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What is ALTCS?
ALTCS — the Arizona Long Term Care System — is the long-term care component of Arizona's Medicaid program (AHCCCS). It is designed for Arizona seniors and adults with disabilities who need nursing-home level care but prefer to remain in their home or community setting whenever possible. ALTCS is one of the most comprehensive state long-term care programs in the country in terms of home- and community-based coverage.
ALTCS is administered through three contracted managed care organizations (MCOs):
- UnitedHealthcare Community Plan (UHCCP) — serves most ALTCS members in the Phoenix metro and statewide
- Mercy Care — a division of Southwest Catholic Health Network serving ALTCS members primarily in Maricopa County and several other counties
- DDD (Division of Developmental Disabilities) — serves members with developmental disabilities
Your assigned MCO coordinates all covered ALTCS services through a care coordinator who helps arrange and monitor the services you receive at home.
ALTCS eligibility in Arizona
ALTCS eligibility has two components: clinical need and financial eligibility.
Clinical eligibility: The individual must require nursing-home level care — meaning they need significant assistance with daily activities such as bathing, dressing, eating, toileting, and mobility, to a degree that a clinical assessment (the Pre-Admission Evaluation, or PAE) determines meets the standard for nursing facility level of care.
Financial eligibility (2026 figures):
- Monthly income: generally at or below approximately $2,829 for an individual
- Countable resources: $2,000 or less for an individual ($3,000 for a couple)
- A primary home, vehicle, personal belongings, and certain other assets are typically exempt from the resource count
- Married couples have different rules — the community spouse (at home) may retain significantly more assets under Medicaid spousal protection rules
If income exceeds the limit but other criteria are met, Arizona allows individuals to set up a Qualified Income Trust (also called a Miller Trust) to meet the income threshold. An elder law attorney or the hospice social worker can help with this process if needed.
What ALTCS covers for home care in Arizona
ALTCS covers a broad range of home- and community-based services designed to allow individuals to remain in their homes and avoid or delay nursing facility placement. Covered services include:
- Personal care: Assistance with bathing, dressing, grooming, toileting, and mobility
- Homemaker services: Light housekeeping, laundry, and meal preparation
- Respite care: Temporary relief for family caregivers — in-home or short-term facility-based
- Adult day health: Structured daytime programs providing medical monitoring, social engagement, and activities
- Home-delivered meals: Meal delivery for those unable to prepare food independently
- Transportation: Non-emergency medical transportation to appointments
- Medical supplies and assistive devices: Covered when medically necessary
- Caregiver training: Training for family members or informal caregivers on safe care techniques
- Nursing facility care: For members who cannot safely remain at home despite home-based support
ALTCS does not cover room and board in assisted living — only the care services provided there. The facility's room and board fees are paid separately, either by the resident or through other assistance programs.
How ALTCS works with hospice in Arizona
For ALTCS members who have a terminal diagnosis and meet hospice eligibility criteria, the Medicare Hospice Benefit typically becomes the primary payer for hospice services. ALTCS continues in a secondary role — covering services that the hospice benefit does not include.
This can work to a family's advantage: hospice covers clinical services (nursing, medications, equipment, social work, chaplain), while ALTCS can continue covering personal care hours, homemaker services, and other daily support above and beyond what the hospice benefit provides. The result is often more comprehensive combined coverage than either program provides alone.
Key points for ALTCS members considering hospice in Arizona:
- Notify your ALTCS care coordinator when enrolling in hospice — coordination between the MCO and the hospice team is important to avoid service gaps
- The hospice team and ALTCS care coordinator should communicate regularly to avoid duplication and ensure all needs are covered
- ALTCS can continue providing non-hospice services that remain appropriate alongside the hospice benefit
- For dual-eligible patients (Medicare and AHCCCS), virtually all costs are covered between the two programs
Arizona hospice social workers are experienced with ALTCS coordination — it is one of the most common coverage scenarios they manage. Ask the hospice team's social worker to help coordinate if you are already enrolled in ALTCS.
How to apply for ALTCS in Arizona
The ALTCS application process has several steps and can take weeks to complete — starting early is important, especially if a family member is already showing signs of decline that may soon require more intensive care.
- Contact AHCCCS: Call 1-800-654-8713 or submit an application through the AHCCCS website (healthearizonaplus.gov)
- Financial screening: AHCCCS will review income and asset documentation to assess financial eligibility
- Pre-Admission Evaluation (PAE): An ALTCS nurse conducts a home visit to assess clinical eligibility — the level of care needed and the type of setting appropriate
- Managed care organization assignment: Once approved, you are assigned to an ALTCS managed care organization (UnitedHealthcare Community Plan or Mercy Care in most cases)
- Care coordinator assignment: Your MCO assigns a care coordinator who conducts a comprehensive needs assessment and develops your service plan
Arizona hospice social workers can help families navigate the ALTCS application process if the patient is already enrolled in or being admitted to hospice. Elder law attorneys in Arizona can assist with more complex situations involving trusts, spousal protection planning, or disputes about eligibility determinations.
Frequently Asked Questions
What is ALTCS in Arizona?
ALTCS (Arizona Long Term Care System) is the long-term care component of Arizona's Medicaid program (AHCCCS). It covers home- and community-based services or nursing facility care for eligible Arizona seniors and adults with disabilities who require nursing-home level care.
Who qualifies for ALTCS in Arizona?
Eligibility requires clinical need (nursing-home level care) and financial eligibility (individual income generally at or below ~$2,829/month and countable resources of $2,000 or less for a single person, based on 2026 figures). A Pre-Admission Evaluation (PAE) determines clinical need.
What home care services does ALTCS cover in Arizona?
Personal care, homemaker services, respite care, adult day health, home-delivered meals, transportation, medical supplies, assistive devices, and caregiver training — all aimed at supporting individuals to remain safely at home.
Does ALTCS cover hospice care in Arizona?
ALTCS members can enroll in hospice, with Medicare serving as the primary payer for hospice services. ALTCS can continue to cover certain home-based services above and beyond what hospice provides, potentially giving ALTCS members more comprehensive combined coverage.
How do I apply for ALTCS in Arizona?
Contact AHCCCS at 1-800-654-8713 or apply through healthearizonaplus.gov. The process includes a financial screening and a clinical Pre-Admission Evaluation (PAE) conducted by an ALTCS nurse. Start early — the process takes time.
Which managed care organizations administer ALTCS in Arizona?
UnitedHealthcare Community Plan and Mercy Care administer ALTCS for most members in Arizona (excluding those with developmental disabilities, who are served by the Division of Developmental Disabilities). Your MCO assigns a care coordinator who manages your service plan.
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