Medicaid Eligibility for Seniors in Arizona in 2025

Arizona Long Term Care System (ALTCS)

Arizona’s long term care Medicaid program is also known as the Arizona Long Term Care System or with the acronym ALTCS. ALTCS is designed for people who are medically needy but cannot afford the care they need to remain healthy and safe. Applicants must meet certain medical requirements as well as income and asset requirements.

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. If an applicant’s income is higher than the state’s limit, an income-only trust must be created for any excess income above the maximum.

ALTCS Program Description:

Arizona’s Medicaid Program provides payment for special long-term care support services and full Medicaid health coverage to eligible people who, because of their medical conditions, require assistance with activities of daily living (eating, bathing, dressing, grooming, transferring, etc.). Long-term care support may be provided in a facility or an individual’s home. If care is desired in a facility, the facility must be contracted with ALTCS to provide care. There are no state-run facilities, but rather private facilities and residential group homes that contract with ALTCS to accept Medicaid as a form of payment. This allows for a wide variety of choices for ALTCS members.

For those who prefer to receive care at home, ALTCS will pay for up to 40 hours of care per week, depending on medical necessity. Another benefit of remaining at home is that, in most cases, a person will be able to keep 100% of their income while still receiving ALTCS benefits.

Who is Eligible for ALTCS?

1. Residency and Citizenship – the applicant must be a resident of Arizona and a U.S. citizen or have proper immigration status.

2. Age/Disability – the applicant must be age 65 or older, blind, or disabled. The applicant must meet certain medical requirements consistent with the level of care requested.

3. Income Limitations – If single, the applicant’s income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be no higher than $2,901 /month (2025 income limit) to become eligible for Medicaid. Income that is not considered countable includes a personal needs allowance of $141.45/month per individual (2025 personal needs allowance). Persons with income in excess of $2,901 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 recipient when the beneficiary dies.

4. Asset Limitations (Exempt vs. Available) – Medicaid divides assets into Exempt and Available categories. Exempt assets are specifically designated under the rules, and the applicant’s ownership of an exempt asset will not result in a denial of benefits. If an asset is not listed as exempt, it needs to be liquidated and applied toward the costs of nursing home care before the applicant can receive Medicaid benefits.

The state has a look-back period of five years with a penalty for people who sell assets below fair market price, transfer assets to others, or give money and property away. Basically, all money and property, and any item that can be valued and turned into cash, is a countable asset unless it is listed as exempt.

Exempt Assets for an ALTCS Applicant Include:

$2,000 or less in cash/non-exempt assets if single. If the assets exceed the limit on the first of the month, the applicant is ineligible for the entire month.
One home is exempt (equity limit $713,000) if planning to return, a spouse, a child under 21, or a disabled person resides in it. Whenever an institutionalized person sells a previously exempted residence, the money from the sale becomes a countable asset. The recipient may then lose eligibility for Medicaid until he/she has spent down the money and their countable resources are once again less than the maximum.
One automobile, no equity amount specified.
Burial spaces/plots up to $1,500 in value.
Irrevocable burial trusts worth up to $9,000.
Non-saleable property, household furnishings, furniture, clothing, jewelry, and other personal effects are not counted.
Value of life insurance if the face value is $1,500 or less.

ALTCS Spousal Rules for 2025:

Amount of assets the community spouse may retain: The community spouse can keep non-exempt resources owned by one or both spouses with a maximum of $157,920. If the community spouse’s assets do not equal the minimum of $31,584, the community spouse is able to retain assets from the institutionalized spouse until the minimum is reached.

Community spouse impoverishment protection: The community spouse can keep part of the institutionalized spouse’s income if the community spouse has a monthly income of less than $2,555. The maximum amount of income that can be retained is $3,853.50/month, varying by case, depending on unique living expenses.

Arizona Long Term Care Insurance Partnership:

This is a program between the state and private insurance companies. Partnership policies protect assets by matching dollar for dollar what policyholders pay into their policies. For example, if you bought a Partnership Policy with a maximum benefit payout of $155,000, you can protect $155,000 of your assets. For married couples, each spouse needs to purchase their own policy. Once the $155,000 worth of long-term care coverage is used, you may apply for Medicaid with $155,000 worth of assets exempted.

ALTCS Benefits and Coverage:

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 support 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:

ALTCS application Arizona Medicaid paperwork

If Applicable, Behavioral Health Care
Up to $1,000/year in Dental Care
Adult Day Care or Respite Care
Home Health Services
Medical Supplies and Durable Medical Equipment
In-home Caregiving
Long-Term Care Facility Payments
Health Insurance
Medicaid Insurance
Doctor’s Appointments
Hospice Care
Meal Delivery

Getting Paid as a Family Caregiver

Beyond paying for care at an approved long-term care facility or paying for a professional caregiver, ALTCS can also pay a family member to provide in-home care. ALTCS will pay up to 40 hours a week of care, depending on medical necessity. When paying a family member as a caregiver, the ALTCS recipient is allowed to keep all of their income as long as it is below the ALTCS limit. This means the family caregiver is paid entirely by the state unless the ALTCS recipient chooses to pay them for extra services out of their own pocket.

How Long Does the ALTCS Application Take?

Generally, if everything is submitted on time and there are no hiccups, the Arizona Medicaid application will take between 60-90 days. Processing time will increase for applications that require the use of a Miller Trust. 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.

Does Medicare Pay for Long Term Care in Arizona?

In a word, no. Medicare is not designed to pay for long-term care beyond a qualified stay at a rehabilitation center or a short-term stay at a skilled nursing facility (SNF). For individuals who need care longer than 100 days per Medicare pay period or for individuals who have not been hospitalized but still need long-term care, ALTCS is the Arizona program you need. For veterans needing long-term care, other benefits might be available in addition to ALTCS.

Can Someone Apply to ALTCS for Me?

Yes. Arizona Medicaid allows each applicant to have what is called an authorized representative to help them through the application process. The representative can be a friend, family member, or even a paid representative. Because the ALTCS application is the first experience many people have with state bureaucracy, the process can be extremely complicated. Errors or failure to submit correct documentation can result in delays or denial of the application. Also, the application will be denied immediately if a person is over assets or income. This is why many Arizonans choose to hire a professional. Call Senior Planning today for a free consultation to learn how we might be able to help you. We can assess where the application might have gone wrong if you believe you have been unfairly denied coverage.