The Complete Arizona Family Guide to ALTCS: Eligibility, Application, and What to Expect

What Is ALTCS?

Arizona's Long-Term Care System (ALTCS) is the state's Medicaid program specifically designed to cover long-term care services for elderly and disabled individuals. Unlike standard Medicaid (AHCCCS), ALTCS covers services such as assisted living, nursing facility care, adult day health care, and home-based personal care services.

ALTCS is administered by the Arizona Health Care Cost Containment System (AHCCCS) and is available through two types of contractors: the Arizona Long-Term Care System (for most counties) and the Department of Economic Security (DES) for tribal members.

Who Is Eligible?

To qualify for ALTCS, an individual must meet three separate criteria:

1. Financial Eligibility

Income must be below 300% of the federal Supplemental Security Income (SSI) rate (approximately $2,742/month in 2025 for an individual)

Assets must be below $2,000 for a single individual (certain assets are exempt, including a primary home, one vehicle, and personal belongings)

If income exceeds the limit, a Special Income Trust (also called a Miller Trust or QIT) can be established to qualify

2. Functional Eligibility

The individual must require a nursing-facility level of care — meaning they need significant assistance with Activities of Daily Living (ADLs) such as bathing, dressing, eating, mobility, and continence

This is assessed through a Pre-Admission Screening (PAS) conducted by an ALTCS assessor

3. Residency and Citizenship

Must be an Arizona resident

Must be a U.S. citizen or qualified immigrant

The Application Process: Step by Step

Step 1: Contact ALTCS

Call AHCCCS at 1-888-621-6880 or visit an ALTCS office to begin the application. You can also apply online through the AHCCCS portal.

Step 2: Financial Documentation

Gather documentation including: bank statements (last 3 months), income verification (Social Security, pension, retirement), property records, insurance policies, and any recent large financial transactions.

Step 3: Pre-Admission Screening (PAS)

An ALTCS assessor will visit the applicant (at home, hospital, or facility) to evaluate functional needs. This assessment determines whether the individual meets the nursing-facility level of care requirement.

Step 4: Application Review

ALTCS has 90 days to process the application. During this time, they verify financial and functional eligibility. If additional documentation is needed, they will contact you.

Step 5: Enrollment and Plan Selection

If approved, the individual is enrolled in ALTCS and assigned to a managed care contractor. They will work with a case manager to develop a care plan.

Common Challenges and How to Avoid Them

Challenge: Incomplete financial documentation

ALTCS requires a thorough review of financial history, often going back 5 years (the "look-back period") to identify any asset transfers that might affect eligibility. Work with a benefits counselor or elder law attorney to ensure all documentation is complete and accurate.

Challenge: Functional assessment disagreements

If you believe the PAS assessment does not accurately reflect the individual's care needs, you have the right to request a reassessment or appeal the decision.

Challenge: Long processing times

Applications can take the full 90-day window. During this time, if the individual is in a facility, they may need to pay privately until ALTCS approval is confirmed. CareRoots can help families plan for this gap period.

How CareRoots Can Help

CareRoots Health provides ALTCS navigation support as part of our family services. We help families:

Understand eligibility before applying

Gather and organize required documentation

Prepare for the Pre-Admission Screening

Identify appropriate care settings that accept ALTCS

Navigate the transition from private pay to ALTCS coverage

Our guidance is provided as a care coordination service — we do not accept placement commissions or referral fees from facilities.

*This guide is provided for informational purposes and reflects general ALTCS program requirements as of early 2025. Program rules and income/asset limits change periodically. Contact CareRoots Health or an ALTCS specialist for guidance specific to your situation.*