Arizona Long Term Care System (ALTCS)

Many families and individuals in Arizona face the same challenge when it comes to long-term health care: how to pay for the rising costs of care. In Arizona, Medicaid can help cover the long-term costs of nursing level care, including assisted living, nursing homes and even in-home residential care.

In-home care options can often cost $20 to $30 per hour or more, and skilled nursing communities can cost as much as $8,500 per month or more. It’s no wonder that many families struggle to find the best financial options when a loved one is faced with long-term health needs.

Fortunately, there are programs in Arizona to help cover these long-term costs. Arizona Long-Term Care System, or ALTCS, is a branch of Arizona’s Medicaid program that covers long-term health care for qualifying individuals. ALTCS provides health insurance and coverage to people who need “nursing home” levels of care, and this may include care in a licensed nursing facility, residential care facility, rehabilitation center, assisted living facility, or even at-home care.

ALTCS provides incredible benefits, but the application and approval process can be daunting. In fact, 79% of ALTCS applicants are denied eligibility for long-term health care coverage because the ALTCS application process is so complex.

With the right planning, however, you can get approved for ALTCS and protect your assets during the process. At JacksonWhite, we’ve helped thousands of individuals become eligible for ALTCS, qualify quickly, and protect their assets in the process.

To learn more about how we can help your loved ones with the ALTCS process, call us today at (480) 467-4337 or read more below.

Get to know ALTCS

Arizona Long Term Care System (ALTCS) is a complex medical health insurance program, but we’ve organized the basics to better understand the process. Here’s how ALTCS works.

What is ALTCS?

Arizona Long-Term Care System, or ALTCS, is the Medicaid program in Arizona that covers long-term health coverage to those who meet financial and medical eligibility requirements. Despite the similarity in titles, Medicaid is very different from Medicare, and the two should not be confused. Above all else, ALTCS differs from Medicare because it is needs based, meaning that only those who meet strict eligibility requirements qualify for the benefit.

The ALTCS benefit is unique to Arizona, and is based on a managed care concept that enables the state to pay for a variety of services. In addition to helping with skilled nursing and nursing home costs, ALTCS covers certain in-home services as well. These home and community based services are less expensive for the state to provide and are oftentimes preferable to individuals as well. As such, it is often in everyone’s best interest to give ALTCS members in-home care for as long as possible.

What does ALTCS pay for?

ALTCS provides many health coverage benefits, including:

• Acute care services: includes doctors, hospitalization, reduced prescription costs, lab work, x-rays, tests, and specialist treatments.
• Alternative facility care: includes care provided in a licensed nursing facility, residential care facility, rehabilitation care facility, assisted living center, or group home.
• Home and community-based services: includes home day care, personal and respite care, medical transportation, mental health services, homemaker services, attendant care, and home health aides.
• Services for developmentally disabled adults and children: benefit includes specialized care for developmentally disabled adults and children.

Learn more about ALTCS eligibity.

Why is it so important to plan for ALTCS?

Unfortunately, many people wait too long to apply for the ALTCS benefit and end up jeopardizing their opportunity to take advantage of in-home care. Proactive individuals, on the other hand, might obtain in-home care that helps them postpone moving to a community or facility.

Individuals should begin preparing for the ALTCS benefit at the first signs of needing long-term care. Put bluntly, individuals who start the planning process earlier generally preserve the most resources.

It is particularly important to prepare for the future when it comes to health care. Planning for ALTCS eligibility is often the best way people can prepare to meet their long-term health care needs. First, long-term health care insurance can be difficult to obtain; second, Medicare only covers a limited amount of care in a skilled nursing facility; third, paying out-of-pocket is extremely expensive.

Why are most ALTCS applications denied?

Each year, the majority of ALTCS applicants are denied eligibility for long-term care coverage because of poor planning.

It can take roughly three to five months for ALTCS to process an application. Preparing for ALTCS in advance may be the best approach, but even those who have not prepared, and need immediate care, can become eligible for the ALTCS benefit if they meet strict medical and financial requirements.

The JacksonWhite Elder Law Team is dedicated to helping our clients accomplish the twin goals of preserving resources and qualifying for healthcare. JacksonWhite understands the fear of becoming impoverished by the cost of long-term care and is here to help.

What is the difference between ALTCS and Medicare?

Although people sometimes confuse Medicare and Medicaid, it is important to understand that these are two distinct programs. These programs have major differences which make them each beneficial in their own right.

Medicare is a federally-funded health insurance program which provides health care primarily to individuals 65 years of age and older. Although Medicare’s range of benefits has recently been expanded, long-term care costs are still not covered.

ALTCS Eligibility

Who is eligible for ALTCS?

To qualify for ATLCS, applicants must meet specific medical and financial requirements set by the state of Arizona.

To qualify medically for the ALTCS benefit, applicants must undergo a medical screening process known as the Pre-Admission Screen (PAS). Applicants begin by providing an assessor with personal information such as age, date of birth, living arrangements, and physician information.

ALTCS applicants must also meet certain general and financial criteria to be eligible for benefits. The financial requirements are much more complex than the general eligibility criteria, and it is not uncommon for applicants to struggle with this portion of the eligibility process.

Learn more about ALTCS eligibility to see what you can do to qualify a loved one for ALTCS as quickly as possible.

Does my income affect my ALTCS eligibility?

Whether applicants are married determines the amount of income they can receive under ALTCS rules. Single applicants cannot have monthly income of more than $2,523 as of 2022. Determining and reviewing income can be complex, but an ALTCS-experienced elder law attorney should be able to help individuals successfully apply for ALTCS and obtain eligibility.

Individuals who would like to apply for the ALTCS benefit, but whose income is too high, might be able to establish a Miller/Income-Only Trust to help them qualify.

Learn more about Miller Trusts and how they can help improve your changes of ALTCS approval.

How can I get help qualifying for ALTCS?

Although many families choose to apply for ALTCS without help, the majority of these applications are denied.

But speaking to a professional can help improve your odds of success and remove the fear and stress of applying. For instance, an elder law attorney can provide families with answers to questions related to paying for long-term health care, preserving assets and preparing an ALTCS application.

Aside from finding and paying for care, many families need help protecting their rights and their resources during the ALTCS process. To accomplish these goals, families might seek out a professional who can thoroughly examine the situation and find the best result for everybody involved.

While financial planners, insurance salesmen, social workers, and CPAs may all claim to have this ability, unqualified professionals all too often overlook important legal issues. Even attorneys without ALTCS experience are unlikely to provide families with a complete range of options. To ensure the best professional counsel possible, families should speak with an elder law attorney or law firm with extensive ALTCS experience.

JacksonWhite Law has decades of experience helping families go through the ALTCS process, from planning before the application to follow-up after successful approval. When your loved one needs financial assistance with long-term care, we’re here to help.

Get Your Loved One Qualified for ALTCS Today

As you can see, ALTCS and the application process are complex and often lead to frustration and rejection for first-time applicants. But you don’t have to go through the ALTCS process alone. With the right help, you can get a loved one qualified for ALTCS and help preserve their most important assets.

At JacksonWhite, we help families navigate long-term care crises every year. We help families prepare, plan and apply for ALTCS so that they have the best possible chance of getting approved for benefits. We also work to help ALTCS applicants preserve assets in a way that doesn’t burden their families.

To learn more about how we can help your loved one get on ALTCS and protect their assets, call us today at (480) 467-4337.

ALTCS Case Studies