Navigating the ALTCS (Arizona Long Term Care System) application process can feel overwhelming, but understanding the steps and updated requirements can significantly increase your chances of approval. ALTCS is a program under Arizona's Medicaid system designed to provide long-term care support for elderly, disabled, or chronically ill residents who meet specific medical and financial eligibility criteria. This guide will walk you through the essential steps for successfully applying in 2025.
Financial Eligibility Criteria for ALTCS in 2025
To qualify for ALTCS, applicants must meet specific income and asset limits:
Income Limits:
Single Applicant: Monthly income must not exceed $2,901.
Married Applicants (both applying): Each spouse can have a monthly income up to $2,901, totaling $5,802combined.
Married Applicant (one spouse applying): The applicant spouse's monthly income limit is $2,901. The non-applicant spouse's income is not counted towards this limit.
Asset Limits:
Single Applicant: Countable resources must not exceed $2,000.
Married Applicants (both applying): Combined countable resources must not exceed $4,000.
Married Applicant (one spouse applying): The applicant spouse can have up to $2,000 in countable assets, while the non-applicant spouse may retain up to $157,920 in countable assets, known as the Community Spouse Resource Allowance (CSRA).
Exempt Assets:
Certain assets are excluded from the asset calculation, including:
Primary Residence: Equity up to $688,000 is exempt if the applicant or their spouse resides there.
Vehicle: One automobile, regardless of value.
Personal Belongings: Household goods and personal effects.
Burial Arrangements: Irrevocable prepaid funeral plans and burial plots.
Note: Applicants with income exceeding the limits may still qualify by establishing an Income-Only Trust (Miller Trust).
Steps to Apply for ALTCS
1. Determine Eligibility
Ensure you meet both medical and financial eligibility criteria. Medical eligibility requires a need for a nursing home level of care. To gain a deeper understanding of ALTCS and determine your eligibility with this eligibility checklist.
2. Gather Required Documentation
Prepare necessary documents, such as:
Proof of income (e.g., pay stubs, Social Security statements).
Bank statements and asset documentation.
Identification documents (e.g., birth certificate, Social Security card).
Medical records and doctor’s reports.
Legal documents (e.g., power of attorney, guardianship papers).
*For more detailed information and to start your application, view the official form DE-828.
3. Submit the Application
Apply through your local ALTCS office or online via the AHCCCS website. Ensure all sections of the application form are accurately completed and include all required documents.
4. Complete a Pre-Admission Screening (PAS)
A caseworker will schedule a Pre-Admission Screening to assess medical eligibility. This involves evaluating the applicant’s physical and cognitive abilities.
5. Financial Interview
A financial interview will verify your financial information. Be prepared to discuss all sources of income and assets. The caseworker will review your financial records to ensure compliance with eligibility requirements.
6. Wait for the Decision
The decision process can take several weeks. During this time, the ALTCS team will review your application, medical assessment, and financial interview results. If additional information is needed, provide it promptly to avoid delays.
7. Approval and Choosing a Care Plan
If approved, you will receive an approval notice and can start choosing a care plan. You can select from various care providers and services that best meet your needs.
Common Mistakes to Avoid When Applying for ALTCS
The ALTCS application process can be daunting, and mistakes can lead to delays or denials. Avoid these common pitfalls to improve your chances of a smooth application:
Incomplete Documentation: Missing documents, such as bank statements or medical records, can slow down the process. Double-check that all required paperwork is included before submitting your application.
Overlooking Exempt Assets: Many applicants mistakenly include exempt assets, such as their primary residence or one vehicle, in their financial calculations. This can make it seem like they exceed asset limits when they do not. Ensure you understand what is and isn’t counted.
Mismanaging Income Overages: If your income exceeds the eligibility limits, failing to set up an Income-Only Trust (Miller Trust) can result in denial. Work with a professional to establish the trust if needed.
Delaying the Application: Waiting too long to apply can result in delayed care or financial strain. If you think you may qualify, begin the application process as soon as possible.
Not Preparing for the PAS Assessment: The Pre-Admission Screening (PAS) evaluates your need for care. Applicants who fail to communicate their medical needs thoroughly during this step risk being deemed ineligible. Practice answering questions about your daily needs and health conditions clearly.
Underestimating the Complexity of the Financial Interview: Many applicants underestimate the level of scrutiny during the financial interview. Be prepared to discuss and provide evidence for all financial transactions over the past five years (commonly referred to as the “look-back” period).
Going It Alone: Applying for ALTCS without assistance can lead to errors or oversights.
*Use available resources, such as SeniorVue’s free guidance by calling (833) 583-1262 or professional advisors, to ensure your application is complete and accurate.
Tips for a Successful ALTCS Application
Stay Organized: Keep all documents in a dedicated folder.
Be Honest and Thorough: Provide accurate and complete information.
Seek Professional Help: Consider consulting with a Medicaid planner or elder law attorney for assistance with complex cases.
Follow Up: Regularly check the status of your application and promptly respond to any requests for additional information.
Tips for a Successful ALTCS Application
Stay Organized: Keep all documents in a dedicated folder.
Be Honest and Thorough: Provide accurate and complete information.
Seek Professional Help: Consider consulting with a Medicaid planner or elder law attorney for assistance with complex cases.
Follow Up: Regularly check the status of your application and promptly respond to any requests for additional information.
Get Free Help!
Navigating the ALTCS application process in 2025 can be complex and overwhelming. Many people believe they need to pay for expensive preparation services, but that's often not the case. Unless you require the specialized assistance of an estate planning attorney or licensed social worker, you can avoid these costs.
SeniorVue partners with trusted organizations that can help you complete your ALTCS application at little or no cost to your family. Don't go at it alone—reach out to us for guidance and support to ensure your application is thorough and accurate, increasing your chances of success.
Contact us today to get started!
Contact SeniorVue at (833) 583-1262 for free assistance with your application!
Or contact ALTCS toll-free at (888) 621-6880.
Great article - thank you!