ALTCS eligibility
ALTCS eligibility in Arizona: income, assets, and the level of care test (2026)
Two separate tests decide whether Arizona’s Medicaid long-term care programme will pay for a parent’s care — a medical test and a financial test. Both have to be met. Here is what each one actually checks.
Two tests, and an applicant has to pass both
ALTCS — the Arizona Long Term Care System — is Arizona’s Medicaid programme for long-term care, administered by AHCCCS. To qualify, an applicant must meet a medical and functional standard and a financial standard. Passing only one of the two does not result in approval. Both are assessed, usually at the same time, by different reviewers.
The medical test: nursing facility level of care
An applicant must need the kind of care ordinarily provided in a nursing facility. AHCCCS calls this Nursing Facility Level of Care, or NFLOC. It is measured through a Pre-Admission Screening, known as the PAS, carried out by an assessor who reviews how the person actually functions day to day — not what a chart says about them.
This is the point families most often get wrong. A dementia diagnosis on its own does not automatically qualify someone. The assessor is looking at functional and cognitive need — what the person can do without help, on a difficult day, not the name of the diagnosis. Two people with the same diagnosis can land on opposite sides of the NFLOC line depending on how much support they genuinely need.
The PAS typically looks at:
- Bathing, dressing, and grooming without physical help
- Toileting and continence
- Transferring — getting in and out of bed or a chair safely
- Eating, including whether food must be prepared or given to the person
- Mobility, balance, and fall risk
- Orientation, memory, judgment, and safety awareness
- Behaviours that put the person or others at risk — wandering, exit-seeking, aggression
Families understandably describe a parent’s best day. Assessors need the typical one. We walk through how to prepare honestly for the PAS on our how to apply page.
The financial test: income and assets in 2026
For a single applicant, ALTCS sets a monthly income ceiling and an asset ceiling. Both are checked as of the date of application, and both change periodically as federal and state figures update.
| Test | 2026 limit |
|---|---|
| Gross monthly income | $2,982 (effective 1 January 2026) |
| Countable assets | $2,000 |
| Community spouse resource allowance | Minimum $32,532, maximum $162,660 (January 2026) |
| Community spouse minimum monthly needs allowance | $2,705 (effective 1 July 2026) |
| Look-back period on transfers | 60 months |
$2,982 is exactly 300% of the 2026 SSI Federal Benefit Rate of $994. ALTCS income eligibility is tied to that federal figure every year, which is why the limit moves annually rather than staying fixed.
Income over the limit does not automatically disqualify someone in Arizona — a Miller Trust (also called a Qualified Income Trust) can sometimes bring excess income into compliance. Setting one up correctly is a legal matter, not something a placement agency should attempt to walk you through.
Married couples: protecting the spouse who stays home
When one spouse needs long-term care and the other continues living independently, federal spousal impoverishment rules exist so the at-home spouse is not left destitute. The Community Spouse Resource Deduction lets the couple keep a protected share of their combined countable assets for the spouse who is not applying — a minimum of $32,532 and, depending on the couple’s total resources, up to $162,660 as of January 2026.
Separately, the Community Spouse Minimum Monthly Needs Allowance, $2,705 effective 1 July 2026, protects a floor of monthly income for the spouse remaining at home. If that spouse’s own income falls short of the floor, some of the applicant’s income can be diverted to make up the difference before ALTCS counts the rest.
The 60-month look-back
AHCCCS reviews financial records going back 60 months from the date of application, looking for gifts, transfers, or asset sales below fair market value. Transfers found in that window can trigger a penalty period — a stretch of time during which ALTCS will not pay, calculated based on the value transferred. This is exactly why the timing and structure of any transfer needs an elder law attorney, not a guess.
Assets that generally don’t count
The $2,000 asset limit (2026) is for countable assets. Several things are excluded:
- The primary residence, within programme equity limits
- One vehicle
- Burial plots and certain prepaid burial arrangements
- Ordinary household goods and personal effects
Figures on this page are current for 2026 and were last reviewed 15 August 2026. ALTCS limits change — confirm the current numbers directly at azahcccs.gov or in AHCCCS’s own eligibility summary, DE-828.
Over the limits? Here is what actually helps
Being over the income or asset limit today does not mean a family is out of options. Legitimate Medicaid planning strategies exist — Miller Trusts, certain annuities, spend-down of countable assets on exempt items, and structuring transfers correctly ahead of a future need.
Medicaid asset planning is the practice of law in Arizona. Heaven Sent Senior Placement does not advise on it, draft trusts, or restructure finances, and no placement agency legitimately can. If a family is over the limits and needs a plan, the right next call is an Arizona elder law attorney — ask for one who specifically handles ALTCS planning, not general estate work.
Please note. This page is general information, not legal, medical, or financial advice. Eligibility determinations are made solely by AHCCCS. Heaven Sent Senior Placement is a placement and referral service, not a healthcare provider, and does not perform medical assessments or make eligibility determinations. For asset planning, consult an Arizona elder law attorney.
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