The ALTCS application, step by step
Updated July 2026
ALTCS — the Arizona Long Term Care System — is the state’s Medicaid program for long-term care, and it’s how families without deep savings afford assisted living. The application is genuinely bureaucratic, but it is beatable, and thousands of Arizona families get approved every year. Here’s the whole path, in order, with the traps marked.
Figures below are the 2026 limits. Nothing on this page is legal advice — for gifting, trusts, or a house in more than one name, a Tucson elder law attorney is the right call, and we’re happy to point you to ones families have trusted.
1Check the 2026 financial limits first
ALTCS looks at income and assets separately, and both have to fit. In 2026 a single applicant can have up to $2,982 in monthly income and $2,000 in countable assets. Married couples where only one spouse applies get more room: the healthy spouse keeps the house they live in, a car, and a protected share of the couple's savings (between roughly $32,500 and $162,660 in 2026). The home itself, one vehicle, and personal belongings usually don't count. Over the income limit? Don't stop reading — a Miller Trust (income-only trust) can fix that, and it's routine, not exotic.
2Gather the paperwork before you apply
The single biggest cause of delay is missing documents. Pull together: Social Security card and Medicare card, birth certificate or proof of citizenship, 3 months of bank statements for every account, proof of income (Social Security award letter, pension statements), life insurance policies, property deeds and vehicle titles, and any trust documents or powers of attorney. If your parent gave away money or property in the last 5 years, gather those records too — ALTCS checks, and surprises hurt more than disclosures.
3File the application
Apply online at Health-e-Arizona Plus (healthearizonaplus.gov) or call ALTCS at (888) 621-6880 and ask them to start an application by phone — a real person walks you through it and schedules what comes next. There's no fee to apply. You can also apply in person at an AHCCCS/ALTCS office; the Tucson office serves all of Pima County.
4The financial review
A caseworker verifies everything from step 2. They will also review the last 5 years of financial history (the "look-back") for gifts or transfers below market value — giving the grandkids money or signing the house over to a sibling within that window can trigger a penalty period during which ALTCS won't pay. If something like that happened, tell your caseworker up front. There are legal ways to handle it, and an elder law attorney is worth every penny in that situation.
5The medical assessment (PAS)
A nurse or social worker does the Preadmission Screening — usually in person, sometimes by phone. They score how much help your parent needs with daily living: bathing, dressing, eating, moving around, memory and orientation, behaviors, and medical conditions. Be honest about the hard days, not the good ones. Family often instinctively minimizes ("Mom manages okay") — but the assessment needs the 2 a.m. reality, not the front-porch version. Have a family member present who can speak plainly about what a bad day looks like.
6The decision — and what approval actually means
Count on 45 to 60 days from a complete application; incomplete paperwork stretches it to months. If approved, ALTCS assigns a program contractor and a case manager, and it pays for care in settings that hold an ALTCS contract — which is the catch families discover late: not every assisted living home accepts ALTCS. That's why we keep track of which homes do — ask us before falling in love with one that doesn't. If denied, you can appeal — and many denials are paperwork problems, not true ineligibility.
7While you wait: plan the bridge
ALTCS doesn't pay retroactively for assisted living the way families often hope, and a 60-day wait is real money. Common bridges: private-paying the first months (some homes discount while an ALTCS application is pending), VA Aid & Attendance if your parent or their spouse served, or family cost-sharing. When we help you choose a home, we factor the ALTCS timeline in from day one so nobody gets a surprise bill.
The shortcut nobody tells you
Start the ALTCS application and the home search at the same time — not one after the other. Families who wait for approval before looking at homes lose two months, and families who pick a home first sometimes fall in love with one that doesn’t take ALTCS. We run both tracks together: we know which Tucson-area homes hold ALTCS contracts — it changes as homes sign and drop contracts, so the reliable list lives in our heads, not on a filter. Call (520) 525‑2755 and we’ll tell you which ones fit, each with its state inspection record. It costs your family nothing.
ALTCS questions families ask us
What are the ALTCS income and asset limits for 2026?
A single applicant can have up to $2,982 per month in income and $2,000 in countable assets. The house they live in, one car, and personal belongings generally don't count. A married couple where only one spouse applies keeps more — the at-home spouse is allowed a protected resource allowance between about $32,500 and $162,660 in 2026.
How long does the ALTCS application take?
Plan on 45 to 60 days from a complete application. Missing documents are the most common reason it stretches to 3–6 months, so gather bank statements, income proof, and legal documents before you file.
What if my parent is over the income limit?
An income-only trust (Miller Trust) is the standard fix — income flows through the trust and your parent can still qualify. It's routine in Arizona; an elder law attorney can set one up quickly, and the ALTCS office will tell you if you need one.
Does every assisted living home accept ALTCS?
No — only homes that hold an ALTCS contract with a program contractor. Many excellent Tucson homes are private-pay only. We keep track of which homes hold ALTCS contracts — ask us, and our help finding one is free to your family.
Can we apply for ALTCS while Mom is still in the hospital or rehab?
Yes — and if a discharge is coming, you should. Starting the application while she's still in a facility gets the clock running so the funding lands closer to when the assisted living bill starts.
Don't do the ALTCS maze alone.
Tell us where you are in the process — even if it's "we haven't started and Mom's discharge is Friday." We'll help you find a home that takes ALTCS, plan the bridge until it kicks in, and walk with you the whole way. Our service is always free to families. When you choose a home we've introduced you to, that home pays us a referral fee. You never pay more because you worked with us, and we show you every home's state record either way.
Our service is always free to families. When you choose a home we've introduced you to, that home pays us a referral fee. You never pay more because you worked with us, and we show you every home's state record either way.