8,000+
FreedomCare helps Pima County families get paid through Arizona Medicaid for the care they're already giving a parent, sibling, or other loved one at home.
Pima County families often find themselves caring for an older parent or a spouse with very little warning. It usually starts with something specific. A fall. A hospital stay that ends with a discharge planner saying the word "rehab" or "nursing facility." A diagnosis that changes everything about daily life. If that is where you are right now in Tucson, Marana, Oro Valley, Sahuarita, or one of the communities just outside the city, you are not alone, and you do have options.
FreedomCare helps Pima County families understand how Arizona Medicaid can pay a family member or trusted person to provide care at home. The goal is simple. The person you love should not have to move into a facility to get the help they need, and you should not have to choose between caring for them and earning a living. We work through the Medicaid rules with you so you can see what is actually possible.
Pima County has one of the oldest populations in Arizona, and that has steadily pushed up the need for Medicaid-funded home care. More than one in five residents here is a senior, which is well above the national average. When that many people are reaching the age where daily help becomes necessary, the question of how to provide care at home stops being abstract and becomes a weekly reality for thousands of families across Tucson, Marana, Oro Valley, Sahuarita, and the communities just outside the city.
In a county this large, knowing where to turn for aging and caregiver support matters. The Pima Council on Aging (PCOA) is the Area Agency on Aging for Pima County, offering a help line and care navigation for older adults and families. For many families, home and community-based services (HCBS) are the option that lets care stay at home instead of moving into a facility.
For families who want a relative to provide ongoing care at home, ALTCS is usually the pathway that matters. Standard AHCCCS coverage can include some limited personal care, but ALTCS is the long-term care program that can fund ongoing help at home for people who need a nursing-facility level of care. You can read more on the AHCCCS website.
Arizona's Medicaid program is called AHCCCS, short for the Arizona Health Care Cost Containment System. Most people just say "access." Within AHCCCS there is a long-term care program called ALTCS, the Arizona Long Term Care System. ALTCS is the part of Arizona Medicaid that can pay for ongoing care at home for people who need a nursing-facility level of care but want to stay where they are.
This is the part most families do not realize at first. ALTCS does not only pay for nursing homes. It also pays for home and community-based services (HCBS), which means the help can come to the house instead of the person moving into a facility. For a lot of families, that single fact changes the whole picture. The care your parent or spouse needs can happen in their own bedroom and kitchen, not in an institution across town.
To qualify for ALTCS, a person has to meet two separate tests. The first is medical. An assessment has to show they need a nursing-facility level of care, based on how much help they need with activities of daily living such as bathing, dressing, eating, and moving around safely. The second is financial. ALTCS reviews income and assets against limits set by the program. Meeting one test but not the other is not enough, which is exactly why the screening matters and why guessing on your own can waste weeks.
Standard AHCCCS coverage can include some limited personal care, but for families who want a relative to provide ongoing care at home, ALTCS is usually the pathway that matters. You can read more on the FreedomCare Arizona page and on the AHCCCS website.
Here is the part that brings most families to us. Once someone is approved for ALTCS and is living in their own home, they can often choose who provides their care. This is called member-directed care, and it is what allows a family member or trusted friend to be paid for the help they are already giving. Arizona offers two main models for this, and the right one depends on how much of the administrative work your family wants to take on.
With Agency with Choice, you work with a provider agency that handles payroll, tax paperwork, training support, and the rest of the administrative side, while the ALTCS member still chooses and directs their own caregiver. FreedomCare is an Agency with Choice provider in Arizona. In plain terms, that means we handle the back-office work and make sure the caregiver gets paid, so the family can put their energy into care instead of forms. You can learn more on our Agency with Choice page.
With Self-Directed Attendant Care (SDAC), the member takes on more of the employer responsibilities directly, with support from a financial management service. This model gives the family more direct control, but it also asks more of them administratively. Both models let an adult child, a relative, or a trusted friend serve as the paid caregiver. The difference is mostly about who carries the paperwork.
This is one of the most common questions we hear, and the answer is more nuanced than a simple yes or no. Under AHCCCS policy, a legally responsible spouse may be able to provide paid attendant care, but the allowed hours are capped and the rules are specific. A parent caring for an adult child, or an adult child caring for a parent, generally has more straightforward options than a spouse does. Because this is the area where families most often get tripped up, it is worth confirming the current rules for your exact situation before you count on a particular arrangement.
Pima County has one of the oldest populations in Arizona, and that has steadily pushed up the need for Medicaid-funded home care. More than one in five residents here is a senior, which is well above the national average. When that many people are reaching the age where daily help becomes necessary, the question of how to provide care at home stops being abstract and becomes a weekly reality for thousands of families.
Sources: U.S. Census QuickFacts, USAFacts population data, and AHCCCS Population Statistics. Figures reflect the most recent Census and USAFacts estimates available and should be refreshed when newer data is published.
Most families do not arrive at this because of paperwork or programs. They arrive because someone they love needs help, and the idea of that person moving into a facility does not sit right. Staying home means staying in a familiar place, surrounded by the routines, the photographs, the kitchen, and the people that make someone feel like themselves. For an older adult especially, that familiarity is not a small thing. It can be the difference between holding steady and declining quickly.
There is also the matter of trust. When the caregiver is a daughter, a son, a spouse, or a longtime friend, the person getting care is not handing their most private moments, bathing, dressing, using the bathroom, to a stranger who rotates out every few weeks. They are being cared for by someone who already knows them, already loves them, and already notices when something is off.
FreedomCare believes people should be able to grow older at home, with someone they trust, and that the family member doing that work should not have to do it for free while quietly wearing themselves down. Caregiving is real work. Arizona Medicaid recognizes that, and so do we. The point of all of this is to make it possible for Pima County families to keep care where it belongs, at home, without going broke or burning out to do it.
FreedomCare works with Pima County families to take the confusion out of Arizona Medicaid home care. We are an Agency with Choice provider, so once your family member is approved for ALTCS, we handle caregiver onboarding, payroll, and ongoing support while you focus on the care itself.
In practice, that looks like a few specific things. We help you figure out whether the person you care for is likely to qualify before you sink weeks into an application. We explain the medical and financial requirements in plain language instead of program jargon. We help you get the paperwork right the first time, which is where most delays come from. And once everything is approved, we make sure you actually get paid for the hours you work, on time, without you having to chase it down.
Just as important is what we are not. We are not a nursing home, and we are not a staffing agency that sends a rotating cast of strangers to the door. Our entire model is built around letting people receive care from someone they already know and trust. You can read more about what we stand for on our vision and values page, and see the difference this approach makes for families on our impact page.
Tucson has a strong network of senior and disability services, including the Pima Council on Aging, which helps older adults and their families work through long-term care questions. Even so, families often tell us the Medicaid side of things stayed confusing until someone explained how ALTCS and home care actually fit together. That is where we come in.
Here is a simple side-by-side of the main pathways. It is a starting point, not the full picture. For the complete comparison, including waiver details, see the FreedomCare Arizona page.
| Pathway | How It Works | Who It Tends to Fit |
|---|---|---|
| ALTCS | Long-term care for people who need a nursing-facility level of care; can fund care at home. Requires both medical and financial eligibility. Member must live in their own home, not a facility. | People who need ongoing nursing-facility-level support and want to stay home through Arizona Medicaid. |
| Standard Medicaid home care | Limited personal care under standard AHCCCS coverage; not the main long-term care pathway. More limited in scope and approved hours. May serve as a bridge for lighter needs. | Members with lighter needs who are not on the ALTCS long-term care pathway. |
| Family caregiver support | Member-directed models (Agency with Choice, SDAC) that let a relative or friend be paid. Available to ALTCS members who direct their own care. Spouse pay is allowed but capped; other relatives have broader options. | Families who want a relative or trusted person to provide care, with Agency with Choice or SDAC handling pay and compliance. |
ALTCS is the Arizona Long Term Care System, the part of Arizona Medicaid (AHCCCS) that pays for long-term care. It can cover care at home, not just in a nursing facility, for people who meet a nursing-facility level of care and the program's financial limits. It is administered by AHCCCS, the state's Medicaid agency.
Yes. Through ALTCS, Arizona Medicaid covers home and community-based services for people who qualify, so they can receive care in their own home instead of moving into an institution. This includes services like attendant care, personal care, and homemaker support.
In most cases, yes. ALTCS is built around helping people stay at home when that is safe and cost-effective for the state. The person needs to meet both the medical and financial requirements and live in their own home rather than a facility.
Yes. Through member-directed models like Agency with Choice and Self-Directed Attendant Care, an ALTCS member can often choose a family member or trusted friend as their paid caregiver. An adult child, sibling, relative, or friend can usually serve in this role. Spouse rules are more limited and capped, and should be confirmed with AHCCCS.
Meeting the requirements for Medicaid home care eligibility under ALTCS depends on two things. First, a medical assessment has to show the person needs a nursing-facility level of care, based on help needed with activities of daily living. Second, a financial review looks at income and assets against program limits. Both have to be met, which is why the screening is the right first step.
Timelines vary. After you apply, ALTCS conducts both a medical and a financial assessment, and the process can take several weeks or longer depending on how complete your documentation is. Having your paperwork ready up front is the single best way to avoid delays.
Call the ALTCS office at 888-621-6880 to request an application and set up an eligibility screening. Pima County residents can also get help from the Pima Council on Aging, which assists older adults and families with long-term care questions. FreedomCare can help you prepare your paperwork and understand the medical and financial review before you apply, so the process moves as smoothly as it can.
Finding out whether you qualify does not cost anything and does not commit you to anything. A short conversation can tell you whether the person you care for in Pima County is likely to meet the ALTCS requirements, which caregiving model fits your family, and whether you can be paid as their caregiver. If you have been stuck trying to get answers on your own, this is the part where it gets easier.
Important Disclaimer: This information is provided for educational purposes and is not legal or financial advice. Medicaid rules and program details change, and eligibility requirements, caregiver rules, and benefit levels may vary by managed care organization and individual circumstances. Always confirm current program requirements directly with AHCCCS or your managed care organization before making decisions about long-term care. For advice specific to your situation, consider speaking with a qualified enrollment specialist, social worker, or elder law attorney.
If you are getting started in Pima County, these official Arizona resources can help. We have included a short note on what each one is for, so you are not clicking around blind.
County-level Medicaid enrollment data published by the state.
azahcccs.gov/Resources/Downloads/PopulationStatisticsCall 888-621-6880 to request an application and schedule an eligibility screening.
azahcccs.gov — ALTCSThe Area Agency on Aging for Pima County, offering a help line and care navigation for older adults and families.
pcoa.orgState services and support programs for older Arizonans.
des.az.gov/services/older-adultsPopulation, senior, disability, and poverty data for the county.
census.gov/quickfacts — Pima CountyStatewide overview of ALTCS home care and Agency with Choice with FreedomCare.
freedomcare.com/arizonaHow FreedomCare supports paid family caregivers under Arizona's Agency with Choice model.
freedomcare.com/agency-with-choiceWe’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across Arizona every day.
We’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across Arizona every day.
You’ve been caring for your loved one because it’s the right thing to do. FreedomCare can help you navigate Arizona’s ALTCS program, understand your options, and take the first step toward care from someone you trust while they get paid for it.
