How Arizona Medicaid Is Organized for Seniors
| Acronym | What it means | Why seniors should care |
| AHCCCS | Arizona Health Care Cost Containment System—the state’s Medicaid agency | Runs all Medicaid plans, pays the bills, sets the rules |
| ALTCS | Arizona Long-Term Care System—Medicaid’s nursing-home-level program for people who are 65+ or disabled | Lets medically-qualified Arizonans get nursing-facility-level care at home through Home- & Community-Based Services (HCBS) |
| HCBS | Menu of in-home supports funded by ALTCS | Personal care, attendant care, respite, skilled home-health care, meals, case management & more |
What In-Home Services Can ALTCS Pay For?
- Attendant / personal care (help with bathing, dressing, eating, mobility)
- Homemaker & chore assistance
- Respite care to give family caregivers a break
- Skilled home‑health nursing & therapies (PT/OT/ST) when ordered
- Adult day health & home‑delivered meals
- Durable medical equipment & minor home modifications
- Case management & transportation to medical appointments
Eligibility at a Glance (2025 limits)
| Test | Key numbers & rules |
| Medical | Must need a nursing-facility level of care (determined by a Pre‑Admission Screening) |
| Income | ≤ $2,901 /month gross for an individual (3× SSI). Couples: $2,901 each or $5,802 combined. Over‑income applicants can use an Income‑Only (Miller) Trust. |
| Assets | ≤ $2,000 countable resources (single). Community spouse may keep $31,584 – $157,920 (2025 CSRA). |
| Home equity | Up to $1,071,000 (federal 2025 cap). |
| Residency / citizenship | Arizona resident & U.S. citizen or qualified immigrant. |
Applying for ALTCS
- 1. Call ALTCS Intake – 602‑417‑6600; request Form DE‑828.
- 2. Submit financial documents (last 3 months bank/retirement statements, deeds, titles, insurance values).
- 3. Pre‑Admission Screening (PAS) – nurse evaluates functional need.
- 4. Choose a Managed‑Care Contractor (Banner U‑Care, Mercy Care, UnitedHealthcare Community Plan, etc.).
- 5. Service‑plan meeting within about 30 days of approval; in‑home supports can start immediately.
Average timeline: 45–60 days start‑to‑services—expedited if someone is already in a hospital or SNF.
How Family Caregivers Can Get Paid
| Option | Who can be paid | Pay particulars & caps | How to set it up |
| Self‑Directed Attendant Care (SDAC) | Almost any adult relative (incl. adult children); member is the legal employer | ALTCS allocates a personal budget; fiscal agent handles payroll. Typical aide pay ≈ $18/hr. | Request SDAC during care‑plan; complete employer training; pick a fiscal agent; hire caregiver. |
| Agency With Choice (AWC) | Family member hired by a partnering home‑care agency | Agency shares employer duties; wage similar to agency aides (varies by county). | Case‑manager provides AWC list; agency puts family caregiver on payroll. |
| Spouse‑as‑Paid‑Caregiver | Legally married spouse | Capped at 40 hrs/week; same SDAC payroll process. | Discuss during service‑plan; spouse completes attendant‑care certification. |
Training & CPR certification are free via the managed‑care plan. Wages are taxable income.
Other Supports Inside Arizona Medicaid
- Family Caregiver Support Program – respite vouchers, training, peer groups via Area Agencies on Aging.
- Area Agencies on Aging – options counseling, benefits checks, legal/ombudsman help.
- HCBS Rules Ombudsman – protects member rights in community settings.
- ALTCS Transition Services – pays security deposits & basic furnishings when moving from facility to home.
By the Numbers Cheat‑Sheet
- ALTCS income limit: $2,901 /month
- Asset limit: $2,000 (single)
- Community spouse may keep up to $157,920
- ALTCS members statewide: ~73,000
- Typical caregiver wage: ≈ $18 per hour
- Spouse pay cap: 40 hrs/week
- ALTCS Intake Line: 602‑417‑6600
Official Resources & Forms
- ALTCS Overview & Application (azahcccs.gov)
- 2025 ALTCS Income & Resource Limits handout
- Self‑Directed Attendant Care Toolkit (AHCCCS)
- HCBS Annual Report CYE 2024
- Area Agency on Aging Directory (des.az.gov)
Bottom Line
Arizona’s Medicaid long‑term‑care program is flexible: qualify once, choose where you live. With the right paperwork, families can unlock a full care team plus a paycheck for the person who’s already doing most of the work. If you need help, start with your local Area Agency on Aging—they’ll walk you through the alphabet soup.