If you or a family member needs long-term care in Arizona — whether that means in-home support, assisted living, memory care, or nursing home placement — the Arizona Long Term Care System (ALTCS) may cover most or all of the cost. ALTCS (pronounced “all-tecks”) is Arizona’s Medicaid program for long-term care, and it’s one of the most valuable benefits available to Arizona seniors and people with disabilities. The catch is that the application process is complex, and even small mistakes can result in denial or costly delays.
This guide walks you through the entire ALTCS application process from start to finish so you know what to expect, what to gather, and how to give yourself or your loved one the best chance of approval.
What Is ALTCS and Who Is It For?
ALTCS is a division of AHCCCS (Arizona Health Care Cost Containment System), Arizona’s Medicaid program. While standard AHCCCS covers basic medical needs, ALTCS specifically covers long-term care services for people who need ongoing help with daily living activities. The program serves Arizona residents who are 65 or older, blind, or have a qualifying disability.
ALTCS can pay for a wide range of services depending on where the member lives and what level of care they need. Covered services include nursing home care in a licensed skilled nursing facility, assisted living and residential group homes, in-home care including personal care attendants, homemaker services, and respite care, adult day care programs, medical services such as doctor visits, hospital stays, prescriptions, dental, vision, and behavioral health, case management, and non-emergency medical transportation.
One of the things that makes ALTCS especially valuable is that the program emphasizes keeping people in their homes and communities whenever possible, rather than defaulting to institutional placement. Many ALTCS members receive care in their own homes or in small residential settings.
Step 1: Determine If You Might Be Eligible
Before starting the formal application, it helps to understand the two main eligibility requirements. You must pass both a medical evaluation and a financial evaluation to qualify.
Basic Requirements
To even be considered, the applicant must be an Arizona resident, must be a U.S. citizen or qualified immigrant, must have a Social Security Number (or apply for one), must be 65 or older, blind, or have a qualifying disability, must apply for any other cash benefits they may be entitled to (such as Social Security, VA benefits, or pensions), and must live in an approved arrangement such as their own home, an AHCCCS-certified nursing facility, or a licensed assisted living facility.
Medical Eligibility (The PAS Assessment)
The medical side of ALTCS eligibility comes down to one question: does the applicant require a nursing home level of care? This does not mean they have to live in a nursing home — it means their care needs are significant enough that they would need that level of support.
This determination is made through a Pre-Admission Screening (PAS) assessment, conducted by an AHCCCS-employed nurse or social worker. The PAS evaluator reviews medical records, conducts an interview (in person or by phone), and scores the applicant based on how much help they need with Activities of Daily Living (ADLs). These activities include bathing, dressing, eating, toileting, transferring (moving from bed to chair, standing up), mobility, grooming, and meal preparation.
Additional factors that contribute to the PAS score include cognitive impairment and dementia diagnoses, behavioral issues and wandering, incontinence, and hearing or visual impairment.
The applicant must score at least 60 points on the PAS to qualify medically. If the score falls between 55 and 59, a management review is triggered, and a physician may review the case. Everyone over age 65 automatically receives a physician review as part of the process. The PAS assessment is valid for 180 days, and it can be retaken at any time if the applicant does not initially reach the 60-point threshold.
An important tip: many families are surprised when a loved one scores lower than expected on the PAS because the applicant downplays their limitations during the interview. For example, someone who is incontinent may not admit it to a stranger, even though incontinence scores significant points. Having a family member present during the PAS to provide an honest picture of daily challenges can make a real difference.
Financial Eligibility
Arizona is an income cap state, which means there is a hard limit on how much income an applicant can have to qualify. For 2026, the key financial limits are as follows. The monthly income limit for a single applicant is $2,982 (this is 300% of the Federal Benefit Rate and is updated every January). The asset or resource limit for a single applicant is $2,000 in countable resources.
Income that ALTCS counts includes wages, Social Security, Supplemental Security Income (SSI), disability payments, pensions, and retirement income. ALTCS uses gross income — the amount before taxes and deductions, including Medicare Part B and D premiums.
Countable resources include checking, savings, and credit union accounts, stocks, bonds, and investment accounts, and additional real estate beyond a primary residence.
Resources that are generally NOT counted include the applicant’s primary residence (as long as the home equity interest does not exceed $752,000 in 2026), one vehicle, household goods and personal property, and certain pre-paid burial plans or accounts.
If You Are Married
ALTCS has specific protections for the “community spouse” (the spouse who is not applying for ALTCS). The community spouse is allowed to keep a portion of the couple’s combined assets so they are not left without resources. The non-applicant spouse’s income is generally not counted toward the applicant’s income eligibility. Additionally, income from the applicant can be transferred to the community spouse as a Spousal Income Allowance (also called the Monthly Maintenance Needs Allowance), though this allowance cannot push the community spouse’s total monthly income above $4,066.50 in 2026. Married applicants should request the Community Spouse Information Sheet from ALTCS for details specific to their situation.
If Income Is Too High: The Miller Trust
If the applicant’s gross monthly income exceeds $2,982 — even by a single dollar — the application will be denied unless the applicant establishes an Income-Only Trust, commonly called a Miller Trust. This is a special legal arrangement where all of the applicant’s income is deposited into a trust bank account rather than received directly. The trust then distributes a Personal Needs Allowance (currently $149.10 per month) and can cover certain other approved expenses. Setting up a Miller Trust requires legal assistance and should be done before submitting the ALTCS application. Many elder law attorneys in Arizona handle these routinely.
Step 2: Gather Your Documents
Before you start the application, assemble the following documentation. Having everything ready upfront can prevent the delays and missed deadlines that lead to many denials.
Identity and Residency Documents
Proof of U.S. citizenship or qualified immigration status, Social Security card, Arizona photo ID or driver’s license, and proof of Arizona residency (utility bill, lease, or similar).
Medical Documentation
Recent medical records from all treating physicians, hospital discharge summaries if applicable, a list of current medications, documentation of any dementia or Alzheimer’s diagnosis (ideally from a neurologist), and any home health or skilled nursing assessments already completed.
Financial Documentation
Bank statements for all checking, savings, and investment accounts (typically the most recent three months), Social Security or SSI award letters, pension and retirement income statements, life insurance policies, property deeds or mortgage statements, vehicle titles, and burial plan or pre-need funeral arrangement documents.
If Married
All of the above for both spouses, plus the marriage certificate.
Organizing these documents into a folder before you begin will save significant time and frustration during the application process.
Step 3: Start the Application
There are several ways to initiate an ALTCS application.
Online through Health-e-Arizona Plus — This is the AHCCCS online portal where you can submit an application electronically. Visit http://www.healthearizonaplus.gov to create an account and begin.
By Phone — Call the ALTCS toll-free line at (888) 621-6880 to request an application or begin the process over the phone.
In Person — Visit your nearest ALTCS office. The main processing office is in Phoenix, but there are regional offices across the state in Casa Grande, Chinle, Cottonwood, Flagstaff, Globe/Miami, Kingman, Lake Havasu, Prescott, Sierra Vista, Tucson, and Yuma. You can find the full list of office addresses and phone numbers at http://www.azahcccs.gov/members/ALTCSlocations.html.
Through an Authorized Representative — A family member, legal guardian, caregiver, or professional representative can file on behalf of the applicant.
The key forms involved in the application process include Form DE-101 (Request for Application for Arizona Long Term Care Services) which must be completed first to officially begin the application, Form DE-202 (Authorization to Disclose Protected Health Information to AHCCCS), and Form DE-112 (Authorized Representative Form) if someone other than the applicant is filing. The informational sheet DE-828 (Filing an Application for ALTCS) is not a required form but is an excellent reference document that outlines the process and eligibility basics. All forms are available in English and Spanish through the AHCCCS website at http://www.azahcccs.gov/Members/GetCovered/apply.html.
Step 4: Complete the Medical Evaluation (PAS)
Once your application is filed, AHCCCS will schedule the Pre-Admission Screening assessment. A state nurse or social worker will contact the applicant to arrange the evaluation, which can be conducted in person or by phone. The assessment typically takes about an hour.
Tips to Prepare for the PAS
Have all medical records organized and available for the assessor. Make sure the applicant’s physicians have provided documentation of all diagnoses, especially cognitive impairment, dementia, or conditions affecting daily function. A family member or caregiver who knows the applicant’s daily limitations should be present during the assessment — do not rely on the applicant alone to describe their needs, as many people minimize their difficulties. Be honest about the level of help needed. If the applicant needs assistance with bathing, dressing, toileting, or any other daily activity, say so clearly. If you have concerns about the accuracy of the assessment, you can request a reassessment or appeal the decision.
The Private PAS Option
Some families choose to have a “Private PAS” conducted before submitting the full ALTCS application. This is an independent assessment done to determine whether the applicant is likely to meet the 60-point medical threshold before committing to a facility or making other major care decisions. This can be arranged through a Certified Medicaid Planner or elder law attorney. It provides clarity and can prevent a costly situation where a family moves a loved one into assisted living (which can exceed $8,000 per month in Arizona) only to learn the ALTCS application is denied.
Step 5: Complete the Financial Review
While the medical evaluation is underway, ALTCS will also be reviewing the applicant’s financial documentation. This is where having your documents organized from Step 2 pays off. A Benefits and Eligibility Specialist will be assigned to the case and may request additional documentation.
Respond to every request promptly and by the deadline given. One of the most common reasons for ALTCS denial is simply missing a deadline or failing to provide requested documents. If you are unsure about a request, call your assigned specialist and ask for clarification rather than guessing.
ALTCS conducts a “look-back” review of financial transactions. This means they will examine whether the applicant transferred assets (such as gifting money to family members or selling property below market value) within a certain period before applying. Improper transfers can result in a penalty period during which the applicant is ineligible for benefits. If you are considering any financial restructuring before applying, consult an elder law attorney first.
Step 6: Get Approved and Choose a Health Plan
If the applicant passes both the medical and financial evaluations, they will be approved for ALTCS coverage. The next step is enrollment in an ALTCS health plan (also called a program contractor). As of 2026, the current ALTCS-EPD (Elderly and Physically Disabled) program contractors are Mercy Care, Banner-University Family Care, and UnitedHealthcare Community Plan (Arizona Physicians IPA).
The health plan you choose determines which facilities, care homes, and providers are in your network. All three plans provide the same core ALTCS benefits, but their provider networks differ. Before choosing a plan, find out which plan your preferred care facility or home care provider contracts with. If you choose a plan and later discover your preferred facility is not in that plan’s network, you may have to wait until the open enrollment period to switch.
If you are in the Central region of Arizona (Maricopa County area), all three plans are typically available. In Southern Arizona, plan availability may vary by county — Mercy Care, for example, serves Pima County. In Northern and rural Arizona, plan options may be more limited.
How Long Does the Process Take?
The ALTCS application process typically takes 60 to 90 days from the time the application is filed to a determination. In complex cases or when documentation is delayed, it can take up to six months. The single most important thing you can do to speed up the process is to submit complete, organized documentation from the start and respond quickly to every request from your assigned specialist.
Common Reasons Applications Are Denied
Understanding why applications fail can help you avoid the same pitfalls. The most frequent reasons for denial include not meeting the medical threshold (scoring below 60 on the PAS), having countable resources above $2,000 for a single applicant, having gross income above $2,982 per month without a Miller Trust in place, missing deadlines for submitting requested documentation, incomplete paperwork or missing forms, and improper asset transfers during the look-back period.
Many of these issues are preventable with proper preparation and professional guidance.
Should You Get Professional Help?
While it is entirely possible to complete the ALTCS application on your own, many families benefit from professional assistance. Elder law attorneys in Arizona specialize in Medicaid planning and can help with asset protection strategies, Miller Trust setup, and navigating complex financial situations. Certified Medicaid Planners can guide you through the entire process, including pre-screening for medical eligibility. Senior placement agencies can help you find care facilities that match both your care needs and your ALTCS health plan network.
Given that the application process is long, documentation-intensive, and that errors can result in denial or penalties, professional guidance is often worth the investment — especially in cases involving married couples, significant assets, or income above the cap.
Key Contacts and Resources
ALTCS Toll-Free Line: (888) 621-6880
AHCCCS Main Office: 801 East Jefferson Street, Phoenix, AZ 85034 — Phone: (602) 417-4000
ALTCS Office Locations: http://www.azahcccs.gov/members/ALTCSlocations.html
Online Application Portal (Health-e-Arizona Plus): http://www.healthearizonaplus.gov
ALTCS Application Forms and Information Sheets: http://www.azahcccs.gov/Members/GetCovered/apply.html
AHCCCS General Information: http://www.azahcccs.gov
Final Thoughts
Applying for ALTCS can feel overwhelming, especially when you are already dealing with the stress of a loved one’s declining health. The key is preparation. Start gathering documents early, understand the eligibility requirements before you file, be honest and thorough during the PAS assessment, and respond to every request from ALTCS promptly. Whether you handle the application yourself or work with a professional, knowing what to expect at each step puts you in the strongest possible position.
If you are looking for senior care resources in Arizona — whether you need help finding assisted living, home care, hospice, or other services — our directory at Senior Support Arizona lists over 725 organizations across every county in the state. Use the search tools on our homepage to find providers in your area.
This article is intended as a general informational guide and does not constitute legal, financial, or medical advice. ALTCS eligibility rules are subject to change. For guidance specific to your situation, consult an elder law attorney or Certified Medicaid Planner. Financial figures cited are based on 2026 eligibility standards and are updated each January.