ALTCS Eligibility Requirements & Income Limits

The Arizona Long-Term Care System (ALTCS) helps eligible individuals access long-term care services, such as nursing home care, in-home services, and hospice care. It provides financial assistance to those whose age, disability, or medical conditions require help with activities of daily living.

Applicants must meet specific medical, income, and asset requirements to qualify for ALTCS. However, many prospective applicants struggle to understand these requirements and whether they are eligible. If you need help with the application process or have questions about whether you meet the ALTCS eligibility requirements, the experienced Arizona estate planning attorneys at Mushkatel, Gobbato, & Kile, P.L.L.C., can help. Contact us today to schedule a consultation.

What Are the ALTCS Medical Requirements?

ALTCS requires applicants to meet specific medical requirements that focus on an individual’s need for long-term care due to illness, disability, or age-related conditions. Applicants must demonstrate that they require assistance with activities of daily living (ADLs) related to bathing, dressing, eating, and mobility. ALTCS also considers individuals with physical or mental impairments that prevent them from living independently.

The most common medical requirement is a physician’s certification that the individual requires long-term care. This care may be provided in a nursing facility or at home, depending on the person’s needs. The applicant must show they need this level of care either immediately or soon due to a medical condition that significantly impacts their ability to function independently. While they may already reside in a nursing facility, it is not a requirement for ALTCS.

ALTCS eligibility includes people with various medical conditions, including:

• Alzheimer’s disease
• Parkinson’s disease
• Stroke
• Severe arthritis
• Chronic obstructive pulmonary disease (COPD)
• Heart disease and heart failure
• Spinal cord injuries
• Traumatic brain injuries (TBI)
• Amyotrophic lateral sclerosis (ALS)
• Advanced kidney disease.

The state uses a standardized assessment tool to evaluate physical and cognitive abilities and determine the level of care needed. Applicants who meet these medical requirements may proceed with the ALTCS application process.

What Are the ALTCS Income Requirements?

ALTCS also has strict income limits to ensure the program provides financial assistance to those who need it most. To qualify for ALTCS, an applicant’s income must fall within a specified limit, which is subject to periodic adjustment. As of January 1, 2025, a single individual’s monthly income cannot exceed $2,901. The income limit may be higher for married couples, depending on whether one or both spouses are applying for ALTCS benefits. Your estate planning lawyer can clarify the applicable income limit based on your unique situation.

Income sources for ALTCS eligibility include:

• Wages
• Social Security benefits
• Supplemental Security benefits
• Disability or retirement pensions
• Other regular financial sources.

Not all income is counted in the same way. For example, income from certain veterans’ benefits may be treated differently.

If your income exceeds the limit, you can work with an experienced Arizona estate planning attorney to reduce your countable income. The spend-down process may be one option. You can use excess income to pay for medical or care-related expenses and, in turn, reduce your countable income.

What Are the ALTCS Asset Requirements?

Applicants for ALTCS must meet specific asset requirements. However, some assets may be excluded from the countable total. To qualify for ALTCS, an individual’s total assets must fall below a set limit. As of January 1, 2025, the countable asset limit for a single applicant is $2,000. The limit may be higher for married couples, depending on the circumstances of the applicant and their spouse.

Assets ALTCS treats as countable assets include:

• Checking, savings, and credit union accounts
• Real property you don’t live in
• Cash value of some life insurance policies
• Cash, stocks, bonds, and certificates of deposit
• Non-exempt vehicles.

In short, ALTCS counts assets that you could easily convert into money. If you have assets exceeding the limit, you may need to spend down your savings or transfer assets to qualify for ALTCS. Asset transfers must follow specific rules to avoid penalties.

The limit of $2,000 in countable assets may seem strict. You may have concerns about certain assets and whether they will prevent you from qualifying for ALTCS benefits. Thankfully, some assets are excluded, meaning they are not considered when determining your eligibility. Some commonly excluded assets include the following:

• Your primary home — As long as you or your spouse lives in it, your home does not count toward the asset limit unless a trust holds it.
• Vehicles — You can exclude one vehicle per household, regardless of its value.
• Certain burial funds — You can exclude burial plots and prepaid burial plans. Also, up to $1,500 may be designated for burial and not count toward your asset limit.
• Household and personal belongings — This category includes household items, clothing, and other personal belongings.
• Certain financial accounts — Under federal law, you can also exclude qualified ABLE accounts, Flexible Spending Arrangements, 530 Coverdell Education Savings Accounts, and other financial accounts.

How Do You Qualify and Apply for Long-Term Care in Arizona?

Applying for ALTCS can feel overwhelming. However, the program has specific steps and requirements it uses to determine whether applicants meet the eligibility criteria. Here’s how the process works:

• Call ALTCS — ALTCS applications begin with a phone call. By calling (888) 621-6880, you can speak to a representative who will provide the necessary forms and instructions for completing your application.
• Complete the application — The ALTCS application serves as the first step in determining eligibility. It collects detailed information about your health, income, and assets to assess whether you qualify for benefits.
• Get help with the application if needed — If you are unable to manage the application process yourself, ALTCS allows authorized individuals to act on behalf of applicants. For example, a family member, caregiver, or your Arizona estate planning lawyer can assist you.
• Gather documentation — Documentation is key to the success of your application. You must submit proof of income, assets, residency, and other eligibility factors to demonstrate that you meet the financial and non-financial ALTCS eligibility requirements.
• Demonstrate the level of care you need — A key part of eligibility involves demonstrating that you require assistance with daily living tasks or medical care typically provided in a nursing facility. Documentation and testimony from your physician can support your application.

If you or a loved one needs long-term care, it’s essential to approach the application process with preparation and attention to detail. If you have questions or need help with your application, your attorney can guide you through the process.

What Sort of Benefits Does ALTCS Cover?

ALTCS provides a wide range of benefits to support individuals needing long-term care. These services help individuals maintain dignity and comfort and improve their quality of life while addressing their medical, behavioral, and daily living needs. The following are some of the key types of care and services that ALTCS may cover:

• Institutional care in a nursing facility — ALTCS covers long-term care provided in licensed nursing facilities. These facilities offer around-the-clock medical supervision and assistance with daily tasks.
• Home and Community-Based Services (HCBS) — HCBS allows eligible individuals to receive care outside of institutional settings, including in-home care, adult day care, or other outpatient services. It can help individuals remain in their own homes or community environments.
• Medical services — ALTCS covers many standard medical services, including doctor visits, hospital stays, and prescription medications. However, prescription drug coverage may be under limits for individuals with Medicare.
• Behavioral health services — ALTCS includes mental health and substance use treatments to support emotional and psychological well-being.
• Preventative and wellness care for children — ALTCS provides preventative medical services for children to ensure they receive regular checkups and vaccinations.
• Hospice services — ALTCS covers hospice care for individuals with terminal conditions, offering comfort and support during the end-of-life stage.

Is There a Difference Between ALTCS and Medicare?

While ALTCS and Medicare both provide healthcare-related benefits, they serve different purposes. ALTCS is Arizona’s long-term care program, while Medicare is a federal program that primarily serves older adults and individuals with specific disabilities.

The main difference between these two programs is the type of care they cover. ALTCS focuses on long-term care services, while Medicare primarily covers short-term medical services like hospital stays, doctor visits, and outpatient care. Medicare does not cover most of the long-term care types covered by ALTCS.

ALTCS also has strict financial and medical eligibility requirements, while Medicare benefits eligibility depends more on age or disability status than income or assets.

Contact an Arizona Long-Term Care System (ALTCS) Attorney

Securing the long-term care you or your loved one need through ALTCS can be a source of stress and anxiety. The team at Mushkatel, Gobbato, & Kile, P.L.L.C., brings 50 years of combined legal experience to our work on behalf of individuals in need of ALTCS benefits. If you have questions about ALTCS eligibility requirements or need help applying, we can assist you with the personalized service of a small firm and the resources of a large one. Contact us today to get started with a consultation.

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