Understanding ALTCS: Arizona's Program for Long-Term Care Costs

The Arizona Long Term Care System — commonly called ALTCS — is the long-term care branch of Arizona's Medicaid program, administered by the Arizona Health Care Cost Containment System (AHCCCS). ALTCS was created to help Arizona residents who need ongoing, intensive personal care pay for that care when they cannot afford it on their own. Unlike regular health insurance or Medicare, ALTCS is specifically designed to cover long-term care — the kind of ongoing daily assistance that people with serious illness, physical disability, or cognitive decline may need for months or years. This can include help with bathing, dressing, eating, mobility, medication management, and more. ALTCS operates as a managed care program. Once approved, members are enrolled with a Long Term Care health plan and assigned a dedicated case manager who helps coordinate their care. In Maricopa County, health plans currently serving ALTCS members include Mercy Care, Banner-University Family Care, and UnitedHealthcare Community Plan.

Medicare does not cover long-term custodial care — the day-to-day help with bathing, dressing, and meals that most seniors in assisted living need. ALTCS may help fill this gap by covering these services for people who meet medical and financial eligibility requirements. If your loved one is relying on Medicare to cover assisted living costs, it is important to understand these limits and explore whether ALTCS may be an option. Always verify with AHCCCS at (888) 621-6880.

ALTCS has three layers of eligibility: non-financial (basic residency and status criteria), medical (level of care), and financial (income and assets). To qualify, an applicant generally must meet all three. Basic Requirements:

• Arizona resident with intent to remain
• U.S. citizen or qualified immigrant
• Has a Social Security Number (or is actively applying)
• Age 65 or older, OR blind, OR has a qualifying physical or developmental disability
• Living in an approved setting: own home, AHCCCS-certified assisted living, or nursing facility

Medical / Level of Care: AHCCCS requires that the applicant need the kind of care typically provided in a nursing home — even if they are not currently living in one. This is assessed through a Pre-Admission Screening (PAS), a scored evaluation conducted by a registered nurse or social worker. A minimum score is required. Medical records from physicians and specialists play a critical role in documenting need. A family member or authorized representative may be present during the PAS assessment. Financial Eligibility: Applicants must meet income and asset limits set by AHCCCS. Limits are updated annually. Always verify current figures directly at azahcccs.gov or by calling (888) 621-6880.

Financial eligibility limits are updated by AHCCCS each January, tied to changes in the federal Social Security cost-of-living adjustment (COLA). The figures below reflect January 1, 2026 guidance. Always confirm current limits at azahcccs.gov or by calling (888) 621-6880. Income Limits (Gross Monthly): For 2026, the gross monthly income limit for a single ALTCS applicant is $2,982. If your loved one's gross income exceeds this amount, they may still qualify by establishing an Income Only Trust (also called a Miller Trust or Qualified Income Trust). Consult an Arizona elder law attorney before proceeding with trust planning. Asset Limits: A single applicant may generally have no more than $2,000 in countable resources. Several assets are typically exempt and do not count toward this limit — including the primary home in Arizona (up to $752,000 equity), one vehicle, household goods and personal belongings, and irrevocable burial plans. Married Couples: If your spouse needs long-term care but you remain at home, Arizona law protects a portion of your shared assets. In 2026, the at-home spouse may keep between $32,532 and $162,660 of the couple's combined countable resources (Community Spouse Resource Allowance). The at-home spouse may also keep enough income to meet a monthly minimum maintenance allowance — verify current figures with AHCCCS. Important — 5-Year Look-Back: AHCCCS reviews all asset transfers made in the 60 months prior to your application date. If your loved one transferred assets for less than fair market value during this period, ALTCS may impose a penalty period. Keep thorough financial records and consult a qualified professional before making any transfers. Rules and limits may change annually — always verify directly with AHCCCS before making decisions.

Once approved, ALTCS may cover a range of long-term care and medical services. Services are coordinated through your assigned health plan and case manager, who helps design a care plan tailored to your loved one's needs. The specific services approved depend on the individual care plan. Services ALTCS may cover include:

• Skilled nursing facility care — for members who need that level of care
• Assisted living care services — at AHCCCS-certified communities (see important note below)
• In-home personal care — attendant care, help with bathing, dressing, grooming, and mobility
• Home health services — skilled nursing visits, physical, occupational, or speech therapy at home
• Adult day health care — supervised daytime programs with personal care assistance and health monitoring
• Case management — a dedicated case manager coordinates your care plan
• Home-delivered meals — for members who cannot safely prepare their own food
• Behavioral health services — mental health counseling, crisis services, and related support
• Hospice services — end-of-life comfort care for members with terminal diagnoses

What ALTCS does not cover:

• Room and board costs at assisted living or memory care communities
• Services at facilities that are not AHCCCS-certified
• Costs above the Share of Cost threshold already covered by the member's income

For many Arizona families, ALTCS may help make assisted living more financially accessible — but there are important things to understand. ALTCS covers care services, not room and board. When your loved one lives in an AHCCCS-certified assisted living community, ALTCS may cover personal care services such as help with bathing, dressing, medication management, and supervision. Room and board costs (rent, meals, utilities) are typically paid by the resident from their own income, such as Social Security and pension. Not all assisted living communities accept ALTCS. The facility must be AHCCCS-certified and must have an active contract with the member's assigned health plan. Acceptance can also depend on availability, care level needs, and facility policy — and this can change. Families should confirm directly with each community and with their health plan before making placement decisions. Some communities may require a private-pay period. Because ALTCS typically reimburses facilities at a different rate than private pay, some Arizona assisted living communities may require new residents to pay privately for a period before they can transition to ALTCS as the payor. This is individual community policy, not a state rule, and can vary widely. Always ask each community directly. Applying early is important. The ALTCS application and assessment process can take time. Families are encouraged to begin the process as early as possible when long-term care needs arise.

ALTCS may help cover care services at memory care communities in Arizona. AHCCCS does not use the term 'memory care' as a separate program category, but AHCCCS-certified assisted living facilities that include secured memory care units can be approved ALTCS settings. The same general rules that apply to assisted living apply to memory care: ALTCS may cover care services such as personal care, behavioral support, medication management, and supervision — but not room and board. Not every memory care community accepts ALTCS, and acceptance can depend on contracts, availability, care needs, and facility policy. Families should confirm directly with the community and their assigned health plan. Documentation matters for the medical assessment. A formal diagnosis of dementia from a neurologist is one of the most valuable pieces of documentation when applying for ALTCS. Cognitive impairment documented by a neurologist can contribute to the applicant's score in the Pre-Admission Screening (PAS) assessment. Thorough, specific medical records from treating physicians and specialists strengthen any ALTCS application.

The ALTCS application process involves both a financial review and a medical assessment. Having the right documents ready and understanding each step can help reduce delays. Step 1 — Start Your Application: You have three ways to begin:

• Online: Register through Health-e-Arizona Plus (healthearizonaplus.gov)
• Phone: Call ALTCS toll-free at (888) 621-6880
• In Person or by Mail: Submit to your nearest ALTCS office or email altcsregistration@azahcccs.gov

A family member, legal guardian, or authorized representative may start and manage the application on your loved one's behalf. Step 2 — Financial Interview: An ALTCS financial worker will contact you to conduct a financial interview. You will be asked about income, assets, and financial transactions going back 5 years. Have your documents organized. Step 3 — Financial Eligibility Determination: ALTCS verifies income sources, reviews bank records, and assesses countable resources. If resources are over the limit, trust planning or other strategies may need to be addressed with a qualified professional before proceeding. Step 4 — Pre-Admission Screening (PAS): Once financial eligibility is established, a medical assessor conducts the PAS assessment — by phone or in person — evaluating your loved one's ability to perform activities of daily living. Medical records from treating physicians are required. A family member or representative may be present. Step 5 — Eligibility Decision & Health Plan Enrollment: If both financial and medical criteria are met, ALTCS will issue an approval notice. Your loved one will then be enrolled with an ALTCS health plan and assigned a case manager to develop their care plan. The process typically takes approximately 45–90 days. Applications involving trusts or complex asset situations may take longer. Consult a qualified elder law attorney or Arizona-licensed professional if your situation is complex.

Be prepared to gather a significant amount of documentation — especially financial records going back up to 5 years. Your ALTCS financial worker will specify exactly what is needed for your situation. Requirements may vary. Identity & Status:

• Government-issued photo ID (front and back)
• Social Security card
• Proof of Arizona residency (utility bills, bank statements)
• Medicare card and any supplemental insurance cards

Income Verification:

• Current Social Security award letter
• Pension or retirement account statements
• VA benefit award letters (if applicable)

Financial Records (5-Year Look-Back):

• Bank statements — checking and savings (past 30 days minimum; up to 5 years may be requested)
• Brokerage and investment account statements
• Life insurance policy documents (showing cash surrender value)
• Documentation for any large deposits, withdrawals, gifts, or transfers

Property & Vehicles:

• Title for all vehicles owned or co-owned
• Deed(s) for all real property owned
• Current property valuation(s)

Medical Records:

• Recent records from all treating physicians
• Specialist records (neurologist records are especially important for dementia/Alzheimer's applicants)
• Any existing care assessments or discharge summaries

You can start your ALTCS application by phone, online, or in person at an ALTCS office. All applications are processed through AHCCCS. For families in the Gilbert and Mesa areas, the Phoenix ALTCS office serves Maricopa County. Statewide Toll-Free Line: (888) 621-6880 Email: altcsregistration@azahcccs.gov Online: healthearizonaplus.gov Mail: AHCCCS, P.O. Box 6050, MD 15023 ALTCS, Phoenix AZ 85002-5520 Phoenix ALTCS Office (serves Gilbert, Mesa, and all of Maricopa County): 150 N. 18th Ave., MD 3900, Phoenix, Arizona 85007 Call the statewide line: (888) 621-6880 Other Arizona ALTCS Offices:

• Flagstaff: 1701 N Fourth St, Flagstaff, AZ 86004
• Tucson: 7202 East Rosewood Street, Suite 125, Tucson, AZ 85710
• Yuma: 1800 East Palo Verde Street, Yuma, AZ 85364
• Kingman: 2400 Airway Avenue, Kingman, AZ 86409

Office hours are not listed on the AHCCCS website. Call (888) 621-6880 to confirm hours before visiting. Source: AHCCCS ALTCS Office Locations, accessed May 26, 2026.

Navigating ALTCS can be overwhelming — especially when you are also managing your loved one's day-to-day care needs. SeniorVue is a local Arizona senior care guidance resource built to help families understand assisted living, memory care, and long-term care options in the East Valley and across Maricopa County. Here is how we can help:

• Find care options near you — Browse our directory of assisted living and memory care communities in Gilbert, Mesa, and surrounding areas.
• Compare care settings — Our community profiles include information about services, care types, and licensing — so you can make informed comparisons before you call.
• Access plain-language ALTCS guides — Our ALTCS resource hub covers eligibility, income limits, asset limits, trusts, the application process, and more, updated to reflect current AHCCCS guidance.
• Connect with local advisors — SeniorVue can help connect you with Arizona-based care specialists who know the local community landscape.

SeniorVue is an informational resource for Arizona families and does not provide legal, financial, or medical advice. We are not AHCCCS and do not guarantee eligibility, approval, or specific benefit outcomes. Always verify current ALTCS requirements directly with AHCCCS at (888) 621-6880.