The Arizona Long Term Care System (ALTCS) is a Medicaid program designed to help financially and medically eligible Arizona residents who are aged, blind, disabled, or have a developmental disability. However, navigating the eligibility criteria can be a complex process. This guide aims to provide a comprehensive understanding of ALTCS eligibility.
Financial eligibility
To qualify for ALTCS, applicants must meet certain financial criteria. These include both monthly income limits and resource limits.
Income Limit
As of 2023, the monthly income limit for an individual applicant is $2,382. For married couples, if both spouses are applying, each has an income limit of $2,382.
Resource Limit
The resource limit for an individual is $2,000. Resources include cash, bank accounts, stocks, bonds, etc. For married couples, if only one spouse is applying, the non-applicant spouse can retain up to $130,380 in resources.
It’s important to note that some assets, like your home, are not counted as resources, provided the equity value does not exceed $603,000. Additionally, certain resources may be exempt from counting towards the resource limit if they are considered essential for daily living.
Medicaid eligibility
In addition to financial criteria, ALTCS requires applicants to meet certain medical eligibility requirements. Applicants must require a level of care typically provided in a nursing facility. The state uses a tool called the Pre-Admission Screening (PAS) to determine this. The PAS assesses an individual’s ability to perform Activities of Daily Living (ADLs), such as eating, bathing, dressing, toileting, transferring, and continence.The PAS also evaluates an individual’s cognitive abilities.
Applicants must also meet medical criteria related to their physical or mental health condition. This includes being diagnosed with a chronic or disabling condition that requires ongoing medical care and supervision.
Special Eligibility Groups
Certain individuals may be eligible for ALTCS without meeting the income and resource limits. These include:
- Children who are medically fragile or have a developmental disability
- Individuals receiving Supplemental Security Income (SSI)
- Individuals who are blind or visually impaired
- Individuals who are eligible for Medicare and have high medical expenses
The ALTCS Application process
Applying for ALTCS involves several steps:
- Initial Inquiry: You or a representative will contact ALTCS to express interest in the program.
- Phone Interview: An ALTCS worker will conduct a phone interview to gather basic information about your financial situation, living arrangement, and health status.
- Documentation Collection: You will need to gather and submit financial documents, medical records, and other required paperwork.
- In-Person Assessment: An ALTCS nurse or social worker will visit your home to conduct a medical assessment.
The application process can take up to 60 days from the date ALTCS receives your completed application. It’s essential to provide accurate information and respond promptly to requests for additional documentation to avoid delays.
Understanding ALTCS benefits and financial and medical eligibility can be challenging, but it’s a crucial step to access the long-term care you or a loved one may need. If you are unsure about your eligibility, it may be helpful to consult with an elder law attorney or a Medicaid planning professional.
Remember, this is only a general guide. ALTCS eligibility rules and financial requirements can change, and each person’s situation is unique. Always check with ALTCS or a knowledgeable professional for the most accurate and current information.