What is ALTCS? Arizona’s Medicaid program for long-term care, explained

ALTCS (the Arizona Long Term Care System) is Arizona's Medicaid program that helps pay for long-term care — including assisted living, memory care, skilled nursing, and in-home care — for people who qualify both financially and medically. It is administered through AHCCCS, Arizona's Medicaid agency, and is one of the most important resources for families who cannot afford care indefinitely on their own.

What ALTCS covers

For those who qualify, ALTCS can cover:

Assisted living in contracted communities.
Memory care for dementia.
Skilled nursing (nursing home) care.
In-home care and home and community-based services so people can stay at home when possible.
Case management, medical care, and related services.

Not every community accepts ALTCS, so it is important to confirm before you make a move-in commitment.

Who qualifies for ALTCS

ALTCS has two tests: financial and medical.

Medical eligibility

The applicant must need a nursing-facility level of care, as determined by an assessment (the PAS, or Preadmission Screening). This does not mean they must live in a nursing home — it means their care needs are significant enough to qualify.

Financial eligibility

ALTCS looks at both income and assets. Limits change each year, so verify current figures with AHCCCS. The 2026 figures (effective February 1, 2026, per AHCCCS):

Income: The monthly income cap is $2,982 for a single applicant (set at 300% of the federal SSI benefit rate). Arizona allows a Miller Trust (Income-Only Trust) if income exceeds the cap, so being over the limit does not automatically disqualify someone.
Assets: Countable assets must be below $2,000 for an individual ($4,000 for a couple when both apply). However, many assets are exempt, including a primary home (up to an equity limit), one vehicle, and personal belongings.
Spousal protections: If one spouse needs care and the other does not, rules protect a portion of the couple's income and assets for the healthy spouse.

Because the rules are complex, many families work with an elder law attorney to plan properly and avoid costly mistakes.

How to apply for ALTCS

Contact ALTCS/AHCCCS to start an application (online, by phone, or in person at a local office).
Complete the medical assessment (PAS) to establish level-of-care need.
Provide financial documentation — bank statements, income records, property, and insurance information.
Ask about income above the cap. AHCCCS or a qualified elder-law attorney can explain whether a Miller Trust is appropriate and how it must be handled.
Await a determination. Processing can take several weeks, so apply as early as possible.

Common ALTCS mistakes to avoid

Waiting too long to apply. Approval takes time; start before money runs out.
Giving away assets carelessly. ALTCS reviews all transfers made in the 60 months (5 years) before application — the "look-back period" — and uncompensated gifts can trigger months of ineligibility (AHCCCS publication DE-818 explains the penalty formula). Get legal advice first.
Assuming the home disqualifies you. A primary residence is often exempt within limits.
Not confirming a community accepts ALTCS before moving in.

ALTCS vs. Medicare

Medicare does not pay for long-term assisted living or long-term custodial care. Medicare covers short-term skilled care and rehab under specific conditions. ALTCS (Medicaid) is the program that covers ongoing long-term care for those who qualify. See how to pay for assisted living in Arizona for the full picture.

Get help navigating ALTCS

Between the medical assessment, income caps, Miller Trusts, and finding a community that accepts ALTCS, the process is a lot to manage during a stressful time. Our local advisors know which East Valley communities accept ALTCS and can point you to trusted elder law resources — free to your family. Request information to get started.

Frequently asked questions

What does ALTCS pay for?

For people who qualify medically and financially, ALTCS covers assisted living and memory care in contracted communities, skilled nursing care, in-home care and other home and community-based services, plus case management and medical care. Not every community accepts ALTCS, so confirm before committing.

What are the ALTCS financial limits?

Countable assets generally must be below about $2,000 for an individual, though the primary home (within an equity limit), one vehicle, and personal belongings are typically exempt, and spousal protections preserve income and assets for a healthy spouse. If income exceeds the monthly cap, Arizona allows a Miller Trust. Limits change each year, so verify current figures with AHCCCS.

How long does ALTCS approval take?

The medical assessment and financial review can take several weeks to a few months. Ask AHCCCS what is missing from the application, when to expect a decision, and which dates and services may be covered. Plan how care will be paid for while a decision is pending rather than assuming reimbursement.

Sources & references

AHCCCS — Arizona Long Term Care System (ALTCS) — Official eligibility rules and application process for Arizona's Medicaid long-term care program.
Medicare.gov — Long-term care coverage — Official explanation of what Medicare does and does not cover for long-term care.
Administration for Community Living — LongTermCare.gov — Federal guidance on planning and paying for long-term care.