What services does ALTCS provide?

ALTCS is Arizona’s Medicaid long-term care program.

Medicaid is a federally funded program that is administered by the individual states. Currently Medicaid pays for over 50% of people in America that need long-term care. Many people have a question about what services does ALTCS provide.

In Arizona, Arizona Health Care Cost Containment System (AHCCCS) administers the states Medicaid  program, which is ALTCS. 

Noteworthy, Arizona has one of the best Medicaid programs in the United States. This is because we are a Medicaid Wavier State or a Home and Community Based Services state. There are 39 states currently that are approved wavier states. 

Many waivers states have added restrictions or exceptions that they have applied for and Medicaid or the Center for Medicaid Services, CMS has approved. Because of this they have  and long waiting list. Or only offer home care benefits and do not pay for Assisted Living. 

Arizona’s Medicaid Program is a financial safety net for impoverished individuals who need long-term health care, sometimes referred to as extended health care.  Arizona’s Medicaid program is funded with federal and state funds and administered by AHCCCS – Arizona Health Care Cost Containment System. I hope you are understanding about what is ALTCS.

It’s important to note that Arizona’s Medicaid program isn’t just a safety net for the impoverished. With proper planning and assistance from a Certified Medicaid Planner™ or CMP™ it can be accessed by those with a high net worth that’s well above the maximum allowed asset limits.  That’s why we say “ALTCS a Safety Net for the Impoverished, and for the SMART™” 

Medicaid or ALTCS planning can be a very complicated and confusing subject. If your net worth exceeds the limits,  it’s important you work with a professional who understands Medicaid asset conversion strategies. A Certified Medicaid Planner™ or CMP™ is a professional certification in the Medicaid Planning Field.  A CMP™ will help you develop a plan in order to be approved for benefits and then help file the Medicaid Application for you too. 

What services are being provided by ALTCS?

Not many people are aware about what services does altcs provide. Arizona’s Medicaid Program will cover the following:

  1. Medical expenses including doctor visits and prescription medications. 
  2. The cost of long-term care in an approved  Medicaid Facilities.  This includes Nursing facilities and under the HCBS program assisted living facilities and group assisted living homes. Note; Some approved providers may require a period of private pay before the residents can roll on or use Medicaid as a payor source.
  3. Home care services, both medical and non-medical home care. 
  4. Hospice services
  5. Speech, physical and occupational therapies
  6. Medical supplies and durable medical equipment. 
  7. Private duty nurse 
  8. Emergency dental care.  

Additional Services covered by the “Home and Community-Based Services (HSBS)

  1. Adult Day programs
  2. Home care services for individuals that might otherwise need to be in a nursing home
  3. Home delivered meals
  4. Home health aids
  5. Personal care services, help with the assistance of another individual with, bathing, eating, dressing, ambulating, and walking.

ALTCS Qualifications

In order to be eligible, you must be both financially and medically qualified for your Arizona’s Medicaid Program  Application to be approved. 

Arizona’s Medicaid Program  Financial Qualification

The financial qualification requirements can be complicated depending on the individual and their financial situation. 

Financial Qualification | The Basics- Asset and Income Limits 

The Income Cap:  

The income cap can be confusing to some. First, the maximum income that an applicant can have is $2,523. per month for 2022.  This is gross income before any deductions, meaning before Part B Medicare premiums are deducted from Social Security Income or any taxes are taken from a pension payment.

This is where many are denied for benefits because they simply take the amount that is deposited into a checking account and since it is below the income cap they falsely believe they are qualified.  

But is that really the limit?  In a way, “Not not really.”

Arizona is an income cap state and does allow the use of an Miller Trust Arizona a.k.a. Income Only Trust.  The Income Only Trust is a type of Grantor Trust that all the income is directed to a bank account titled to the trust.

Then, after the Personal Needs Allowance is subtracted and married, the Minimum Monthly Spousal  Allowance is paid to the healthy spouse if any is due, then the balance is used to share the cost of care. 

This can be confusing for some, here is where your advisor can help explain this based on your situation. See Certified Medicaid Planner

Medical Qualification

The ALTCS Application Process

Over 70% of all Arizona Medicaid applications are denied! Why is this?

The application process is divided into two parts they are financial and medical qualifications.  

So part of the reason the application denial rate is so high is that a person can be medically qualified but not financially qualified or financially qualified and not medically qualified. 

A medical care worker and a financial caseworker will both be assigned to your application.  

Why are over 70% of Arizona Medicaid Applications denied?

It’s hard to believe that over 70% of all Applications are denied, but it’s true.

Why is this? There are several reasons why application denials are so high.  

The first reason is the applicant doesn’t qualify medically.  

The Applicant must be at the nursing home level of care to be medically eligible.  See Medical Qualification above. 

A large number of applications are denied due to the applicants not providing the required documentation and requested information made by the financial caseworker at AHCCCS.

Medicaid puts time deadlines on the requests that if not meet the claim will be denied.

How to apply for Arizona’s Medicaid Program ?

Application Steps

Step 1: Determine if you can do this on your own or should you hire a Certified Medicaid Planner™ to help you qualify for ALTCS benefits. 

A Certified Medicaid Planner™ or CMP™ has not only been awarded this prestigious designation by the CMP™ Governing Board but they have also have annual continuing educational requirements to satisfy in order to maintain the CMP™ designation.  

A CMP™ will not only help with various pre-application planning options but full ALTCS Application Assistance. 

See Certified Medicaid Planner

Step 2: A Certified Medicaid Planner™, is familiar with the various assisted living options for care. But they are not necessarily familiar with specific amenities that various providers offer. This is the function or job description of a Certified Placement and Referral Specialist (CPRS).

So Step 2 is to contact a CPRS for help.

Step 3: Apply for ALTCS 

Step 4: Be approved for ALTCS

ALTCS Frequently Asked Questions.

Does Arizona’s Medicaid, ALTCS provide funding in an Assisted Living Facility or Group Home setting? 

Arizona Medicaid or ALTCS does provide funding for assisted living facilities and group homes. 

Because of this benefit those that are potentially eligible for Medicaid are moving to Arizona or contemplating moving to Arizona. Because their current resident state doesn’t offer this expanded coverage. 

Does ALTCS provide Home Care?

Yes ALTCS will provide home care up to 50 hours per week and pay a family member even the Spouse up to 40 hours a week to be the caregiver. 

The rules restrict the spouse to a maximum of 40 hours per week 

How long do I need to be in Arizona to apply for ALTCS? 

Arizona considers you a resident once you are in Arizona even for one second and plan to stay in Arizona. So you can apply immediately for ALTCS benefits. 

What does ALTCS Stand for? 

ALTCS is an acronym for Arizona Long Term Care System.  It’s pronounced ALL-Tex or ALL-Techs. 

Often the acronym is misspelled as ALTCES or ALTECS. 

What services does ALTCS – Medicaid provide?

First, understand you must be in a Certified ALTCS Approved Home or receiving home care from a Certified ALTCS Home Care Agency**. On this website, you can find Certified ALTCS Providers near you.

Finding both an approved provider and one that is accepting new residents can be a daunting task. We recommend that you seek help from a Certified Placement and Referral Specialist (CPRS).

A Certified Placement Agent will help you find the appropriate care provider in your area that is ALTCS Certified. They are a free service.

We have covered in detail about what services does ALTCS provide.

 

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Arizona Care Alliance