Arizona

What Is Arizona Medicaid Long-Term Care?

Arizona Medicaid provides healthcare coverage for low-income residents across various age groups. This summary focuses specifically on long-term care options available to older adults in Arizona, typically those aged 65 and above. Medicaid in Arizona, known as the Arizona Health Care Cost Containment System (AHCCCS), offers support not only in nursing homes and assisted living facilities but also through services designed to help elderly individuals remain in their own homes or live with family members.

What Are the Types of Long-Term Care Medicaid in Arizona?

Institutional / Nursing Home Medicaid

This benefit is guaranteed for those who meet eligibility criteria and covers care provided exclusively in licensed nursing homes.

Home and Community Based Services (HCBS)

Arizona replaced its previous Medicaid waiver programs with a managed care model. Under this system, long-term services may be received in a participant’s home, assisted living residence, adult foster care setting, or adult day care center. Unlike traditional waiver programs, the managed care model in Arizona has no enrollment caps, which means there are no waiting lists for eligible applicants.

Standard Medicaid (Aged, Blind, and Disabled)

This option is also an entitlement program and offers services like adult day care or in-home personal care to individuals who qualify.

What Is the Arizona Long Term Care System (ALTCS)?

The Arizona Long Term Care System (ALTCS) is the branch of AHCCCS that manages long-term care for individuals who are elderly, physically disabled, or blind. While funding comes from both state and federal sources, AHCCCS oversees administration within the state.

A quick and free AZ Medicaid eligibility check for seniors is available through the American Council on Aging.

What Are the Income and Asset Limits for Arizona Medicaid Eligibility?

Each long-term care program type in Arizona has distinct eligibility rules based on income, assets, and medical need. These limits vary by marital status and change yearly.

Example: Basic Eligibility for a Single Nursing Home Applicant (2025)

• Monthly income limit: $2,901
• Asset limit: $2,000
• Functional requirement: Must need nursing home-level care

Not qualifying on all criteria does not automatically disqualify someone from Medicaid. Several pathways exist for individuals who exceed financial thresholds.

What Is the 2025 Financial Eligibility Overview for Arizona Seniors?

For married applicants, income and asset thresholds vary depending on whether one or both spouses are applying.

Patient liability applies in institutional settings, where all but a small allowance (e.g., $141.45/month) must go toward care costs.

What Income Rules and Exceptions Apply to Arizona Medicaid?

Countable Income Includes:

• Wages
• Social Security
• Retirement account withdrawals
• Dividends and pensions

Exempt Income May Include:

• Holocaust restitution payments
• VA Aid & Attendance benefits (in Arizona)

How Is Income Counted for Married Couples?

• Only the applicant’s income is counted when only one spouse applies.
• The non-applicant spouse may qualify for a Monthly Maintenance Needs Allowance (MMMNA).

Arizona’s MMMNA (2025):

• Minimum: $2,643.75
• Shelter standard: $793.13
• Maximum: $3,948/month

For Regular Medicaid (ABD), income from both spouses is considered.

What Asset Rules and Exceptions Apply?

Countable Assets Include:

• Cash, checking/savings
• Investments
• Real estate (not primary residence)

Exempt (Non-Countable) Assets Include:

• Personal property
• Primary home (equity under $730,000)
• One vehicle
• Prepaid burial expenses (up to $9,000)
• Irrevocable burial trusts

How Are Assets Counted for Married Couples?

Assets are considered jointly owned. Arizona allows the non-applicant spouse to keep a Community Spouse Resource Deduction (CSRD).

2025 CSRD Limits:

• Up to 50% of assets, with a maximum of $157,920
• If under $31,584, the full amount up to that limit may be retained

What Is the Medicaid Look-Back Rule in Arizona?

Arizona enforces a 60-month (5-year) look-back for Nursing Home and HCBS Medicaid to ensure assets were not gifted or sold below fair market value. Violations result in a penalty period during which the applicant is ineligible for benefits.

This rule does not apply to Regular Medicaid (ABD).

Note: The federal gift tax exclusion (e.g., $19,000 per person in 2025) does not exempt gifts from Medicaid scrutiny.

When Is a Home Exempt from Medicaid Eligibility?

• The applicant or their spouse lives in it
• If the spouse does not reside there, the applicant must show “intent to return”

2025 Home Equity Cap: $730,000 (only for Nursing Home / HCBS Medicaid)

There is no equity limit under Regular Medicaid.

Can Arizona Medicaid Recover Costs from an Estate?

Yes. While a home may be exempt during a recipient’s life, Arizona may attempt to recover care costs after their death by claiming assets from the estate, including the home.

What Are the Functional Medical Requirements?

• Nursing home care: Requires nursing home level of care
• HCBS: Must be at risk of institutional placement
• Regular Medicaid: Must have functional impairment in daily activities (not necessarily nursing home-level care)

What If You Are Over the Income or Asset Limits?

Qualified Income Trusts (QITs / Miller Trusts)

For individuals with income exceeding limits. Income placed in the trust is excluded from eligibility calculations. Funds must be used for medical-related expenses. AHCCCS must be named as the remainder beneficiary.

Asset Spend Down

Applicants may legally reduce assets by converting them into exempt assets. Examples include:

• Home or vehicle modifications
• Prepaying burial costs
• Paying off debt

Important: Gifting assets or selling below market value violates the look-back rule.

Medicaid Planning

Professional planning helps individuals qualify by applying advanced strategies and protecting assets like the home from estate recovery.

Use the Arizona Medicaid Spend Down Calculator to estimate spend down needs.

What Services Are Offered Through ALTCS?

The ALTCS program under AHCCCS provides services for individuals who require long-term care. Services include:

• Nursing facility care
• Assisted living
• Adult foster care
• In-home care

ALTCS participants can opt for:

• Agency with Choice (AWC)
• Self-Directed Attendant Care (SDAC)

These models allow individuals to choose and hire their own caregivers, including family members.

How Do You Apply for Arizona Long-Term Care Medicaid?

• Contact your local ALTCS office
• There is no online application for long-term care services
• Individuals applying only for regular medical coverage (not long-term care) may apply through the AHCCCS website

Before applying, ensure that all eligibility criteria are met. Medicaid planning can assist if you are over income or asset limits.