Arizona Long Term Care System (ALTCS)

The Arizona Long Term Care System (ALTCS) is Arizona’s Medicaid program for long-term care. It covers nursing home care, care at home and care in assisted living, all through managed care health plans. Arizona does not run separate waivers for older adults in the way most states do: ALTCS is the program. It sits alongside our Arizona Long-Term Care Medicaid guide, which covers the nursing home rules.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

ALTCS in brief

Put simply, responsibility for ALTCS sits with AHCCCS (Arizona Health Care Cost Containment System), through ALTCS health plans. Who it is for: 65 and older, or blind or disabled. Care need required: Needs a nursing facility level of care. As for waiting: No waiting list for eligible members. More detail on each point follows, and the Arizona state guide covers the shared financial rules. If ALTCS is not the right fit, the related pages at the end point to other Arizona programs and general guides.

What the program is

AHCCCS decides eligibility for ALTCS, including a financial review and a medical and functional assessment called the Pre-Admission Screening (PAS). Once a person qualifies, they are enrolled with an ALTCS health plan; for older adults and people with physical disabilities this is an ALTCS Elderly and Physical Disability (EPD) plan. The plan assigns a case manager, who works with the member and family to decide where care will be given and which services are needed.

In a managed long-term services and supports program, the state pays a health plan a monthly amount to arrange all of a member’s long-term care, at home, in assisted living or in a nursing home. Members pick a plan where more than one is available, and that plan’s care coordinator manages the plan of care. Plan decisions can be appealed, and the state, not the plan, sets the financial rules. See Managed long-term services and supports.

Who qualifies in 2026

In Arizona, the basic requirements for ALTCS are that the person:

• Is 65 or older, or blind or disabled
• Is found at risk of institutionalization through the Pre-Admission Screening (a nursing facility level of care)
• Qualifies for full Medicaid under Arizona’s long-term care financial rules (see the money test below)
• Lives in Arizona and is a U.S. citizen or qualified non-citizen

The money test. ALTCS requires full Medicaid eligibility under Arizona’s long-term care financial rules. The table’s figures are Arizona’s 2026 long-term care numbers, taken from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by AHCCCS. Married couples get extra protection in Arizona: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.

About the level-of-care assessment. AHCCCS’s assessment covers daily activities, from bathing and dressing to toileting and medications, plus memory and safety. The visit is normally face to face, at home or in a hospital or facility. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.

What services it can pay for

Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:

• Nursing facility care
• Attendant care and personal care at home
• Homemaker help
• Home health care
• Adult day health
• Home-delivered meals
• Respite
• Emergency alert systems
• Care services in an approved assisted living home or center (not room and board)
• Regular acute medical care, coordinated by the plan

No program pays for everything. ALTCS services are based on assessed need, and a family caregiver who is already helping is usually counted when the plan is written. A change in health is a reason to request a reassessment.

Directing your own care and paying family

ALTCS offers member-directed options for attendant care, under which the member (or a representative) can choose and supervise their own caregiver. Family members can be hired in many cases.

How to apply

There are two tracks, a financial one and a care one, and both must say yes. The usual path for ALTCS is:

1. Apply for ALTCS with AHCCCS (online or by paper application).
2. AHCCCS reviews income and assets. Gather bank statements, income proof and property records.
3. An AHCCCS assessor completes the Pre-Admission Screening (PAS), usually in person.
4. If approved, choose or be assigned an ALTCS EPD health plan.
5. The plan’s case manager visits and arranges services at home, in assisted living or in a nursing home.

For the paperwork, use our documents checklist before applying for ALTCS; Applying for a waiver explains the general process.

Waiting lists

ALTCS is an entitlement program in Arizona: people who meet the rules are enrolled. There is no general waiting list. Delays usually come from the financial review and scheduling the assessment.

General advice is in Waiver waiting lists.

How it relates to nursing home Medicaid

ALTCS covers nursing home care directly, so there is no separate nursing home program. Whether a person lives at home, in assisted living or in a nursing home, the same income rule ($2,982 a month, with an income-only trust needed above that) and asset limit apply. Members with income above set allowances pay a share of cost toward their care. The plan’s case manager can help a member move between settings as needs change.

Rules shared with nursing home Medicaid. Arizona’s financial rules for ALTCS track the nursing home rules closely. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Under ALTCS, income above an allowance may go toward the cost of care each month.

Personal needs allowance. If the person does move to a nursing home, Arizona’s 2026 personal needs allowance is $149.10 a month. Most of the rest of their income goes toward the cost of care. The state guide explains the nursing home side.

Tips for families

• Do not wait for a crisis. Lists and assessments for ALTCS take time, and the start date is usually when you first request help.
• Keep a paper trail: copies of forms and notices, plus the names and dates of every call to AHCCCS.
• Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
• Report changes promptly, including income, assets, a move or a new living arrangement.
• Expect yearly reviews of both Medicaid eligibility and the care assessment. See Renewals.
• Get help with complex ALTCS cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how Arizona’s rules fit a family’s situation.

Common questions

Does ALTCS pay for assisted living? It can pay for care services in an approved assisted living home or center. It does not pay room and board.

What if my income is above $2,982 a month? Arizona allows an income-only trust so that income above the limit does not block eligibility.

Can a family member be paid? ALTCS members can use self-directed attendant care, and in some cases family members, including a spouse under specific rules, can be paid caregivers.

Related pages

• Arizona Long-Term Care Medicaid guide
• Managed long-term services and supports
• Miller trusts
• Three kinds of Long-Term Care Medicaid
• PACE programs

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.