403 Arizona Long Term Care System (ALTCS)

 

 

Revised 06/30/2020

Policy

The conditions of eligibility for the Arizona Long Term Care System (ALTCS) are listed in the following chart:

If the customer...

Then the conditions of eligibility are...

Is eligible for SSI Cash, Title IV-E Foster Care or Title IV-E Adoption Subsidy (MA502)

·        Valid application (MA533);

·        Interview (MA519);

·        Resident of Arizona (MA531);

·        Not incarcerated (MA525);

·        Assignment of rights to medical benefits and cooperation (MA503); and

·        Transfers (see Chapter 900);

·        Does not have a trust which causes the resources or income to exceed the limit (see Chapter 800); and

·        Medical need for long term care (MA509).

·        Is not receiving or deemed to be receiving SSI Cash; or

·        Is not receiving Title IV-E Foster Care or Adoption Subsidy

·        Valid application (MA533);

·        Interview (MA519);

·        Categorical element;

o       Aged (MA501);

o       Blind (MA504); or

o       Disabled (MA509);

·        Resident of Arizona (MA531);

·        Social Security number (MA532);

·        US Citizen (MA507) or appropriate non-citizen status (MA524);

·        Not incarcerated (MA525);

·        Reside in an appropriate ALTCS living arrangement (MA521);

·        Apply for potential benefits (MA526);

·        Assignment of rights to medical benefits and cooperation (MA503);

·        Resources (MA701):

o       $2,000 for individual; or

o       $3,000 for couple;

·        Resource Assessment (Community Spouse only) (MA707);

·        Income (MA615.1):

o       300% of FBR for an Individual; or

o       100% of the FBR for persons who are only eligible for limited AHCCCS Medical Assistance benefits and

·        Medical need for long term care (MA509).

 

The AHCCCS ALTCS local offices throughout the State determine eligibility for ALTCS.

 

Definitions

Term

Definition

Arizona Long Term Care System (ALTCS) Program

ALTCS is an AHCCCS Medical Assistance program. 

ALTCS provides long term services to customers who:

·        Are medically and financially eligible;

·        Are elderly, physically disabled or developmentally disabled; and

·        Have a medical need for long term care services.

 

Service Package

The table below describes the type of service package an ALTCS customer may receive based on the customer's circumstances.

If the customer...

Then the service package is...

Is in a living arrangement where long term care services can be received (MA521A)

Full ALTCS service package

Is in a living arrangement where long term services cannot be received (MA521A)

Limited ALTCS service package (ALTCS Acute Care)

Refuses the home and community based services (HCBS) offered by the case manager (MA521)

Has made an uncompensated transfer that makes the customer ineligible to receive long term care services (Chapter 900)

Owns home property in which the equity value exceeds the limit (MA705K)

For a description of the AHCCCS Medical Assistance service packages, see (MA302).

 

Enrollment

Customers approved for coverage under ALTCS are enrolled with an ALTCS Program Contractor (MA1104).

 

Customer Costs

Some ALTCS customers have to pay a share of the cost for their ALTCS health insurance (MA1201).

 

Legal Authority

This requirement applies to the following programs:

Program

Legal Authorities

ALTCS

Title 42, Chapter 7, Subchapter XIX of the USC

Title 42, Chapter IV, Part 435 of the CFR

Title 36, Chapter 29, Article 2 of the ARS

Title 9, Chapter 28 of the AAC