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AHCCCS
ALTCS
Arizona Long Term Care System
Do you know someone who needs long term care services either at home, in an assisted living home or facility, or in a nursing facility?
Is that person running out of money to pay for the long term care services?
Is your income too high to qualify for ALTCS?
Do you need an income-only trust?
Do you want to know if there is a way to preserve assets and still qualify for ALTCS?
Do you need help with the paperwork maze?
Have you been told that any gifts or transfers you made will make you ineligible for three to five years?
Our ALTCS Planning services are based on a sliding fee schedule.We use a flat-fee system can keep your planning costs down.Our consultants can help you navigate the ALTCS maze of eligibility and can provide you with valuable time and money-saving options to qualify for this program.
Arizona Long Term Care System (ALTCS) program helps pay for long term care and acute care expenses for the Elderly, Physically Disabled, Blind, and Developmentally Disabled.
In order to qualify for the ALTCS program, a person must meet all three sets of eligibility criteria:
Non-financial, Medical, and Financial.
NON-FINANCIAL ELIGIBILITY GUIDELINES
Categorical Element—Is the member over 65, Disabled, Blind, Under 18, Pregnant, or Deprived?
Social Security Number—The member must have proof of his/her SSN.
Citizenship or Alien Status—Is the member a US Citizen or a lawful alien?
Identity—Can the member prove their identity?
Arizona residency—Is the member intending to stay in the state of Arizona?
Marital Status—If the member is married, he/she may be able to retain more of their combined assets if they can verify marital status.
Living arrangement—Where does the member reside?Is it an ALTCS approved setting?Will he/she have to move? Does the setting have an AHCCCS Provider ID number?
Applying for potential benefits—Is the member a Veteran or a widow of a Veteran?Did he/she work for a company with a pension plan?
Third-party liability—Does the member have other health insurance or benefits to help pay for the medical expenses?If yes, those must be assigned to AHCCCS.
Medical assessment—Is the member at risk of institutionalization?Does he/she require assistance with activities of daily living?
MEDICAL CRITERIA
In order to be eligible for ALTCS, the applicant must meet or exceed a combination of functional and medical factors as established by the Preadmission Screening process. The applicant must need long term care at a level of care comparable to that provided in a nursing facility, but which is below that of an acute care setting (hospitalization or intense rehabilitation) and above that of a supervisory/personal care setting. In the aggregate, the eligible ALTCS customer will have a functional and/or medical condition that is so impaired as to interfere substantially with the capacity of the individual to remain in the community, and result in long term limitation of the individual’s capacity for self care. An individual who meets ALTCS criteria for Title XIX eligibility will present with a combination of the following needs or impairments:
Requires nursing care by or under the supervision of a nurse on a daily basis;
Requires regular medical monitoring; Impaired cognitive functioning;
Impaired self care with activities of daily living;
Impaired continence; Psychosocial deficits.
The following medical records can aid the medical assessor in determining if the ALTCS applicant meets the medical requirements:
Most recent history and physical Physician progress notes for the past year
A copy of a CT scan or MRI reports (if applicable)
List of current medical conditions or medical diagnoses
List of current prescribed and over-the-counter medications
Discharge summary from a hospitalization within the past 6 months
FINANCIAL GUIDELINES
Resources
For single individuals: Does the member have less than $2000.00 in countable assets?
For couples: Does the member and his/her spouse have less than $22,880.00* in countable assets?
Income
For single individuals: When you add together the gross monthly Social Security and all other gross monthly pensions, is the total less than $1911.00?
For couples: When you add together the couples gross monthly Social Security and all othe gross monthly pensions, is the total less than $3822.00?**
Transfers
Has the member given away money or assets that he/she could have used to help pay for his/her care? If so, ALTCS may impose a penalty period of ineligibility depending on the circumstances of the gift or transfer and whether or not there is any uncompensated value for the gift or transfer.
* There are separate guidelines for couples who can verify marital status. In some instances, the "well" spouse is able to retain half of the total resources owned at the time the other spouse began needing long term care services. The half can be at least $20,880.00, but cannot exceed $104,400.00 (for year 2008).
** If the income exceeds these numbers, an applicant may qualify with an income-only trust (AKA: Miller Trust).
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The information on this website is provided "as is" for general information purposes only. The content of this website may not be comprehensive, up-to-date, or applicable in all jursdictions. The content may not reflect the views of Montgomery & Associates, Inc. and Montgomery & Associates, Inc. makes no warranty of any kind, whether express or implied, with respect to any information provided on this website. Montgomery & Associates, Inc. assumes no liability for any errors or omissions in the content on this website and the information provided is not to be construed as legal advice. The information is intended to provide a general, factual overview of legal documents and planning options available. For legal matters you should always seek counsel of a qualified attorney licensed in your jurisdiction. Use of any information on this website is at your own risk.
**IMPORTANT NOTICE**
Our CLDP, Carol Aragon-Montgomery, prepares legal documents.OUR CLDP IS NOT AN ATTORNEY AT LAW AND IS NOT EMPLOYED BY ATTORNEYS AT LAW AND CANNOT GIVE LEGAL ADVICE.Your communications with our CLDP are kept CONFIDENTIAL by our CLDP, but since our CLDP is not an attorney at law, such communications are NOT PRIVILEGED (i.e., immune from Subpoena). Our CLDP can give you general factual information pertaining to legal rights, procedures, or options available to you in a legal matter when you are not represented by an attorney.Our CLDP cannot give you specific legal advice, opinions, or recommendations about your legal rights, remedies, defenses, options, or strategies. Please note that the Long Term Care Planning Services are of a financial planning nature and are not specific “legal” advice.
