ALTCS Income Limits in Arizona: What Families Need to Know

For 2026, the ALTCS gross monthly income limit for a single applicant is $2,982 per month. This figure equals 300% of the federal Supplemental Security Income (SSI) Federal Benefit Rate, which is $994/month for 2026.

This limit is updated each January when the federal SSI rate is adjusted. The figures below reflect the 2026 standards derived from the Arizona AHCCCS Eligibility Standards Desk Aid:

• 2024 income limit: $2,829/month (300% × $943 FBR)
• 2025 income limit: $2,901/month (300% × $967 FBR)
• 2026 income limit: $2,982/month (300% × $994 FBR)

All gross monthly income from all sources is counted, including:

• Social Security retirement or disability (SSDI/SSI) benefits
• Pension or retirement income
• Veterans benefits (VA pension, Aid & Attendance)
• Required Minimum Distributions (RMDs) from IRAs or 401(k)s
• Rental income
• Annuity payments
• Any other regular monthly income

If total gross monthly income is at or below $2,982, the applicant meets the income test for 2026 and no income trust is required.

Note: These figures are drawn from the Arizona AHCCCS Eligibility Standards Desk Aid and verified as of May 2026. Figures update each January — always confirm the current threshold with AHCCCS or a qualified professional before relying on any specific number.

ALTCS counts gross monthly income — before deductions such as Medicare premiums, taxes, or health insurance premiums. This distinction matters because many families assume those payments reduce countable income at the eligibility stage. They generally do not.

Once enrolled in ALTCS, members are typically required to contribute most of their income toward the cost of their care. AHCCCS calculates a patient pay amount (PPA) — the monthly contribution the member must make — after allowable deductions. These deductions may include:

• A personal needs allowance (the amount the member keeps for personal expenses — set by AHCCCS policy)
• Health insurance premiums (such as Medicare Part B)
• A community spouse income allowance, if applicable
• Other allowable deductions per AHCCCS policy

The patient pay calculation is separate from the income eligibility test and happens after an application is approved. The specifics vary by situation and are determined by AHCCCS.

Exceeding the income limit does not automatically disqualify someone from ALTCS. Arizona is a Qualified Income Trust (QIT) state, which means individuals whose gross monthly income is above $2,982 may still qualify by establishing an Income Only Trust — commonly called a Miller Trust or QIT.

A QIT is a specific type of legal trust used to route excess income so that AHCCCS can treat the applicant's income as within the eligible range. In general terms, how it works:

1. An attorney drafts and executes the QIT — this is a one-time legal setup.
2. Each month, income above the ALTCS limit is deposited into the trust account.
3. The trust must be properly administered each month. Errors or missed deposits can affect ALTCS eligibility.
4. Upon the member's death, remaining trust funds are generally paid to AHCCCS as reimbursement for benefits paid.

The QIT must be established before ALTCS approval is granted. Setting up and maintaining a QIT correctly involves legal requirements — families should work with a qualified elder law attorney familiar with Arizona Medicaid rules. Learn more about ALTCS trusts, including QITs →

When one spouse applies for ALTCS while the other remains at home (the community spouse), the income rules are more nuanced:

Income eligibility test: Generally, only the applicant's own income is counted toward the ALTCS income limit. The community spouse's income is not included in this test.

Community spouse income protection: Federal and Arizona law protect the at-home spouse from becoming financially destitute. The community spouse is entitled to a minimum monthly income — called the Minimum Monthly Maintenance Needs Allowance (MMMNA) — and may receive a portion of the ALTCS member's income to meet this floor.

For the 2025–2026 period, the MMMNA standard (Monthly Spousal Need) is $2,644/month, with a maximum MMMNA of $4,066.50/month (figures from the Arizona AHCCCS Eligibility Standards Desk Aid, effective July 2025).

If the community spouse's own income is below the MMMNA floor, the ALTCS member's income may be allocated to the spouse to make up the difference — which also reduces the member's patient pay amount.

Married-couple ALTCS cases involve additional financial protections around assets as well. These calculations can be complex, and the specifics are determined on a case-by-case basis by AHCCCS. A qualified elder law attorney familiar with Arizona Medicaid spousal impoverishment rules can help families understand their specific situation before applying.

Meeting the income limit — or qualifying through a QIT — is necessary but not sufficient for ALTCS approval. ALTCS has four eligibility requirements that must all be satisfied at the same time:

• Arizona residency
• Citizenship or qualified immigration status
• Financial eligibility — includes both income (this page) and assets (see ALTCS asset limits)
• Medical/functional eligibility — a nursing facility level of care is required (see ALTCS eligibility overview)

Applicants who meet the income test but do not meet the medical/functional assessment will be denied. Applicants who meet medical criteria but have assets above the allowed limits — without a plan to address them — may also be denied. Each criterion must be evaluated together.

SeniorVue is a senior care guidance resource, not an AHCCCS office or Medicaid advisor. We help families understand their care options and connect with appropriate local professionals. If you are exploring ALTCS for a loved one, we encourage you to speak with a qualified elder law attorney or AHCCCS-experienced specialist alongside any guidance we provide.

Explore related ALTCS topics:

• ALTCS Overview — what it covers, who it helps, and how it works
• ALTCS Eligibility Requirements — the four criteria explained
• ALTCS Asset Limits — what counts, what is exempt, and how to plan
• ALTCS Trusts — QITs, Miller Trusts, and Special Needs Trusts explained
• How to Apply for ALTCS — step-by-step guidance for families

If you have questions about senior care options in Arizona, a SeniorVue advisor can help your family understand the landscape — at no cost. Get free guidance →