ALTCS Requirements | ALTCS Eligibility 2024

Frequently Asked Questions

Some common questions asked when applying for ALTCS Eligibility 2024 have been addressed below.

Do I need a Certified Medicaid Planner™?

While you can definitely apply for ALTCS on your own, it is recommended that you seek help from a  Certified Medicaid Planner™ or a more costly option, an attorney, to help you through the ALTCS application process.

The ALTCS application is a highly complicated process. It has many facets to it, and without help from an experienced practitioner, either a Certified Medicaid Planner™ or a costly elder law attorney, those who try to complete the process on their own tend to overlook errors that cause their application to get delayed or even denied.

Certified Medicaid Planner can help you with the best asset protection strategies. Strategies that protect your assets and maximize your chances of getting accepted in the program.

They can help you out with your medical assessments, give you financial advice and make the overall experience much smoother.

More than 70% of applicants find their applications getting denied for approval due to minor errors, so seeking professional help is something you should definitely consider!

It is understandable if you have limited resources and do not wish to spend additional money for a professional ALTCS Planner, but advice from a Certified Medicaid Planner™ can help save a lot more money in both the short and long run for meeting ALTCS Requirements than if you decide to do-it-yourself.

Think of it this way. The complicated ALTCS application process is a fast-flowing river with an extremely strong current. You need to cross the river and get to the other side. While you can definitely swim to the other side and still reach the shore, would it not be better if you could get someone with a boat to help you navigate the current?

Last two points:

One: Each day that the ALTCS application is delayed cost you up to $300 per day! Divide that into the Certified Medicaid Planners™.

And if denied you are going to start all over and this could be an additional 45 day delay!

Two: The fee paid to a Certified Medicaid Planner™ , is allowed by ALTCS and is part of the spend-down process.

So I say this, you’re going to spend money to get through this process you might as well use some of the assets to hire a Certified Medicaid Planner™.

What happens if I give away or transfer my excess assets to qualify for ALTCS before app lying?

I’ve produced a series of helpful videos: “Gifting is not Illegal”,  it would be beneficial to watch this at this time.

If an ALTCS applicant is found to have transferred their resources to anyone except for their spouse, it may result in the applicant becoming ineligible for long-term care for a period of time.  

This period of time or ineligibility is determined by the amount of the gift.

At the time of application, applicants are required to disclose all gifts/ transfers of their or their spouse’s assets for a value less than the fair market value within the previous 5 years.

The calculation for determining the time of ineligibility proceeds this way:

The total asset transfer value is divided by the average monthly cost of care as decided by the ALTCS, depending on the county. Currently for 2024, this amount stands at $7,867.16 for all counties in Arizona, with the exception of Maricopa, Pima, and the Pinal Counties, wherein this amount is $7,281.17. The result of this calculation is the number of months the penalty gets imposed for, beginning at the time (month) of application.

Gifting Example:

Mary gave her Granddaughter $25,000 for college 3 years ago. The $25,000 gifted is divided by $7,867.16 which equals, ($25,000 ÷ $7,867.16 = 3.18 months) So though the application will be approved benefits will not begin for 3.18 months.

Oh, you must apply to start the penalty period.

Note: Not all transfers/gifts result in a penalty. Transfers to a spouse, disabled child (transfer may be made in the name of the child or to a specific trust for the child’s benefit), Special Needs Trust Pursuant etc are free from this legislation and are not considered. Transfers made more than 60 months prior to the time of application are also not considered.

In case you have made any such transfers, or you think you might have made any such transfers that may risk your application’s chances of approval, it is recommended that you seek professional help from a Certified Medicaid Planner™ or an experienced elderly law practitioner. 

What is ALTCS Planning or Medicaid Planning?

There are two types of planning done; these are Pre-planning and Crisis Planning.

Pre-planning is done several years before needing long-term care, whereas crisis planning is when some suddenly find themselves in need of long-term care.

Who should consider pre-planning for long-term care?  I suppose I could say, everyone.  Yet, what surprises me the most is this in 2020, only 7 percent of the U.S. population owned long-term care insurance.  

As I work with a family member in a crisis with a loved one, I often say, “Once we get your loved one approved, I would like to talk to you about your future long-term care.”

I provide them with a long-term care insurance quote and some alternative long-term care insurance products information, like annuities that take advantage of the Pension Protection Act and life insurance policies that have long-term care insurance as part of the benefits,

Later, I would contact them about these plans; with rare exceptions, they don’t no return calls, complete silence.  Being busy helping others, I move on, leaving them for the same fate as their family member with a  Long Term care Crisis in the future.

Crisis Planning

Crisis planning uses legal strategies under Title XIX and state-specific rules to convert countable assets into non-countable assets to qualify for Long-Term Care benefits. Benefits that you paid for with your taxes. 

The key to successful crisis planning is to begin as soon as the need for long-term care or possible care becomes apparent. The sooner planning begins, the more opportunities exist to obtain maximum asset preservation.

Keep in mind that the rules regarding ALTCS eligibility are complex and ever-changing; timing is crucial in the planning process. State financial caseworkers are specifically instructed not to assist in the completion of the application.

It’s essential to work with a Certified Medicaid Planner™,  CMP™.  A CMP™ understands the rules and can ensure a successful outcome of a plan.

Is planning for ALTCS legal and ethical?

Similar to federal income tax planning, planning for ALTCS is perfectly legal and ethical.

Planning for ALTCS is a strategic process to ensure that you can retain your property while getting the benefits that the state offers.

Planning for ALTCS is not hiding your resources or fooling the government. Instead, it is a simple restructuring of assets and utilization of gifts or trusts. As long as every transfer/gift is reported and everything is kept transparent, it is a hundred percent legal and ethical.

However, since proper planning requires exquisite knowledge and experience in the field, many people go about it the wrong way and end up committing errors that reduce their chances of getting accepted. In order to ensure this doesn’t happen to you, consult a Certified Medicaid Planner™, before you gift your assets.

I will leave you with this thought: Is it unethical to preserve an asset for a spouse to continue to live, set aside money for emergencies, or pay for additional needed care and comfort? A private room or non-emergency dental work?

I personally don’t believe it is, the answer it up to you to decide for yourself.

Will the ALTCS take my house?

No, but the State of Arizona Medicaid or AHCCCS reserves certain rights to make a claim towards the estate of an ALTCS applicant, but applicants generally do not lose their property.

TEFRA leins

The AHCCCS has the right to impose a TEFRA lien on the applicants property in order to recover the expenses it covered towards the customer’s care during their lifetime. This is applicable for permanently institutionalized customers over the age of 55. This property may be their home or property subject to probate.

Note: The State may not always impose a lien. There are certain exceptions to this claim which protect the individual’s assets.

For example, AHCCCS cannot impose a lien if a family member such as the applicant’s spouse, child below 21 years of age or child who has a disability are lawful residents of the property.

Applicant’s siblings with an equal interest towards the property, who have been lawful residents of the property for a minimum of 12 months before the applicant was institutionalized, are also considered.

Furthermore, AHCCCS cannot impose a lien as long as the residing family member is survived by their spouse, child below 21 years of age or child suffering from a disability.

Estate recovery program

Another way the state can make a claim towards an applicant’s estate is through the estate recovery program.

It is applicable during the probate of the applicant’s will, for deceased customers over the age of 55. AHCCCS does not have a right to this claim as long as the customer is alive. In case a family member such as the spouse or a child with disability is a lawful resident of the property, AHCCCS shall not seek to claim the estate.

To understand all of the exceptions applicable for you which can help protect your assets, it is imperative that you seek help from a Certified Medicaid Planner™.

Will the State decide where I will live?

Applicants reserve the right to determine where they are accommodated and offered services. Their place of residence may be their home or an ALTCS  certified or ALTCS Approved assisted living facility.

What exactly is an ALTCS approved assisted living facility or group care home?

An ALTCS  approved assisted living facility or group care home serves both ALTCS pay as well as private residents in their care.

Both the ALTCS pay as well as the private residents are entitled to the same rooms, beds and caregivers that the facility has to offer.

They also enjoy the same food, amenities as well as activities offered by the facilities.

Virtually, there are no restrictions separating the private pay residents from the resident on ALTCS except for one; the ALTCS pay residents are not entitled to a private room, and must share a semi-private space with another resident – unless the community or care home only has private rooms, then the ALTCS pay resident will have a private room too.

While this is certainly an ALTCS requirement, ALTCS does not mandate that the facility accommodate the individual in a semi-private room. Many ALTCS approved assisted living facilities only have private rooms and therefore allow private pay residents on ALTCS to be in a private room. Also, the family can choose to pay the additional cost for a private room.

Whether or not a private pay resident on ALTCS gets a private room to themselves is up to the facility and not the individual.

If I am eligible and qualify, will the state take over my social security and pension?

No, AHCCCS does not have a direct claim towards the applicant’s income. ALTCS customers, however, are required to pay a designated amount towards the expenses the state bears for their long-term care.

How much will I have to pay towards my long-term care?

ALTCS beneficiaries are obligated to pay a designated portion of their income for their long-term care. This amount is referred to as the “share of cost”, and is determined by the ALTCS at the time of application. The share of the cost depends on multiple factors, such as the amount of monthly Income, Personal Needs Allowance, type of accommodation, uncovered medical expenses etc.

For single customers, the share of cost is determined by taking into account all these factors. Generally, the amount is equivalent to the amount left in the customer’s income after subtracting their Personal Needs Allowance and uncovered medical expenses.

Currently, the Personal Needs Allowance for customers in a residential accommodation is $141.45, and $2,829 for those residing at home. In essence, this means that customers living at home with an income below $2,829have to bear virtually no expenses towards their care.

For customers who are married, their spouses may be entitled to a portion of their income. This is known as the CSMIA, or Community Spouse Monthly Income Allowance. The community spouse is entitled to a minimum of $2,465  per month, while the maximum amount stands at $3,853 per month.

If the community spouse is below $2,465, they may be entitled to a draw additional funds from the customer’s income (spouse’s income on ALTCS) to cover the difference. ALTCS Financial Eligibility requirements 2024 are complex and difficult to understand without the help of a Certified Medicaid Planner.

Conclusion and Summary

Applying for ALTCS financial eligibility requirements and medical eligibility requirements is a complicated process. Even after going through every webpage on the internet that deals with ALTCS criteria, applicants make errors that cost them thousands of dollars in penalties and lost time.

While the information provided here gives you a general overall understanding of the ALTCS application approval process and proceedings, there is a multitude of facets concerning your current situation, which can only be identified by an experienced professional.

There is not a one size fits all scheme, and it is imperative that you consult a Certified Medicaid Planner™ or elder law attorney with extensive ALTCS experience before or at the time of application so that they can help you to meet ALTCS Requirements.

When approached correctly, ALTCS may be the perfect assistance program to cater to your needs. However, without paying attention to all the legal criteria and conditions involved, you may end up depriving yourself of the potential benefits you could have otherwise received or needlessly lose or significantly reduce your assets.

To prevent this from happening to you, contact us at Care Funding Solutions so that we can help you out for meeting ALTCS Requirements.

First and smartest way to use some of your countable assets is to hire a Certified Medicaid Planner

The fee that a CMP charges is an allowable expense by ALTCS.

See The CMP PowerTeam™