Introduction
Looking for long-term care plans in Arizona? Wondering if ALTCS is the same as Medicaid? Whether you’re already receiving long-term care or think you may need it in the future, ALTCS can help.
Depending on your medical needs and financial situation, you may qualify for benefits including in-patient and out-patient services. Without the help of this type of service, the cost of care can be overwhelming.
With the right information, you’ll feel empowered to start your application and get the assistance you need.
What is Arizona Long Term Care?
ALTCS is Arizona’s Medicaid program. The system helps disabled individuals and fixed income seniors get access to the care they need through financial assistance. This program is unique to Arizona and enables the state to cover multiple services, including nursing home costs.
What Does ALTCS Pay For?
The benefits you’ll receive depend on whether you live at home or a nursing facility. At-home residents will receive different care than people who live in assisted living institutions, for example. Here are some of the services that ALTCS participants may qualify for:
- Emergency response services
- Medical transport assistance
- Behavioral care services
- Adult day care
- Dental care
- Home health care
- Home nursing
- Hospice care
- Meal preparation
- Meal delivery
- Personal care
- Respite care
In addition to the services above, ALTCS members may also access care coordination assistance, physician’s appointments, community transition services, and homemaker services. Eligible applicants can receive full coverage for acute care needs such as hospitalization, specialist treatments, lab work, x-rays, and tests. Some individuals also receive specialized furniture, housekeeping help, and more.
Determining ALTCS Eligibility
If you or a relative is already receiving home health care, adult home care, assisted living, skilled care, or is planning to in the future, Medicaid can help you cover expenses. But who qualifies for ALTCS, the state Medicaid program, and how can you know it’s right for you?
Generally speaking, it suits individuals with specific medical situations and low income. Let’s look a bit closer at the categories that impact ALTCS eligibility below:
General Requirements
To qualify for ALTCS, you must be a citizen of the U.S. (or qualified immigrant) and live in Arizona. You must have a Social Security Number and live in a participating care facility or otherwise approved arrangement.
Before you can apply for ALTCS benefits, you must have already applied for other sources of assistance such as VA or pension benefits. Otherwise, you may not be eligible.
Financial Situation
As of 2024, Arizona residents cannot be earning more than 300 percent of the FBR (SSI Federal Benefit Rate) monthly and still qualify for ALTCS. Note that some exceptions may apply. The income cap is $2,829 gross monthly pay for individuals and $5,658 for married applicants who are both applying for benefits.
If you’re applying as a single person, you must have no more than $2,000 worth of countable resources. This refers to assets (like property or money) that you can convert to cash. Here are some examples:
- Retirement accounts
- Cash and bank accounts
- Nursing home accounts
- Promissory notes
- Assets held in trust
While some people think they can give assets to their family or friends to qualify for benefits, this may not work. If you’ve given away or transferred any of your assets without receiving fair value in return within the 5-year period before your application, it may result in a penalty.
Medical Needs
Once you pass the financial eligibility requirements, you’ll meet with a social worker or nurse to check your medical eligibility. They’ll determine if you’re at risk for institutionalization, though you don’t have to actually be living in an institution currently. They’ll also consider your mental and physical impairments to see if you meet their minimum requirements.
What if You Earn More than the Monthly Limit?
Even if you earn more than the monthly limit listed earlier, you may still qualify for ALTCS. Individuals who want to apply for these benefits might be able to qualify through establishing a Special Treatment Trust.
Keep in mind that this exception must pass stringent legal requirements to work, so the best way to navigate this option is with the help of a qualified Elder Law attorney.
Monthly Maintenance for Non-Applicant Spouses
Arizona has special rules set in place for the protection of a healthy spouse when their partner is getting long-term care services. The state will let the applicant spouse give their non-applicant spouse a monthly maintenance allowance to protect their financial security. As of 2024, this amount is $3,853.50 monthly.
Entitlement to Benefits
Rather than using participant enrollment caps like other states, ALTCS provides services using a managed care model. This means that any individual can receive services and benefits if they meet the eligibility requirements.
Once you’ve applied for ALTCS benefits and receive confirmation of acceptance, you’ll meet with a caseworker. This will help you determine a long-term care plan likely involving adult foster care, home care, nursing home care, or alternative residential services.
How to Apply for ALTCS
These benefits are potentially available to residents in all Arizona counties. If you think you might be eligible for ALTCS services, you should apply as soon as possible.
To access these benefits, you must fill out an application and prove that you meet the financial and medical requirements. You must be an Arizona resident with a recognized disability or be older than 65. Approval usually takes between 60 and 90 days.
Receive Help with Your Application
While it’s possible to apply for ALTCS benefits on your own, the application process can be complex. Working with an Elder Law attorney with professional experience in this area can help reduce your odds of getting denied. If any of the following apply to you, consulting legal expertise is necessary:
- You have excess countable resources
- You own real property (other than your home)
- You’ve made a transfer/gift in the past 5 years
- You’ve already been denied ALTCS benefits
- You want to increase your odds of acceptance
Whether you have questions, want help filling out the application, or need to get around the income limit issue, one of our experts can help.
Contact the JacksonWhite ALTCS team today at (480)467-4337 and learn more your options for long term care.