ALTCS Eligibility Criteria
For many individuals, meeting the eligibility criteria requires estate and asset planning, an area in which Frazer Ryan attorneys offer valuable experience.
ALTCS has three eligibility criteria:
- medical need
- income eligibility
- resource eligibility
Medical need
is determined by a "pre-admission screening" (PAS). This is a determination performed by an ALTCS nurse who visits with the applicant and reviews relevant medical information to determine whether the applicant meets the eligibility requirements for being in need of a level of institutional care.
With respect to income eligibility, in most cases only the income of the applicant will be used toward his or her share of cost. In other words, with some minor exceptions involving the method of calculating income, the amount of income received by the applicant's spouse is irrelevant to the eligibility determination.
Resources, on the other hand, are categorized as either "countable" or "non-countable" (exempt). Of those countable resources, the value of all countable resources will be considered, regardless of whether the resource is held in the name of the applicant or his or her spouse.
ALTCS Eligibility Guidelines
Below are 2023 eligibility guidelines for qualifying for benefits through the Arizona Long Term Care System. These amounts are adjusted annually and coincide with federal law. Please confirm these amounts to ensure that they are current.
Resources
Only assets that are countable are reflected in these numbers.
- Maximum Amount of Countable Assets for the ALTCS Applicant: $2,000
- Maximum Community Spouse Resource Allowance: $148,620
(half of the couple’s Countable Assets, up to a maximum of $148,620)
- Minimum Community Spouse Resource Allowance: $29,724 (the amount of Countable Assets that the community spouse can retain even if it is more than half of the couple’s Countable Assets)
- Home Equity Limit: $688,000 (the net equity value of the applicant’s primary residence that is excluded as a countable resource)
Income
- Monthly Income Limit for Individual: $2,742 (the maximum amount of income the ALTCS applicant is allowed to have without the use of an income trust)
- Minimum Monthly Maintenance Needs Allowance for Spouse: $2,289 (the minimum amount that the community spouse is assumed to need on a monthly basis to pay for his or her own living expenses; if the community spouse’s income is less than this amount, he or she can retain a portion of the applicant’s income before the applicant’s share of the cost of his or her care is calculated)
- Maximum Monthly Maintenance Needs Allowance for Spouse: $3,715 (the maximum amount that the community spouse can retain each month, if he or she can document certain expenses)
- Individual Personal Needs Allowance: $137.10 (the amount of the ALTCS applicant’s income that the applicant is allowed to retain for personal needs, before the share of the cost is calculated)