Arizona Long-Term Care (ALTCS):
Application & Eligibility
What Is ALTCS?
The Arizona Long Term Care System, or the acronym, ALTCS (pronounced ALTECS) for short, is the long-term Medicaid program in the state of Arizona. Arizona Long Term Care provides health care and related services for individuals who are disabled and meet age and income requirements.
An ALTCS application can be started by a family member, an appointed caregiver or legal guardian, or an authorized representative of the patient. Prospective applicants can also begin their own application and handle the process themselves if they wish. To begin a new application, call your local ALTCS office or let us know and we can request to start a new application.
What Does ALTCS Cover & What Are the Benefits?
ALTCS coverage varies based on where a person is living. For example, if a person resides in a long-term care facility, they will receive different long-term care supports than a person who remains at home. Depending on income level, medical neediness, and where the person lives, applying for ALTCS may help you receive some or all of the following services:
- Doctor visits and medical care
- Nursing homes
- Assisted living facilities
- Hospitals visits and stays
- Pharmacies and prescriptions
- Nursing Facilities
- Attendant Care
- Assisted Living Facilities
- Adult Day Care Health Services
- Home Health Services, such as nursing services, home health aides, and therapy
- Home Delivered Meals
- Case Management
- Dental Services (up to $1000 per contract year)
What Is the Difference Between ALTCS and Medicare?
It’s critical to understand the difference between ALTCS and Medicare, especially for those requiring long-term care. Medicare, a federal program, offers health coverage primarily to individuals aged 65 or older but isn’t designed to cover long-term care beyond a limited stay at a rehabilitation center or a Skilled Nursing Facility (SNF). It typically only extends to a maximum of 100 days per pay period.
When long-term care surpasses this limit, ALTCS becomes a crucial lifeline within Arizona. Unlike Medicare, ALTCS is a long-term Medicaid program providing healthcare and related services for individuals with disability or long-term care needs, making it a more suitable choice for long-term care needs. For veterans, it’s important to note that there might be additional benefits on top of ALTCS to better support their long-term care requirements.
Who Is Eligible for Arizona Long-Term Care?
Arizona is an income cap state, meaning that in order to be eligible for Medicaid long-term care, there is a hard income limit. Non-income cap states allow applicants to spend down money for their care, whereas income cap states require the amount to be no higher than their limit at the time of application.
Like many other states, Arizona sets its income limit at 300% of the Federal Benefit Rate. The exact dollar amount changes annually.
An ALTCS application has two components. The first part is a medical evaluation and the second is a financial evaluation or a means tests. You must pass both in order to receive ALTCS. Priority is given to those who need full-time care because of their medical difficulties.
ALTCS Medical Requirements
The applicant must be age 65 or older, or blind, or disabled. Medical qualifiers can include: dementia or Alzheimer’s disease, difficulty cooking and eating, trouble maintaining a household, problems bathing, or difficulty performing other activities of daily living. ALTCS is intended to provide care for those who cannot care for themselves.
ALTCS Financial Requirements
The second portion determining eligibility is evaluating the applicant’s finances. Some ALTCS applicants are frustrated when they are rejected on these grounds, but it is important to remember that ALTCS is funded by the state and federal government, and ALTCS must conserve its funds for those who most need them. ALTCS accepts people who have less than $2000 dollars in cash assets and less than $2,742 in monthly income.
|Cash in any type of Bank Account
|One House that the Applicant Lives in
|Up to $2,000 in cash
|Stocks, Bonds, Money Markets, Etc.
|$1,500 Designated for Burial Expenses
|Some Life Insurance Policies
|Personal Effects and Household Items
Can I Qualify for ALTCS If I Am Over the Limits?
Persons with income in excess of $2,742 can still qualify for Medicaid coverage if excess income is placed into a Miller Trust. The trust must be irrevocable and Arizona Medicaid must be the designated recipient when the beneficiary dies.
Senior Planning specializes in helping people who are over income or assets secure an approval. Give us a call today before opening an application.
How to Apply for Arizona Long-Term Care?
Before beginning a new ALTCS application it is wise to gather all financial information and documentation. Relevant documentation includes statements from checking and savings accounts, money market accounts, certificates of deposit, life insurance policies, burial policies, 401(k)s and pensions, real estate the applicant may own, marriage certificates, and more. Financial statements must be dated within the month that the application is opened. Having documentation gathered before beginning the application will make the application process easier and faster.
Once a new application is started, a financial eligibility worker will contact the designated point of contact to review the applicant’s financial status. The most recent statements for the aforementioned resources will need to be submitted to the eligibility worker.
Generally, if everything is submitted on time and there are no hiccups, the Arizona Medicaid application will take between 60-90 days. For applications that require the use of a Miller Trust, processing time will increase. A Miller Trust is necessary if an applicant is over the ALTCS income limit. Senior Planning can assist with the creation of a Miller Trust, sometimes called an Income Only Trust.
Why Do Many ALTCS Applications Get Denied?
While the ALTCS application process may seem straightforward initially, it’s far from simple. The task requires a significant amount of paperwork, thoroughness, and in-depth understanding of ALTCS requirements and procedures. For those trying it for the first time, the chances of success can be discouragingly low, resulting in many giving up, thus missing out on critical benefits.
Persistence pays off for some who choose to re-apply or appeal their denials, but this process often extends the application period from the estimated 60-90 days to a lengthy six months to a year.
We strongly advise seeking professional assistance with your ALTCS application. The complexity of the process and the high stakes involved in its outcome make expert guidance indispensable for a smooth and successful application process.
What Does an ALTCS Application Cost?
The only real con of getting assistance with your ALTCS application is the cost associated with the service. Many people apply to ALTCS using a lawyer, which as you can imagine, is extremely cost-prohibitive. Lawyers can cost anywhere from $6,000-$10,000 for an ALTCS application. Obviously, people applying to ALTCS are in need of financial assistance or they would not be applying to ALTCS.
This is why Senior Planning offers a much more cost-friendly, but equally as robust, application service. Although we cannot offer legal advice, we are licensed legal document preparers. In terms of ALTCS, there are many instances when you do not need legal advice and a legal document preparer will suffice, providing an affordable solution. Please give us a call at 855-460-2171 and we will help you figure out your options at no cost to you. If we can’t assist, we will let you know immediately and can even recommend an attorney if that is the only way forward.
Filing an Application for ALTCS
What to expect:
- Open up an ALTCS application directly through ALTCS, a lawyer, or through a Medicaid planning service like Senior Planning.
- ALTCS will perform an eligibility review of the applicant. This process can take anywhere from 60 to 90 days and must be completed with no mistakes or the applicant will be denied.
• Financial Review: a caseworker will determine that the applicant is below the asset limit of $2,000 total countable resources and below the monthly income limit.
• Medical Review: A medical caseworker will confirm that the applicant needs help with most or all of their activities of daily living.
- If an applicant is approved, they must select a program contractor. The program contractor is the insurance company contracted with the state of Arizona to provide long-term care services. If an applicant is hoping to use ALTCS at a long-term care facility, the long-term care facility must be contracted with the chosen program contractor.
• Banner University Family Care
• United Healthcare Community Plan
• Mercy Care Plan
Get Professional Assistance in Qualifying for ALTCS
The pros of using a professional service like Senior Planning are many. We will assist with both the medical and financial portions of the application. This means we will gather all requisite medical records, which will save you hours of work calling doctors, hospitals, and caregivers. We will also organize the applicant’s finances so that they are eligible before we begin the application. If you start the application and a person is over assets, they will be denied and you have to wait another 30 days to apply.
This is a delay many people cannot afford. We will also send detailed requests for exactly what information we need, taking the guesswork out of the application. Otherwise, ALTCS could look up to 60 months back and has the right to request all of the financial records in that time period.
Although it may feel overwhelming or like the application takes too long, most people we talk to wish they would’ve started the application many months before they actually start it. Don’t let this happen to you– start planning now. Give us a call today or request information through our contact form and we guarantee you’ll be happy you did.