or his/her spouse remain in the home.

On a more practical note, in cases where he/she resides in a care facility and no spouse or dependent child resides in the home, the customer may have no choice but to sell the home.  A single ALTCS customer will pay most of his/her income to the care facility, leaving insufficient funds available to afford maintaining the home, such as taxes, insurance, HOA dues, and utilities.  The sale proceeds may need to be spent down in order for the applicant to qualify for ALTCS.

Our experienced attorney can help you explore your options to avoid TEFRA liens or Estate Recovery.  Call to schedule an appointment today!