ALTCS & Long Term Care Planning Lawyers in Gilbert, AZ

The individual or their representative can determine their own living arrangements. These options include living at home or with a family member well receiving in-home care. If the individual is living in an assisted living facility, the facility but participate with the ALTCS program. 

To qualify for ALTCS, applicants must undergo an in-person screening process called the Pre-Admission Screen (PAS), that is point-based and is how ALTCS determines medical eligibility. You’ll have an examination during the screening process, and your overall health will be reviewed. Your Activities of Daily Living (ADLs) will be assessed. Some examples of ADLs are bathing, dressing, using the toilet, transferring (to or from bed or chair) and eating.

ALTCS then assigns a numerical score based on the results of the PAS and your medical records. Applicants do not frequently have difficulty meeting the medical requirements, so long as ALTCS feels they need daily assistance.  A diagnosis of Alzheimer’s or other forms of dementia gives extra consideration for eligibility.

A family member and/or primary physician can and should provide input. Applicants may be reluctant to tell a stranger about incontinence or other personal details or try to show the assessor how well they are doing.

Most Americans are shocked at the cost of long-term care and the United States has no health insurance system to pay for long-term care.  ALTCS applicants must meet the financial requirements including strict income requirements as well as the resource criteria in order to qualify for the program.

Many people struggle with the qualification portion of the ALTCS application. This is one of the reasons why it is helpful to have an experienced Phoenix Medicaid attorney assist you with your application.

Income Limits

Does My Income Affect My ALTCS Eligibility?

Income affects an applicant’s eligibility, as single and married applicants cannot exceed their respective monthly income limits.

Using a Miller Trust (also known as an income Only Trust) are often used to solve the problem of income over the limits. You assign your right to receive Social Security and other income to the trust. This can help solve the issue of excess income so that you can qualify for ALTCS.

Miller Trusts or Income Only Trusts can be difficult to set up, but a qualified Medicaid planning attorney can assist.

For individuals, gross income may not exceed $2,523/month. For married couples, the couple’s joint income may not exceed $5,046/month. If you are one cent over these amounts, you become ineligible.

Minimum Monthly Maintenance Needs Allowance is the minimum income amount for the well spouse. This amount is $2,177.50. If the income of the well spouse is less than this amount a portion of the institutional spouse’s income can be kept by the well spouse. The Maximum Monthly Maintenance Needs Allowance for the well spouse is $3,435.

Asset Limits

ALTCS has very specific and complex resource allowances and asset limits. 

The individual applying may not have more than $2,000 total assets to qualify for ALTCS. Even one dollar over will make you ineligible. Married couples are more complicated to calculate. This is known as the Community Spouse Resource Assessment (CSRA) or the amount the well spouse may keep. The total assets of the couple are added together than divided by two to get the CSRA. The CSRA maximum is $148,620.00, and the minimum is $29,724.00. The applicant may still retain the $2,000 as well. 

Arizona ALTCS Program does allow for certain assets to be non-countable.  For example, all the following assets are excluded when an individual applies for the program. (1) Primary Home, one motor vehicle, pre-paid burial plots, burial funds, some life insurance policies and household goods, including wedding ring, pets, and tools used for income, etc.

It’s also important for applicants to understand ALTCS case reviewer does not only look at someone’s current assets and income but also looks back up to five years proceeding your application date. If ALTCS finds any case where an applicant gave away money and did not receive anything of fair market value back, this will result in a penalty period for the applicant.  The penalty period is calculated by dividing the amount of the gift by the average rate for private pay facility. The result is the number of months, an applicant must continue to pay for their care until ALTCS effective date kicks in.