ALTCS INFORMATION provided by
Senior Application Services
What is ALTCS?
ALTCS stands for the Arizona Long Term Care System and is pronounced "ALL-TEX". ALTCS is part of the Arizona Health Care Cost Containment System (AHCCCS) which is pronounced "ACCESS". AHCCCS is the need based Arizona health care program which is funded by Medicaid, a federal program. ALTCS is the part of AHCCCS that provides Long Term Care Services to financially and medically eligible seniors and disabled persons.
My Family Member Needs ALTCS. Can I Work with SAS on Their Behalf? Do I Need Their Power of Attorney?
Most of the time we primarily work with a close family member or trusted friend of the applicant. You do not need to have their Power of Attorney to help them apply to ALTCS. You do need to have access to their personal information and records, and they will need to sign some forms. If they are medically unable to sign, we can deal with that in other ways.
Can I Apply for ALTCS Without Paid Help?
Yes. Most people do. If you have very low income and assets it is easier, but still not easy. Some applicants run into a lot of frustration and trouble, especially in cases involving trusts or married couples (community spouses). ALTCS is not going to be very helpful when you are exhausted and confused. If you miss a deadline they will deny your case and send you to the back of the line. Many people wind up being denied for small errors that could have been easily fixed because they did not understand or they just gave up. Beware if ALTCS tells you that your are "over income" or "over resources". For single applicants a spend down on care costs is sometimes a practical choice. For married couples it is often not the best option. ALTCS will not tell you that their policy may allow you to become resource eligible sooner while preserving some or all of your hard earned resources. They may tell you that you need an Income Only (Miller) Trust and to call a lawyer. Make sure you understand ALTCS policy and consider all your options before spending down or paying high attorney fees. The advantages of having SAS apply for ALTCS as your Authorized Representative are many. We take much of the burden off exhausted spouses and family members. We know the ALTCS rules and procedures. We save our clients money and time. If you go it alone you may wind up losing far more money from delayed or denied benefits than you would have paid SAS to help. When you hire SAS as your Authorized Representative, you avoid taking on what amounts to a new part-time job that can last several months. You also avoid potentially costly errors in your application process.
How Much Does SAS Charge to Be the Authorized Representative for an ALTCS Application?
We handle cases on a flat fee basis. Simpler cases cost less, and complicated cases cost more. If SAS gets your ALTCS application approved even one month sooner, you will have saved a lot. Hiring SAS is a "no brainer" - unless you have endless patience, tons of free time, and are good with forms and following strict rules. The ALTCS application process is not always horrible, but for many people it is a frustrating and confusing hassle that ends with anger and disappointment. If your case is denied and we think ALTCS was wrong you may need to appeal (apply for a Fair Hearing). We typically do not charge an additional fee to be your witness and assist with presenting your information at a Fair Hearing. We also do not charge an additional fee to re-apply within one year after a denial for medical reasons. Call us for more information.
What Information Do You Need to Evaluate My ALTCS Eligibility?
For your first call we just need an overview of your age, residency, citizenship, marital status, assets, income, insurances, and medical situation. The call takes about five minutes. If you then think you might want us to help you, we will arrange to meet at our office or in your home for a more detailed conversation. If you then decide to work with us, we will request more specific information and copies of documents such as recent bank statements, pay stubs, etc. We will help you gather these things, but it is ultimately your responsibility to provide needed information and copies.
Do You Handle Developmentally Disabled (DD) ALTCS Applications?
Absolutely. Most of the people we help are seniors, but we are equally adept at DD applications.
What if I Have Already Been Denied?
We can still help. Call us and we will figure out if ALTCS made a mistake, or if there is a problem. If there is a problem, we will know how it can be fixed. Once we review your case, we will tell you if you need to request a Fair Hearing or reapply. It is always best to send us a copy of your Denial Notice right away, because the time allowed for filing a Fair Hearing request is short.
How are ALTCS Services Provided? Do They Pay Me Cash?
ALTCS services are provided by ALTCS Program Contractors. ALTCS does not pay you cash, but the Program Contractor may pay cash to a qualified caregiver who takes care of you if they meet certain requirements. ALTCS Program Contractors provide services through a Health Maintenance Organization (HMO) or managed care program. The ALTCS Program Contractors for each county are noted further down on this page.
What is the Monthly Income Limit?
The income limit for applicants is $2,313.00 per month, gross. For married applicants, Community Spouse rules may allow the applicant to have more monthly income. If an applicant is over the income limit, they may elect to have an Income Only Trust, which is also referred to as a Miller Trust. Not all types of income are counted. Some are excluded, such as Agent Orange payments and some VA need-based benefits. It gets complicated, so ask us about your specific case for more information.
What is a Miller Trust?
This is referred to as an Income Only Trust under ALTCS rules. In essence this is a special checking account with set monthly disbursements made by a Trustee that allows ALTCS to recover excess income by way of a Share of Cost payment. The actual piece of paper that creates this trust is sometimes sold by attorneys for a significant fee. This paper is referred to as the "trust instrument". SAS provides an attorney drafted, ALTCS approved trust instrument form to our customers for free. The real work is in getting the trust bank account and disbursement schedule verified and approved by ALTCS. If you are working with an attorney or another ALTCS assistance provider, make sure they will assist you with completing these tasks, as well as selling you the trust instrument. Without expert assistance in getting the disbursement schedule (DE-313) and bank account setup and approved by ALTCS, the trust instrument itself is worthless. ALTCS is very picky about how these trusts are set up, so be very careful and make sure you hire someone who will help you through the entire process.
How Much Can I Own in Assets?
ALTCS calls assets “resources”. The resource limit for single applicants is $2,000.00, not counting your home and one car in most cases. Community Spouse rules allow married applicants to own at least $29,284.00 in counted resources, and in some cases up to $130,420.00 in counted resources. Typically this is not counting their excluded home and vehicle. It gets complicated, so ask us about your specific case for more information.
Will Assets Held in Trust be Counted?
Maybe. First you need to determine whether the applicant is the Grantor, Beneficiary, and / or Trustee. For applicants who are Grantors, cash, real property and other countable assets held in a Revocable Trust are counted. Assets in an Irrevocable Trust may or may not be counted depending on several factors. Generally these factors involve whether the Grantor (applicant) retains rights to receive income, invade principal, or serve as trustee. For an Irrevocable Trust to not be counted the Grantor must not retain any control or rights to receive disbursements or change the terms of the trust instrument. Special Needs Trusts where the applicant is the beneficiary must meet certain requirements to be excluded. Call us for more specific information on how your trust will be treated by ALTCS.
What is the "Five Year Look Back Period" and What is a"Transfer Penalty"?
ALTCS will ask if you have given away, sold, or changed the name on the title or deed for any money or property in the past five years from the first day of the month the application was requested. They will also want to know if any such transfer was compensated. If not, they may still approve the application but assess a Transfer Penalty, unless the transfer falls within an exception. A Transfer Penalty means you would be approved but not receive the Long Term Care Services component of ALTCS for a period of months, just the Acute Care Services component (the medical insurance part). This penalty period is calculated by dividing the amount of the uncompensated transfer by the Private Pay Rate which is somewhere around $5,000 to $7,000 per month, depending on your county. It gets complicated, so ask us about your specific case for more information.
What Happens if I Sell My Home or Car While on ALTCS?
If you sell a resource after you are approved for ALTCS that was not counted (exempt) when you applied, like your house or your car, and you turn it into a counted resource (like cash), this could make you financially ineligible. Be careful! Call us first and we will let you know if you should worry about such a transfer impairing your eligibility.
I am a Veteran. Will That Affect My Application to ALTCS?
Maybe, but not in a bad way. Wartime veterans or their surviving spouses may be required to apply to the VA for a need-based pension as part of their ALTCS process. We will let you know if this affects you when we review your case. If you do need to apply for VA benefits, we will show you what you need to do to meet this requirement. It's no big deal, and you might get an additional cash benefit if you're eligible.
How Can I Know if I am Medically Eligible?
In addition to financial eligibility, ALTCS requires that an applicant need a “Nursing Home Level of Care” in order to be eligible. This is a high standard, and requires that the person needs a high level of assistance with many daily tasks of living such as dressing, toileting, bathing, medications, etc. For applicants with dementia or Alzheimer's, their need for a protective environment will typically result in a higher score and greater chance of medical eligibility. A person from ALTCS called a PAS Assessor will come visit the applicant and do a PAS. "PAS" stands for pre-admission screening, and involves observing, questioning, and reviewing medical records of the applicant. An elderly person needs a EPD PAS score of 60 to be eligible. "EPD" stands for Elderly and Physically Disabled. If the score is 55 or higher but below 60, management will review the score. If it is then still below 60, or if the assessor thinks the score does not accurately reflect the applicant’s needs, a physician will review the case. The ALTCS physician can find an applicant to be medically eligible regardless of the score. Physician reviews often result in the applicant being found medically eligible, but not always. If the applicant is found medically ineligible, you can re-apply when ready. There is no minimum waiting period to reapply, but unless the medical situation has degraded you will probably not get a higher score on a new PAS unless the first PAS was done incorrectly or relied on incomplete information. It gets complicated, so let us review your specific situation to advise you how this may apply to your case.
Can I Find Out if I am Medically Eligible for ALTCS without Applying?
Yes. You can contact ALTCS to request a Private PAS. ALTCS will evaluate your medical eligibility without going through the rest of the application process. This can be a useful tool for applicants who may need to take expensive steps such as creation of a Miller Trust in order to be financially eligible.
What If I am Married? Does This Affect My Eligibility?
ALTCS uses different standards to determine whether married people are eligible. This is called “Community Spouse” policy. Community Spouse rules apply to married applicants unless both married spouses live in nursing homes (as opposed to living at home or in assisted living). Community Spouse rules allow married people to have more income or assets.
How Long Does it Take to Get Approved?
It takes about two months from the day we request the application to get a decision, but if you are approved then medical benefits (other than assisted living expenses) are provided retroactive to the first day of the application month. Cases involving Miller Trusts or other complicated factors may take longer.
Does ALTCS Pay for Assisted Living?
Yes, but the customer must reside in an ALTCS certified assisted living facility or home. Check with SAS or ALTCS before you move to verify whether a particular assisted living facility or home is certified with ALTCS. Assisted living expenses are paid beginning on the application approval date, less the room and board charge. Room and board is the monthly amount the customer pays from their income to the assisted living home or facility. This will leave them at least $115 per month for their incidental needs.
What is a TEFRA lien and Estate Recovery?
ALTCS (AHCCCS) will impose a TEFRA lien, as authorized under 42 U.S.C. 1396(p) (Tax Equity and Fiscal Responsibility Act of 1982) against all real property owned by the customer including the customer’s primary residence. The purpose of the lien is to recover the cost of ALTCS benefits provided upon the member’s death or upon the sale or transfer of the property. Upon an ALTCS customer’s death, HMS (the AHCCCS / ALTCS Collection Agency) will impose a lien on behalf of AHCCCS to secure the real property for recovery of medical assistance paid on the member’s behalf. The amount of the estate claim that will be filed against the ALTCS member’s estate is the total of the ALTCS payments paid on behalf of the customer for Medicaid covered services.
What Happens After I am Approved for ALTCS?
You will be enrolled with an ALTCS Program Contractor under contract in your county. The Program Contractor will then assign a Case Manager who will meet with you to develop a specific plan for your care. To see which Program Contractors serve your county, click on this link: ALTCS Program Contractors by County. If you have a choice and you are in a facility, ask the facility who they prefer to work with.
What Services and Benefits are Available Through ALTCS?
ALTCS Long Term Care Services include nursing home care provided in a licensed Skilled Nursing Facility (SNF), an Intermediate Care Facility for the Mentally Retarded (ICF-MR), a free-standing hospice, a residential treatment facility for persons under 21, or a psychiatric hospital for people age 65 or older. Home and Community-Based Services (HCBS) are provided in your home or in a supervised alternative residential setting such as an Assisted Living Home, Group Home, Adult Foster Care Home, or a Level I, II, or III Behavioral Health Center. In-home services are intended to help you to remain in your home. They include, but are not limited to Home Health Nursing, Personal Care, Homemaker Services, Home Health Aids, Habilitation, Medical Transportation, Attendant Care, Home Delivered Meals, Adult Day Care Mental Health Services, Respite Care, and Hospice. To receive ALTCS care in a facility it must be certified with ALTCS. AHCCCS Acute Care Services include doctors, hospitalization, prescriptions (limited for people who have Medicare), lab work, x-rays, tests, and specialist treatments. Once you are approved, you receive acute care services even during a penalty period.
Can I Choose My Own Physician?
Your ALTCS Program Contractor will give you an opportunity to pick your own primary care physician from an approved listing, or will pick one for you if you do not make a choice. Your ALTCS Program Contractor will only pay for services authorized by ALTCS contracting physicians. If you choose to see a non-contracting physician, you will be responsible for the payment for that medical service.
Is This an Official ALTCS Website? Is This Company Affiliated with ALTCS?
No. This is a private company that helps people apply for ALTCS as their Authorized Representative. We are not affiliated with ALTCS, although our lead eligibility specialist used to work at ALTCS.
Does SAS Guarantee My ALTCS Application Will Be Approved?
We guarantee that we will work hard to make sure you get approved, and that you will not get denied due to any error on our part. We will also help you reapply for no additional fee within one year, and we typically do not charge an additional fee for serving as a witness at a Fair Hearing. Our guarantee is in writing in our Service Agreement. Some ALTCS assistance services state they will refund your fee if you are denied, but be careful. Will they refund the fee for a denial based on any reason? Or just for medical reasons? We usually will refund a prorated portion of the fee when the application is cancelled early in the process, but usually not when it is denied after substantial work has been completed by SAS. This because there are lots of factors that we do not control such as medical eligibility, errors caused by ALTCS, and failure of the customer to submit required documents within the required timeframe.
Is Senior Application Services a Law Firm? Are You Attorneys? Do You Give Legal Advice?
No. This is not a law firm, we are not attorneys in Arizona, and we do not give out legal advice. We help people apply for ALTCS, and we use our knowledge of ALTCS rules and procedures to make sure the job gets done right. If you need legal help as part of your ALTCS application process, we know some great Arizona lawyers who are happy to work with us when you need them. We will let you know when that is the case.
ALTCS stands for the Arizona Long Term Care System and is pronounced "ALL-TEX". ALTCS is part of the Arizona Health Care Cost Containment System (AHCCCS) which is pronounced "ACCESS". AHCCCS is the need based Arizona health care program which is funded by Medicaid, a federal program. ALTCS is the part of AHCCCS that provides Long Term Care Services to financially and medically eligible seniors and disabled persons.
My Family Member Needs ALTCS. Can I Work with SAS on Their Behalf? Do I Need Their Power of Attorney?
Most of the time we primarily work with a close family member or trusted friend of the applicant. You do not need to have their Power of Attorney to help them apply to ALTCS. You do need to have access to their personal information and records, and they will need to sign some forms. If they are medically unable to sign, we can deal with that in other ways.
Can I Apply for ALTCS Without Paid Help?
Yes. Most people do. If you have very low income and assets it is easier, but still not easy. Some applicants run into a lot of frustration and trouble, especially in cases involving trusts or married couples (community spouses). ALTCS is not going to be very helpful when you are exhausted and confused. If you miss a deadline they will deny your case and send you to the back of the line. Many people wind up being denied for small errors that could have been easily fixed because they did not understand or they just gave up. Beware if ALTCS tells you that your are "over income" or "over resources". For single applicants a spend down on care costs is sometimes a practical choice. For married couples it is often not the best option. ALTCS will not tell you that their policy may allow you to become resource eligible sooner while preserving some or all of your hard earned resources. They may tell you that you need an Income Only (Miller) Trust and to call a lawyer. Make sure you understand ALTCS policy and consider all your options before spending down or paying high attorney fees. The advantages of having SAS apply for ALTCS as your Authorized Representative are many. We take much of the burden off exhausted spouses and family members. We know the ALTCS rules and procedures. We save our clients money and time. If you go it alone you may wind up losing far more money from delayed or denied benefits than you would have paid SAS to help. When you hire SAS as your Authorized Representative, you avoid taking on what amounts to a new part-time job that can last several months. You also avoid potentially costly errors in your application process.
How Much Does SAS Charge to Be the Authorized Representative for an ALTCS Application?
We handle cases on a flat fee basis. Simpler cases cost less, and complicated cases cost more. If SAS gets your ALTCS application approved even one month sooner, you will have saved a lot. Hiring SAS is a "no brainer" - unless you have endless patience, tons of free time, and are good with forms and following strict rules. The ALTCS application process is not always horrible, but for many people it is a frustrating and confusing hassle that ends with anger and disappointment. If your case is denied and we think ALTCS was wrong you may need to appeal (apply for a Fair Hearing). We typically do not charge an additional fee to be your witness and assist with presenting your information at a Fair Hearing. We also do not charge an additional fee to re-apply within one year after a denial for medical reasons. Call us for more information.
What Information Do You Need to Evaluate My ALTCS Eligibility?
For your first call we just need an overview of your age, residency, citizenship, marital status, assets, income, insurances, and medical situation. The call takes about five minutes. If you then think you might want us to help you, we will arrange to meet at our office or in your home for a more detailed conversation. If you then decide to work with us, we will request more specific information and copies of documents such as recent bank statements, pay stubs, etc. We will help you gather these things, but it is ultimately your responsibility to provide needed information and copies.
Do You Handle Developmentally Disabled (DD) ALTCS Applications?
Absolutely. Most of the people we help are seniors, but we are equally adept at DD applications.
What if I Have Already Been Denied?
We can still help. Call us and we will figure out if ALTCS made a mistake, or if there is a problem. If there is a problem, we will know how it can be fixed. Once we review your case, we will tell you if you need to request a Fair Hearing or reapply. It is always best to send us a copy of your Denial Notice right away, because the time allowed for filing a Fair Hearing request is short.
How are ALTCS Services Provided? Do They Pay Me Cash?
ALTCS services are provided by ALTCS Program Contractors. ALTCS does not pay you cash, but the Program Contractor may pay cash to a qualified caregiver who takes care of you if they meet certain requirements. ALTCS Program Contractors provide services through a Health Maintenance Organization (HMO) or managed care program. The ALTCS Program Contractors for each county are noted further down on this page.
What is the Monthly Income Limit?
The income limit for applicants is $2,313.00 per month, gross. For married applicants, Community Spouse rules may allow the applicant to have more monthly income. If an applicant is over the income limit, they may elect to have an Income Only Trust, which is also referred to as a Miller Trust. Not all types of income are counted. Some are excluded, such as Agent Orange payments and some VA need-based benefits. It gets complicated, so ask us about your specific case for more information.
What is a Miller Trust?
This is referred to as an Income Only Trust under ALTCS rules. In essence this is a special checking account with set monthly disbursements made by a Trustee that allows ALTCS to recover excess income by way of a Share of Cost payment. The actual piece of paper that creates this trust is sometimes sold by attorneys for a significant fee. This paper is referred to as the "trust instrument". SAS provides an attorney drafted, ALTCS approved trust instrument form to our customers for free. The real work is in getting the trust bank account and disbursement schedule verified and approved by ALTCS. If you are working with an attorney or another ALTCS assistance provider, make sure they will assist you with completing these tasks, as well as selling you the trust instrument. Without expert assistance in getting the disbursement schedule (DE-313) and bank account setup and approved by ALTCS, the trust instrument itself is worthless. ALTCS is very picky about how these trusts are set up, so be very careful and make sure you hire someone who will help you through the entire process.
How Much Can I Own in Assets?
ALTCS calls assets “resources”. The resource limit for single applicants is $2,000.00, not counting your home and one car in most cases. Community Spouse rules allow married applicants to own at least $29,284.00 in counted resources, and in some cases up to $130,420.00 in counted resources. Typically this is not counting their excluded home and vehicle. It gets complicated, so ask us about your specific case for more information.
Will Assets Held in Trust be Counted?
Maybe. First you need to determine whether the applicant is the Grantor, Beneficiary, and / or Trustee. For applicants who are Grantors, cash, real property and other countable assets held in a Revocable Trust are counted. Assets in an Irrevocable Trust may or may not be counted depending on several factors. Generally these factors involve whether the Grantor (applicant) retains rights to receive income, invade principal, or serve as trustee. For an Irrevocable Trust to not be counted the Grantor must not retain any control or rights to receive disbursements or change the terms of the trust instrument. Special Needs Trusts where the applicant is the beneficiary must meet certain requirements to be excluded. Call us for more specific information on how your trust will be treated by ALTCS.
What is the "Five Year Look Back Period" and What is a"Transfer Penalty"?
ALTCS will ask if you have given away, sold, or changed the name on the title or deed for any money or property in the past five years from the first day of the month the application was requested. They will also want to know if any such transfer was compensated. If not, they may still approve the application but assess a Transfer Penalty, unless the transfer falls within an exception. A Transfer Penalty means you would be approved but not receive the Long Term Care Services component of ALTCS for a period of months, just the Acute Care Services component (the medical insurance part). This penalty period is calculated by dividing the amount of the uncompensated transfer by the Private Pay Rate which is somewhere around $5,000 to $7,000 per month, depending on your county. It gets complicated, so ask us about your specific case for more information.
What Happens if I Sell My Home or Car While on ALTCS?
If you sell a resource after you are approved for ALTCS that was not counted (exempt) when you applied, like your house or your car, and you turn it into a counted resource (like cash), this could make you financially ineligible. Be careful! Call us first and we will let you know if you should worry about such a transfer impairing your eligibility.
I am a Veteran. Will That Affect My Application to ALTCS?
Maybe, but not in a bad way. Wartime veterans or their surviving spouses may be required to apply to the VA for a need-based pension as part of their ALTCS process. We will let you know if this affects you when we review your case. If you do need to apply for VA benefits, we will show you what you need to do to meet this requirement. It's no big deal, and you might get an additional cash benefit if you're eligible.
How Can I Know if I am Medically Eligible?
In addition to financial eligibility, ALTCS requires that an applicant need a “Nursing Home Level of Care” in order to be eligible. This is a high standard, and requires that the person needs a high level of assistance with many daily tasks of living such as dressing, toileting, bathing, medications, etc. For applicants with dementia or Alzheimer's, their need for a protective environment will typically result in a higher score and greater chance of medical eligibility. A person from ALTCS called a PAS Assessor will come visit the applicant and do a PAS. "PAS" stands for pre-admission screening, and involves observing, questioning, and reviewing medical records of the applicant. An elderly person needs a EPD PAS score of 60 to be eligible. "EPD" stands for Elderly and Physically Disabled. If the score is 55 or higher but below 60, management will review the score. If it is then still below 60, or if the assessor thinks the score does not accurately reflect the applicant’s needs, a physician will review the case. The ALTCS physician can find an applicant to be medically eligible regardless of the score. Physician reviews often result in the applicant being found medically eligible, but not always. If the applicant is found medically ineligible, you can re-apply when ready. There is no minimum waiting period to reapply, but unless the medical situation has degraded you will probably not get a higher score on a new PAS unless the first PAS was done incorrectly or relied on incomplete information. It gets complicated, so let us review your specific situation to advise you how this may apply to your case.
Can I Find Out if I am Medically Eligible for ALTCS without Applying?
Yes. You can contact ALTCS to request a Private PAS. ALTCS will evaluate your medical eligibility without going through the rest of the application process. This can be a useful tool for applicants who may need to take expensive steps such as creation of a Miller Trust in order to be financially eligible.
What If I am Married? Does This Affect My Eligibility?
ALTCS uses different standards to determine whether married people are eligible. This is called “Community Spouse” policy. Community Spouse rules apply to married applicants unless both married spouses live in nursing homes (as opposed to living at home or in assisted living). Community Spouse rules allow married people to have more income or assets.
How Long Does it Take to Get Approved?
It takes about two months from the day we request the application to get a decision, but if you are approved then medical benefits (other than assisted living expenses) are provided retroactive to the first day of the application month. Cases involving Miller Trusts or other complicated factors may take longer.
Does ALTCS Pay for Assisted Living?
Yes, but the customer must reside in an ALTCS certified assisted living facility or home. Check with SAS or ALTCS before you move to verify whether a particular assisted living facility or home is certified with ALTCS. Assisted living expenses are paid beginning on the application approval date, less the room and board charge. Room and board is the monthly amount the customer pays from their income to the assisted living home or facility. This will leave them at least $115 per month for their incidental needs.
What is a TEFRA lien and Estate Recovery?
ALTCS (AHCCCS) will impose a TEFRA lien, as authorized under 42 U.S.C. 1396(p) (Tax Equity and Fiscal Responsibility Act of 1982) against all real property owned by the customer including the customer’s primary residence. The purpose of the lien is to recover the cost of ALTCS benefits provided upon the member’s death or upon the sale or transfer of the property. Upon an ALTCS customer’s death, HMS (the AHCCCS / ALTCS Collection Agency) will impose a lien on behalf of AHCCCS to secure the real property for recovery of medical assistance paid on the member’s behalf. The amount of the estate claim that will be filed against the ALTCS member’s estate is the total of the ALTCS payments paid on behalf of the customer for Medicaid covered services.
What Happens After I am Approved for ALTCS?
You will be enrolled with an ALTCS Program Contractor under contract in your county. The Program Contractor will then assign a Case Manager who will meet with you to develop a specific plan for your care. To see which Program Contractors serve your county, click on this link: ALTCS Program Contractors by County. If you have a choice and you are in a facility, ask the facility who they prefer to work with.
What Services and Benefits are Available Through ALTCS?
ALTCS Long Term Care Services include nursing home care provided in a licensed Skilled Nursing Facility (SNF), an Intermediate Care Facility for the Mentally Retarded (ICF-MR), a free-standing hospice, a residential treatment facility for persons under 21, or a psychiatric hospital for people age 65 or older. Home and Community-Based Services (HCBS) are provided in your home or in a supervised alternative residential setting such as an Assisted Living Home, Group Home, Adult Foster Care Home, or a Level I, II, or III Behavioral Health Center. In-home services are intended to help you to remain in your home. They include, but are not limited to Home Health Nursing, Personal Care, Homemaker Services, Home Health Aids, Habilitation, Medical Transportation, Attendant Care, Home Delivered Meals, Adult Day Care Mental Health Services, Respite Care, and Hospice. To receive ALTCS care in a facility it must be certified with ALTCS. AHCCCS Acute Care Services include doctors, hospitalization, prescriptions (limited for people who have Medicare), lab work, x-rays, tests, and specialist treatments. Once you are approved, you receive acute care services even during a penalty period.
Can I Choose My Own Physician?
Your ALTCS Program Contractor will give you an opportunity to pick your own primary care physician from an approved listing, or will pick one for you if you do not make a choice. Your ALTCS Program Contractor will only pay for services authorized by ALTCS contracting physicians. If you choose to see a non-contracting physician, you will be responsible for the payment for that medical service.
Is This an Official ALTCS Website? Is This Company Affiliated with ALTCS?
No. This is a private company that helps people apply for ALTCS as their Authorized Representative. We are not affiliated with ALTCS, although our lead eligibility specialist used to work at ALTCS.
Does SAS Guarantee My ALTCS Application Will Be Approved?
We guarantee that we will work hard to make sure you get approved, and that you will not get denied due to any error on our part. We will also help you reapply for no additional fee within one year, and we typically do not charge an additional fee for serving as a witness at a Fair Hearing. Our guarantee is in writing in our Service Agreement. Some ALTCS assistance services state they will refund your fee if you are denied, but be careful. Will they refund the fee for a denial based on any reason? Or just for medical reasons? We usually will refund a prorated portion of the fee when the application is cancelled early in the process, but usually not when it is denied after substantial work has been completed by SAS. This because there are lots of factors that we do not control such as medical eligibility, errors caused by ALTCS, and failure of the customer to submit required documents within the required timeframe.
Is Senior Application Services a Law Firm? Are You Attorneys? Do You Give Legal Advice?
No. This is not a law firm, we are not attorneys in Arizona, and we do not give out legal advice. We help people apply for ALTCS, and we use our knowledge of ALTCS rules and procedures to make sure the job gets done right. If you need legal help as part of your ALTCS application process, we know some great Arizona lawyers who are happy to work with us when you need them. We will let you know when that is the case.