What is ALTCS or Arizona Long Term Care System for Assisted Living Homes?

For elderly care, it can be confusing to understand all the different types of health insurance and medical support our there. In Arizona, we have the Arizona Long Term Care System. What is it, and what does it cover? 

Firstly, the Arizona Long Term Care System (ALTCS, pronounced ALL-Tecs) is Arizona’s Medicaid program that provides long-term care services, at little or no cost, to financially and medically eligible Arizona residents who are disabled, blind, aged, or have a developmental disability. The services for ALTCS can be provided in an elderly care institution, at home, or in assisted living homes like Modern Care Homes.

For those who are caregivers for someone they live with, ALTCS provides income to help with the care provided, called the Difficulty of Care program. While income is included when determining eligibility of Medicaid, income for those providing care isn’t counted against eligibility. If you’ve been denied ALTCS, be sure to contact ACCCHS to report the income as Difficult of Care. 

Counted resources can’t exceed $2000, and include:

1. Savings, checking, and credit union accounts
2. Real property that you don’t live in
3. Life insurance policies cash values
4. Bonds, stocks, cash, and certificates of deposits
5. Vehicles that are non-exempt

Resources that ACCCHS doesn’t count towards ALTCS:

1. One vehicle
2. The home where you reside, if it isn’t part of a trust
3. Burial plans and plots
4. $1500 designated for burial
5. Personal and household belongings
6. By federal law, certain accounts, like Flexible Spending Arrangements (FSA), and 530 Coverdell Education Savings Accounts

If you’re under 65 and your resources are over $2000, setting up a special trust may help with your eligibility. 

Income counted towards ALTCS can include Social Security, SSI, wages, and retirement or disability pensions. The gross monthly limit income is $2901.00 for individuals. For married couples, ask for and fill out the Community Spouse Information Sheet. You may still be eligible if your income is over the limit, but you may have to fill out Special Treatment Trust Information Sheet.

While ALTCS can cover the majority of elderly or disability care, personal income may need to be used to cover the difference. This is called Share of Cost, which takes your monthly income, and subtracts the following:

1. A Community Spouse allowance for the needs of your spouse still living in the home
2. Personal needs allowance
3. Your medical insurance premiums
4. A family allowance for any dependents living in your home
5. A home maintenance allowance if you are in a nursing home but will go home within 6 months
6. Medical expenses that ALTCS does not pay for like hearing aids, eyeglasses, and dental care

Once your medical and financial eligibility have been completed, you and your caregivers will be interviewed by a medical assessor. Your medical records will also be reviewed, to make sure you meet the medical requirements for ALTCS. One thing you’ll need to meet for the medical requirements is being at immediate risk of institutionalization in an immediate care or nursing facility for those with intellectual disabilities. 

When you’ve fulfilled all the eligibility requirements, you’ll be assigned a care worker and be enrolled in a long-term health plan. Your case manager will meet with you and your loved ones to craft a plan for the services you’ll be receiving. Some of the services could be included are:

1. Home and Community Based Services, combining out-patient and in-home care
2. Institutional Care in a Nursing Facility
3. Preventive and well care for children
4. Hospice services
5. Behavioral health services

At Modern Care Homes, we work with people with all sorts of insurance and income programs to provide comprehensive and personalized care for our residents. With physicians, nurses, and caregivers at our disposal, we can all work together to provide the best assisted living care for your or your loved one.