What is ALTCS? Arizona Long Term Care System (ALTCS)
With the start of the new year, we wanted to get back to some of the basics. We thought it might be helpful to give a brief overview of the Arizona Long Term Care System (ALTCS; pronounced all-tex). ALTCS is Arizona’s Medicaid program that provides long-term care services for individuals who are elderly, disabled, or have chronic illnesses. The program is [...]
What is a Resource Assessment and when is one needed?
A "Resource Assessment" is the process that ALTCS uses to determine how much a healthy spouse is entitled to keep and still have the potential applicant qualify resource-wise for benefits. The applicant is allowed no more than $2,000.00 in countable assets. All the countable assets of the marriage regardless of how they are titled or how they came to the marriage [...]
Program Contractors
People are often confused as to the roles that different organizations and people play in the ALTCS process even after benefits are approved. The most confusing of these is the roles of the program contractors. Program contractors are the organizations that manage and provide services to ALTCS members. Here’s a bit as to how they work: Key Functions of Program Contractors: [...]
Medical Eligibility
Medical Eligibility is the cornerstone of Planning as well achieving ALTCS benefits. It does not matter what a client has or what they have done if they do not medically qualify. Right now the majority of denials from ALCTS (about 70%) are coming from clients failing to qualify medically for benefits. The tool the state uses to determine medical eligibility is [...]
ALTCS and Hospice: They each have a roll to play
The Arizona Long Term Care System (ALTCS) and hospice care serve different purposes, but it's possible for an individual to be eligible for both depending on their health needs. ALTCS is a Medicaid program in Arizona that provides long-term care services for individuals who are elderly, physically disabled, or have chronic health conditions. It covers a range of services, including nursing [...]
Sometimes a little help is all that’s needed…
Most people have limited or no experience with ALTCS. The ALTCS application process stuns many due to its incredible bureaucratic nature and volume. The amount of information ALTCS requires overwhelms many, which often leads to paralysis and the feeling that obtaining benefits will be too hard. This paralysis causes a disproportionate number of denials for people who genuinely need assistance and [...]
Key Terms and Numbers 2021
AHCCCS: Arizona Health Care Cost Containment System. The agency tasked with managing several public health care programs here in Arizona. ALTCS: The Arizona Long Term Care System. Arizona’s Medicaid Program. 300% of the Federal Benefit Rate (or FBR): The Single person income limit for ALTCS without having to create a “Millers Trust” (Also known as an Income Only Trust here in Arizona. Currently, the number [...]
ALTCS Medical Eligibility for ages 65 and over
Medical Eligibility is the cornerstone from which eligibility for ALTCS is based. If a person is not medically eligible then regardless of their compliance to the other consonants of eligibility the applicant will be denied benefits. As a planner, Medical Eligibility is the one area I have little ability to directly impact. A person is going to medically qualify based on [...]
ALTCS & Living Arrangements
While you might intuitively think that living arrangements refers to a locations' ability to provide the necessary levels of care for the potential recipient, that would be incorrect. The State takes for granted that the living arrangement will be appropriate to the needs of the individual. Living arrangements fall into two basic categories. Either the individual is living at home alone, [...]
Common Pitfalls in Medicaid Planning
Is the income for a single individual applying for benefits more than $2,250? Are the assets for a single individual applying for benefits greater than $2,000? If the applicant is married, is their individual income more than $2,250 and their joint income greater than $4,500? If the applicant is married, is their joint assets or assets held in trust greater than [...]