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

ALTCS is the Arizona Long Term Care System — the part of Arizona's Medicaid program that pays for long-term care. AHCCCS, the state's Medicaid agency, runs it.

Regular health insurance and Medicare do not pay for daily, hands-on care over months or years. ALTCS can. It helps cover that care when a person cannot afford it on their own.

How ALTCS works day to day

ALTCS is a managed care program. After approval, the member joins a Long Term Care health plan and gets a case manager who coordinates care. In Maricopa County, plans include Mercy Care, Banner-University Family Care, and UnitedHealthcare Community Plan.

Medicare pays for short-term, skilled care. It does not pay for the day-to-day help with bathing, dressing, and meals that most assisted living residents need. That daily help is called custodial care.

ALTCS may cover custodial care for people who meet the medical and financial rules. That is the gap it fills. If your loved one is counting on Medicare to cover assisted living, check whether ALTCS may be an option. Always verify with AHCCCS at (888) 621-6880.

ALTCS checks three things. An applicant must pass all three.

Basic requirements

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

Medical need (level of care)

The applicant must need the kind of care a nursing home provides — even if they live somewhere else. A nurse or social worker scores this in a Pre-Admission Screening (PAS). Medical records from treating doctors matter here. A family member or representative may attend the PAS.

Financial eligibility

Income and assets must fall under AHCCCS limits, updated each January. See the current ALTCS income limits. Full details are on our eligibility page.

These are the headline 2026 numbers. AHCCCS updates them each January with the federal cost-of-living adjustment.

Income

A single applicant may have up to $2,982 per month in gross income. Over the limit? An Income Only Trust (Miller Trust) may still open the door. Talk with an elder law attorney before setting one up.

Assets

A single applicant may keep up to $2,000 in countable resources. The primary home (up to $752,000 in equity), one vehicle, household goods, and irrevocable burial plans usually do not count.

Married couples

The spouse who stays at home keeps more. In 2026, that spouse may keep between $32,532 and $162,660 of the couple's countable resources (Community Spouse Resource Allowance). They may also keep income up to a monthly minimum.

The 5-year look-back

AHCCCS reviews asset transfers from the past 60 months. Gifts or below-market sales can trigger a penalty period. Keep records — and get advice before moving assets.

Full details: ALTCS income limits explained.

Once approved, the member's health plan and case manager coordinate services. Coverage depends on the individual care plan, but common services include:

• Skilled nursing facility care — for members who need that level of care
• Assisted living care services — at AHCCCS-certified communities (see 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 and health monitoring
• Case management — a dedicated case manager coordinates the care plan
• Home-delivered meals — for members who cannot safely prepare their own food
• Behavioral health services — counseling, crisis services, and related support
• Hospice services — end-of-life comfort care

What ALTCS does not pay for

• Room and board costs at assisted living or memory care communities
• Services at facilities that are not AHCCCS-certified
• Costs above the member's share of cost

ALTCS can make assisted living more affordable. Three things matter most.

ALTCS pays for care, not rent

At a certified community, ALTCS may cover personal care, medication management, and supervision. Room, meals, and utilities usually come from the resident's own income, such as Social Security and pension.

Not every community accepts ALTCS

The community must be AHCCCS-certified and contracted with the member's health plan. Acceptance also depends on availability, care needs, and community policy — and it can change. Ask each community and your health plan directly.

Some communities ask for private pay first

Some communities require a private-pay period before a resident switches to ALTCS. That is community policy, not state rule. Always ask.

Start early — the application and assessment take time. See how to apply.

Usually, yes — for the care portion. AHCCCS-certified assisted living communities with secured memory care units can be approved ALTCS settings.

The same rules as assisted living apply: care services may be covered; room and board are not. Each community decides on its own whether to accept ALTCS. Confirm with the community and the health plan.

Documentation matters for memory care applicants

A dementia diagnosis from a neurologist is one of the strongest pieces of medical evidence. Detailed records from treating doctors help the PAS assessment go more smoothly.

The application has two reviews: financial and medical. Here is the short version.

Start the application

• Online: Health-e-Arizona Plus (healthearizonaplus.gov)
• Phone: (888) 621-6880
• In person or by mail: your nearest ALTCS office, or altcsregistration@azahcccs.gov

A family member, legal guardian, or authorized representative can manage the process on your loved one's behalf.

Then the two reviews

A financial worker interviews the family and reviews income, assets, and five years of financial records. Then a medical assessor runs the PAS. If both pass, AHCCCS approves the application and enrolls your loved one with a health plan and case manager.

The process typically takes 45–90 days. Complex finances can take longer. Read the full step-by-step application guide →

Gather documents before you start — especially financial records. Your financial worker will confirm exactly what is needed for your situation.

Identity and 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, and medical records

• Title for all vehicles owned or co-owned
• Deed(s) for all real property owned
• Current property valuation(s)
• Recent records from all treating physicians
• Specialist records (neurologist records are especially important for dementia applicants)
• Any existing care assessments or discharge summaries

You can start an ALTCS application by phone, online, or in person. All applications are processed through AHCCCS.

Statewide contact

Phone: (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 Maricopa County)

150 N. 18th Ave., MD 3900, Phoenix, Arizona 85007

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

Call (888) 621-6880 to confirm hours before visiting. Source: AHCCCS ALTCS Office Locations, accessed May 26, 2026.

ALTCS paperwork is one part of the journey. Finding the right care is the other. SeniorVue helps with the care side — at no cost to families.

• Find care options near you — browse assisted living and memory care communities across Arizona.
• Compare care settings — community profiles include services, care types, and licensing.
• Use plain-language ALTCS guides — eligibility, income limits, trusts, and the application process, kept current with AHCCCS guidance.
• Connect with local advisors — Arizona-based specialists who know the local landscape.

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