What Is ALTCS (Long-Term Care Planning)?
What is ALTCS? Arizona Long-Term Care System (ALTCS) is Arizona’s Medicaid program providing long-term health coverage for those medically and financially eligible.
ALTCS is a program that will pay for some or all of an individual’s living costs either with in-home care or at a full-time facility that accepts with ALTCS.
While many confuse Medicare and Medicaid, they are two different programs. Medicaid is need-based, meaning only the individuals that meet the requirements qualify to receive these benefits. Medicaid is a public assistance program that helps pay costs for individuals with limited income and assets. To be eligible for Medicaid, you must meet the strict income and asset guidelines.
In Arizona, ALTCS can provide individuals with many health coverage benefits. What does ALTCS pay for? The program can help with:
- Facility care, including nursing homes, assisted living, and rehabilitation facilities
- At-home care
- Acute care services, including doctor and medical testing
- Services for mentally disabled children and adults
- Home and community services
- Senior transportation
- Home food deliveries
ALTCS and long-term care planning go hand in hand, as this program helps provide long-term care for seniors and those suffering from a disability. Long-term care is a range of services and support you may need to meet your personal care needs. Most long-term care is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called Activities of Daily Living (ADLs)
ALTCS Eligibility Requirements
The ALTCS eligibility requirements for consist of three categories: General, Financial and Medical. At a minimum to meet the requirements for Arizona long term care the individual needs to be a U.S. citizen, mush had a Social Security Number and must be a current resident of Arizona.
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.
Medical Eligibility Requirements
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.
Financial Eligibility Requirements
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.
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.
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.
Contact Our Gilbert Medicaid Planning Attorneys for a Consultation
Navigating the ALTCS process can be difficult. Call and schedule a consultation with one of our Gilbert Medicaid Planning Attorneys today to begin preserving assets and meeting eligibility.
Why Is Planning for ALTCS & Long-Term Care Important?
Let’s face it, we work hard to build a legacy to leave to our loved ones. That’s why it is so important to plan for your future now before ALTCS benefits are necessary. Using the right ALTCS planning strategies can preserve assets before starting the ALTCS application process.
Strategies to Help You Qualify for ALTCS in Arizona
Contact the Law Offices of Brandon White today to help you qualify for ALTCS. Some strategies that can be used are spend-down plans, Miller Trusts, and Irrevocable Trusts.
How Our Phoenix Experienced Medicaid & ALTCS Planning Lawyers Can Help
Many individuals who choose to apply for ALTCS without assistance are denied. Our experienced elder law attorneys can help you and your loved ones through this difficult process. Getting ALTCS assistance can save time, money and frustration. The Law Offices of Brandon White have experience guiding loved ones through the ALTCS process, from planning before applying, working closely with the eligibility specialist and making sure the transition is smooth after successful approval. When your family needs financial assistance with long-term care, call us to help.
Hear from Some of Our ALTCS/Medicaid Clients