ALTCS Planning / Medicaid Planning
Is financial assistance for long-term healthcare available?
Arizona Long-Term Care System (ALTCS) helps eligible Arizonans pay for long-term healthcare. Not to be confused with Medicare, ALTCS is Arizona’s Medicaid program. ALTCS is not an entitlement program, so only those who meet eligibility requirements qualify for the benefit. For those who do qualify, however, ALTCS is a tremendously helpful tool.
What services does the ALTCS benefit cover?
The ALTCS benefit covers a wide range of services. In addition to helping with nursing home costs, ALTCS provides coverage to individuals receiving healthcare in their home. Unfortunately, however, applicants commonly wait too long before submitting their ALTCS application. Delaying proper healthcare sometimes leads to deterioration in the applicant’s health, such that in-home care is no longer possible. Proactive applicants, on the other hand, may qualify for assistance in their home that helps them postpone moving into an institutional setting.
Benefits covered by ALTCS include:
• Full coverage of acute care services: This includes doctors, hospitalization, prescriptions, lab work, x-rays, tests and specialist treatments.
• Nursing home care: This includes care provided in a licensed nursing facility, residential care facility, or intensive care facility.
• Home and Community Based Services: This includes home health nursing, rehabilitation, adult day care, personal and respite care, medical transportation, mental health services, homemaker services, attendant care, home health aids, and home delivered meals.
• Services for developmentally disabled adults and children: ALTCS has a branch specifically designed for developmentally disabled adults and children, which provides special benefits.
What are the medical requirements for ALTCS eligibility?
Only applicants who pass a pre-admission screening process, known as the PAS, qualify for the ALTCS benefit. The assessor evaluates various aspects of the applicant’s health, including continence, sensory impairments, orientation, behavior, and whether the applicant requires assistance with daily activities. Applicants that truly need long-term medical care should readily pass the screening process. Preparing to meet financial requirements, on the other hand, is sometimes difficult to do.
What are the financial requirements for ALTCS eligibility?
Applicants sometimes have difficulty with the financial portion of the ALTCS application because it requires them to thoroughly understand a complex set of rules. ALTCS closely assesses applicants’ (and spouse’s, if applicable) income and resources. Single and married applicants follow different rules, but their income and resources must always fall below a specified limit.
ALTCS denies benefits to applicants whose income or resources exceed the limit. Applicants whose income exceeds the limit may still qualify for ALTCS, however, by establishing an Income-Only Trust. Likewise, applicants whose resources exceed the allowable amount may still qualify for ALTCS by establishing a Special Needs Trust. Applicants who use these types of trusts to arrange their affairs are one step closer to qualifying for the ALTCS benefit.
Although ALTCS only approves applicants with limited resources, certain resources are not included in the calculation. The following types of resources are exempt, or non-countable, and thus do not count against applicants in any way:
• One home
• One vehicle
• Life insurance
• Burial plots
• Irrevocable prepaid funeral plans
• Certain miscellaneous assets
Countable assets, on the other hand, include all money and property that can be valued and converted into cash. More specifically, countable assets include:
• Cash, checking and savings accounts
• Certificates of deposits
• U.S. savings bonds
• Retirement accounts
• Nursing home accounts
• Revocable pre-paid funeral contracts
For whom is ALTCS planning suitable?
As a benefit program, ALTCS is for those who cannot afford long-term healthcare. Those with significant resources can pay for long-term healthcare out-of-pocket. Others may obtain long-term healthcare insurance, but this option is generally only available to healthy individuals who can afford premiums.
No one should deplete his savings on healthcare; and long-term care planning helps prevent this. Planning also helps married ALTCS applicants save money for their spouses. Advance planning is one of the best ways for people to obtain the healthcare they deserve without going destitute in the process.