Does Medicare cover long-term health care?
Medicare may cover the short-term aspects of skilled care geared to help a person recover. However, as care becomes more custodial in nature, associated costs must be funded from private resources, long-term care insurance or public benefit programs such as Medicaid/ALTCS or VA.

When is the best time to plan for long-term health care?
Whenever long-term health care is a certainty in the present or a probability in the future (i.e. a diagnosis of Alzheimer’s or a chronic disease), steps should be taken to plan for long-term health care. Individuals and families need to make sure their affairs are in order, they are educated on the various health decisions they will face, and their assets are properly aligned to maximize protection from the costs associated with long-term health care.

Does the Medicaid/ALTCS benefit only apply to skilled nursing facilities? Do ALTCS recipients receive the same quality of care as private pay residents?
In Arizona, ALTCS covers skilled nursing facilities, assisted living facilities, group homes, and in-home care as long as the care provider is contracted with ALTCS. Further, the law requires that care providers treat all their patients equally.

Can the assets of a single parent be protected or is protection limited to cases involving spouses?
While Medicaid rules are complicated, an experienced Elder Law Attorney should be able to protect most of the assets for a well spouse. Steps can also be taken to protect assets for a disabled child whose parent requires long-term care. Single individuals requiring long-term health care assistance also have options allowing them to protect their assets.

Does a family really need an Elder Law Attorney?
Congress recently passed legislation that makes qualifying for ALTCS even more difficult. Under the new laws, asset transfers – even those made without consideration of future health care needs – can cause a denial. Because a denial from the Medicaid/ALTCS and VA benefits may be devastating to the applicant’s well spouse or children, we suggest you consult with JacksonWhite to become educated on your options.

Why should we choose JacksonWhite?
Over the years, the Elder Law team at JacksonWhite has guided thousands of families through the Medicaid/ALTCS and VA process and helped them understand their health care options. Because of this experience, our attorneys know and understand the ALTCS and VA systems and their rules. In addition, our Elder Care Consultants, Social Workers, and Elder Care Benefit Specialists are well-versed in the issues surrounding a person’s long-term health care needs and options. Together, the Elder Law team covers all the questions families face when learning about benefits and securing assets.

What services will I be able to get once on the ALTCS program?
There are a number of services available to the ALTCS members. An ALTCS recipient can get services in their own home, in assisted living facilities, and in nursing homes. An ALTCS recipient may also receive acute care services such as hospitalization and doctor visits as well as adult day care, personal care, nursing care, respite care, housekeeping and coverage for nursing home care and assisted living.

Can I be paid to take care of my parent?
One of the benefits under the ALTCS program is called “Attendant Care.” This benefit allows a family member or friend (and as of 2007, the spouse), to become the paid caregiver for the ALTCS client. The person wanting to be the caregiver is hired by a health care agency that contracts with one or more of the ALTCS program contractors. The program contractor case manager then authorizes the number of hours that the caregiver can be paid. These hours are based on the need of the client. In order for this benefit to be available, the client must be eligible for the ALTCS program first.

If I am below all requirements financially for ALTCS, do I need a law firm to help me with the application?
No, you can apply directly to the state ALTCS office. They are happy to take your application over the phone and get you started in the process. For contact information regarding the ALTCS office nearest you, please click here.

What does a contracted facility mean and why is it important to the ALTCS process?
The state contracts with a program contractor to deliver the services to the member. Each program contractor has a list of “contracted providers” who provide the service to the member. In order to get services covered under ALTCS, the member must be in a contracted facility or using a contracted provider. It is similar to using a managed care company for your own health care.

Can I keep my Medicare Health Plan or private insurance while on ALTCS?
Yes, the Medicare recipient always can do what they want with their Medicare. ALTCS is always payer of last resort. It is the member’s choice what Medicare plan they wish to enroll in.

Who makes the decisions about placement after an individual is approved for ALTCS? After getting on ALTCS can I ever change my mind and move facilities or homes once I am placed somewhere?
The member always has control of where they are living but the case manager may make suggestions and offer assistance with placement options. You can always change your mind about location of services. However, it’s important to remember that the facility must be a contracted provider.

Can a family pay privately for additional services for their father or mother once he or she is on the ALTCS program?
Yes, private pay dollars can be used for anything that is NOT covered under ALTCS.

If I move to another county, how can my ALTCS benefits follow me?
It is not automatic that the ALTCS services will follow. You must ask the program contractor to do a program contractor request to switch the county in which you receive services.

Can I keep my own physician?
Yes, it is best when the physician is in the ALTCS network you have chosen, but if not, you may see your existing physician using your Medicare or private insurance. You may have an out of pocket expense.

What is the most recent monthly amount you can make to qualify for benefits?
The current monthly amount for a single person is $1,911 per month.

I was told that your fees are about $4,500... is that true?
Prior to the DRA rules of 2006 that was true, however, with increased difficulty of being able to protect assets under these new rules, our average fees tend to be comparable to about one and a half months in a nursing home. Our fees are assessed on a flat rate depending upon the work our team needs to do in order to get you qualified for benefits.

The hospital told me I had to spend down everything to $2,000 is that true?
Be leery of information given to you by individuals who do not work in this area. There is a lot of “gray” when it comes to ALTCS eligibility requirements. If you want to find out if you are eligible, a JacksonWhite Elder Care Coordinator will be glad to do a free benefit analysis.

I was in an accident and now I need long-term care. Can JacksonWhite help me?
Yes. Although we are called JacksonWhite Elder Law Attorneys, we can help any one who needs long-term care services regardless of age. If you were in an accident there are many issues that you may need help with. The Attorneys at JacksonWhite can work together to make sure your needs are met.