Photo by Georg Arthur Pflueger

What does ALTCS mean?  ALTCS means Arizona Long Term Care System.  This article explains what you need to know about Arizona ALTCS Eligibility Requirements and the ALTCS application process to satisfy the specific ALTCS eligibility requirements.  An elder law attorney practices in this area.  An elder law attorney may also be called an ALTCS attorney or Medicaid attorney. Elder law is an area that we provide service in Arizona.

The average monthly cost of assisted living accommodation in Arizona is $3,750 per month.  For nursing care, a private room averages $8,136 per month in a nursing home.  (Source:  Genworth Financial Insurance, 2019)  Without property legal and financial guidance, the devastating costs of long term care can destroy the most well planned retirement.  And asset protection attorney who practices elder law in Arizona, can guide individuals, spouses, and families through the maze of federal and state law and regulations to get seniors qualified to receive benefits under the ALTCS program in Arizona.

Medicaid is the primary needs based federal program for those who need medical care and cannot otherwise afford the cost.  While Medicaid is a federal program, it is administered at the state level.  Therefore each state’s implementation, rules, and regulations governing the Medicaid eligibility requirements are slightly different.  Arizona will have specific eligibility requirements.

Many people ask what is the Arizona Medicaid program called?  Other people ask what does AHCCCS mean?  The Arizona Medicaid program is called the Arizona Health Care Cost Containment System or simply AHCCCS (pronounced like the word “access“).  Within AHCCCS is a special program addressing how to pay for the long term care of seniors in Arizona and how to pay for the long term care of disabled person in Arizona.  ALTCS (pronounced “all tecks“) is a particular type of Medicaid program addressing these needs.

There are legal ALTCS eligibility requirements.  There are financial ALTCS eligibility requirements.  And there are ALTCS medical eligibility requirements.  We explain the three different eligibility requirements below in details.

To meet the legal Arizona ALTCS eligibility requirements, an applicant must:

• Be a U.S. citizen or legal resident who has a valid Social Security Number
• Be a resident of Arizona who has the intent to remain an Arizona resident
• Make an effort to secure all other government benefits to which the applicant is entitled
• Provide the ALTCS agency evidence to support a claim for benefits
• Reside either in their own home, or certain licensed medical facilities, or in a setting otherwise approved by a state waiver program.

Some clients ask, what if I do not disclose assets when applying for ALTCS?  If one knowingly and willingly attempts to defraud ALTCS by not declaring all assets then that person may be committing a federal crime and/or a state crime of attempting to defraud the government.

To qualify financially for ALTCS, an applicant must meet strict tests measuring both income and assets.  If an applicant qualifies for ALTCS under the income test but not the asset test, then the applicant is disqualified for ALTCS benefits.  The same is true for an applicant who qualifies for ALTCS under the asset test but not the income test.  The income and asset tests are adjusted periodically, at least annually, to account for inflation and other changes as directed by federal and state laws and regulations.

ALTCS INCOME LIMITS

To meet the financial Arizona ALTCS eligibility requirements for income, an applicant must:

• Have income not more than $2,349 per month, if single **
• Have an individual income not more than $2,349 per month, if married **
• Have a combined income not more than $4,698, if both married spouses are simultaneously applying for benefits **

* These are the limits as of January 1st, 2020, and are adjusted periodically.

** ALSO, many seniors who desperately need financial assistance from ALTCS have monthly incomes more than $2,349 per month – sometimes vastly more – and do not investigate applying for ALTCS when learning of these income limits.  However, even when an applicant or husband/wife joint applicants have income that exceeds these limits, an experienced ALTCS attorney (sometimes also called a Medicaid attorney or elder law attorney) can often find loopholes in the law to allow applicants to qualify for ALTCS benefits.  We encourage you to consult with an elder law attorney at the Citadel Law Firm to determine if you can use these loopholes in the law for your benefit and qualify even if your income is above $2,349 per month.

There are some other things to note about “income” when applying for ALTCS.  First, the income limits are gross (before tax) limits.  Second, ALTCS measures income from all sources.  Third, the definition of income for ATLCS purposes may be different and more broad than the definition for income tax purposes used by the IRS.  Therefore what people often think of as income for their whole lives may not meet the definition of income for ALTCS applications.  It is therefore important for many to consult with an attorney and determine what income must be reported to minimize the risk of being penalized by ALTCS by not declaring all gross income when applying.

ALTCS ASSET LIMITS

To determine one meets the ALTCS financial eligibility requirements for assets, an applicant should first create a balance sheet of all assets owned or controlled by the individual (and spouse, if married).  The balance should also detail all debts and other liabilities of the applicant and spouse.  Then there must be a detailed financial analysis of all assets to determine whether each one is classed as a countable resource or a non-countable resource.  If there are too many countable resources, then an applicant will be denied ALTCS benefits.  Moreover, once an ALTCS application is submitted, the assets owned by the individual at the time of the application AND all assets given away as gifts in the last 5 years, will count against the applicant and penalties will be imposed by the ALTCS agency.  An elder law attorney who practices in asset protection for seniors will be able to perform this analysis for the applicant.  An elder law attorney who practices in asset protection for seniors may also be able to identify loopholes in the law.  These loopholes may create opportunities to shift assets and liabilities to either help the applicant qualify immediately or reduce the penalty period to help the applicant qualify for ALTCS benefits as soon as possible.  Whether such loopholes in the law will work for any particular are very fact specific.

Strictly speaking, to meet the financial Arizona ALTCS eligibility requirements for assets, an applicant must have total countable resources of not more than $2,000 in assets to apply for benefits and must not accumulate assets greater than $2,000 in any given month to remain eligible for ALTCS benefits.  Because this countable resource limit of $2,000 in assets is so low, it is often imperative for applicants to work with an elder lawyer to position finances in accordance with the law.  This may include engaging in asset protection strategies that are legal methods of reducing assets with the goal of qualifying for ALTCS benefits.  An elder lawyer can also help the healthy spouses of needy seniors navigate the ALTCS application process and reserve hundreds of thousands of dollars for the healthy spouse survival.

An elder law attorney in Chandler, Arizona, can help the applicant and health spouse engage in asset protection strategies to convert countable resources into exempt resources and qualify for ALTCS benefits.  We encourage you to consult with an elder law attorney at the Citadel Law Firm to learn whether long term care asset protection for seniors is an option for you or your loved one.  Doing so may help to allow an otherwise ineligible senior to go through the ALTCS application process and obtain benefits worth hundreds of thousands of dollars while allowing the healthy spouse to maintain his or her standard of living.

To qualify medically for ALTCS, an applicant must meet strict requirements for medical need.  Generally, receiving assistance every day to perform certain functions defined by ALTCS is required to qualify for benefits.  These functions are akin to the level of care one would receive in a nursing home, whether or not the applicant actually resides in a nursing home now or is receiving care in a home or other community based setting.  Whether one qualifies is determined in the ALTCS application process when the ALTCS agency performs a pre-admission screening (also called the “PAS”).  During the first stage of the PAS, the screener will obtain various basic information about the applicant’s living arrangements, age, and medical providers.  In the second stage of the PAS, the screener will conduct an interview to determine a typical day in the life of the applicant, the applicant’s cognitive abilities, how an applicant performs certain predefined activities the ALTCS agency has determined necessary for independence, the type assistance required to perform these activities, and whether the applicant can receive assistance in their current living environment.  The screener likely will also review the existing medical records of the applicant and determine if there are debilitating neurological disorders like Alzeihmer’s Disease at play.  All of this information is then put into the ALTCS application process formula that determines ALTCS medical eligibility score.  An elder law attorney experienced with the laws and regulations governing ALTCS can advise you on whether you or your loved one is likely to meet the ALTCS medical eligibility requirements.  While an elder law attorney cannot coach you how to answer questions of the PAS screener, an elder law attorney can advise you what to expect in a PAS and what type of questions may be asked.  Most applicants find such a conversation with and elder law attorney or asset protection lawyer helpful in reducing the stress of going through the ALTCS application process.

Although we can help you and your family in a moment of crises we will be able to help you better if we plan ahead. Contact an Arizona Elder Law Attorney and Estate Planning Lawyer from the Citadel Law Firm, PLLC today, our attorneys will be able to access if you meet the requirements and you are eligible for ALTCS in the State of Arizona.

SUMMARY

The Arizona Long Term Care System ALTCS exists to help seniors qualify for long term care benefits.  However, given the generosity of the program, there are strict Legal, Financial, and Medical requirements that all must be met before an ALTCS applicant qualifies for benefits.  The elder law attorneys in Chandler, Arizona, at the Citadel Law Firm can guide you through this process and work with you to ensure your legal, financial, and medical declarations are in order before submitting an ALTCS application.  Navigating the laws and regulations of the ALTCS application process successfully can not only help a needy spouse to qualify sooner for benefits, but also it can preserve assets for a healthy spouse and family.  The key to successful asset protection for seniors in many cases is engaging an elder law attorney and asset protection lawyer as soon as possible to discover what exceptions exist in the law for your loved one.