Did you know that Medicaid can help pay for assisting living, nursing homes and long term care for elderly individuals that may not have the ability to pay on their own? Even though Medicaid programs adhere to federal guidelines, each program is managed at the state level. In Arizona, the Arizona Long Term Care System (ALTCS) under the jurisdiction of the Arizona Health Care Cost Containment System (AHCCCS). The ALTCS Program is dedicated to providing long term care services for qualifying individuals who require extended medical care. In Arizona ALTCS is Medicaid and Medicaid is ALTCS.
Individuals who fulfill specific criteria may qualify for assistance through ALTCS. However, the process of pursuing ALTCS benefits can be extremely complicated, time consuming and nerve wracking. The program requires very specific financial and health conditions be met to qualify for ALTCS. If you or a family member wishes to apply for ALTCS benefits, you should reach out to a Phoenix ALTCS/Medicaid planning lawyer. An experienced attorney could review your eligibility for ALTCS benefits and assist you throughout the application process.
Let’s face it with the average monthly cost of assisted living in Arizona hovering around $6,000 a month, most of us would not just exaust all our savings but may simply run out of money by trying to pay out of pocket.
Elderly or disabled individuals who have few economic resources and meet certain health requirements, meaning they are medically-needy, may be eligible for the ALTCS program’s benefits. There is a wide range of benefits and services available if someone’s application for ALTCS is approved.
Generally speaking, ALTCS benefits cover an array of hands-on, long-term care solutions, including assisting living, memory care, nursing homes, critical care, at-home care, assisted care, and nursing home care. ALTCS can also cover expenses for things like assistive devices, dental expenses, senior transportation providers, and home food deliveries.
Assuming the individual’s ALTCS application is granted, they will work with a care provider who contracts with the state-run program. The individual will be assigned a case manager to help them outline a plan based on the medical assistance, services, and benefits they require. An ALTCS attorney in Phoenix could help someone pursue eligibility for long-term care services and identify any potential obstacles that could hurt their chances of approval.
The requirements to qualify for benefits and services through ALTCS can be complex to understand. It is often wise to consult with a local Medicaid planning attorney who has an in-depth understanding of the process involved.
Specific financial and medical benchmarks must be met to qualify for ALTCS benefits. The individual must be a citizen or legal resident of the U.S., and a resident in the state of Arizona. They must also be 65 or older or have a disabling condition that renders them in need of long-term nursing care.
ALTCS imposes limits on the monthly wages and countable financial assets an applicant may have to be considered for long-term care benefits. Non-countable assets that would not factor into this cap include the individual’s primary residence and one vehicle, as these are exempt and are not countable by ALTCS. On the other hand, equities, bank accounts, and vacant land, vacation homes, rental properties,etc. are countable assets.
To gain approval for ALTCS benefits as a single applicant, an individual’s countable assets must not exceed $2,000, and their monthly wages (i.e., earnings, Social Security, etc.,) should be no higher than $2,349. The cap placed on countable assets, and combined income is higher when a married couple applies for ALTCS benefits.
Also, if an applicant is married, but their spouse does not reside in a care center, the spouse not seeking ALTCS benefits (commonly called the “well spouse”) may retain some of the assets belonging to the spouse applying for benefits. If the applicants’ wages and countable assets meet the criteria to qualify for ALTCS benefits, the grand sum of their monthly earnings will be reviewed to assess whether they should cover part of their long-term care expenses if approved for the program.
The applicant’s condition must entitle them to the nursing home degree of care. Assuming they meet the economic benchmarks for ALTCS, the applicant would sit down with a nurse or caseworker who would assess whether their medical condition entitles them to benefits.
These cases can take anywhere from two months or longer. As you can imagine, Denials are common, and it may be necessary to file an ALTCS appeal in some cases. If you are seeking long-term care services through AHCCCS, you may want to speak with a Phoenix ALTCS/Medicaid planning lawyer.
Our team could assess your current circumstances to determine whether you may qualify for ALTCS benefits and help with your application. To request legal assistance for your ALTCS case, give us a call and schedule an ALTCS Planning consultation with a Phoenix lawyer. We look forward to hearing from you.