The ALTCS application: how to apply for Arizona Long Term Care, step by step

Short answer: To apply for ALTCS (the Arizona Long Term Care System), submit an application to AHCCCS online at Health-e-Arizona Plus, by phone, or at an ALTCS office. AHCCCS then reviews your parent's finances (2026: income under about $2,982/month and countable resources under $2,000 for a single applicant) and sends an assessor for a medical screening called the PAS. A decision usually comes within 90 days. Once approved, you choose a health plan (in Maricopa County: Mercy Care, UnitedHealthcare or Banner), and a case manager arranges care.

Before you apply

Two things decide ALTCS eligibility: medical need (your parent needs the level of care a nursing home provides, which many people with moderate dementia or significant physical needs do) and finances. In 2026, a single applicant generally needs gross income under $2,982 a month and countable resources under $2,000. The home, one car and personal belongings usually don't count.

If income is over the limit, an income-only (Miller) trust can solve it. If a spouse still lives at home, special protections let them keep the house, a car and a share of savings and income. And because ALTCS looks back five years at gifts and transfers, talk to an elder-law attorney or ALTCS planner before moving any money.

Documents to gather

• Photo ID and Social Security card
• Medicare and other insurance cards
• Proof of Arizona residency
• Birth certificate or proof of citizenship / qualified immigrant status
• Income letters: Social Security, pensions, annuities
• Bank statements (usually the last several months)
• Retirement, investment and life-insurance statements
• Property deeds and vehicle titles
• Burial or funeral contracts
• Power of attorney / guardianship papers
• Doctor and medication list
• Marriage certificate (if married)

The ALTCS application, step by step

1. Submit the application. Apply online through Health-e-Arizona Plus, by phone with AHCCCS, or in person at an ALTCS office. The application date matters, since coverage generally starts from the month you apply once approved, so don't wait until every document is in hand.
2. Financial interview. An ALTCS eligibility worker reviews income, assets and the five-year look-back and asks for documents. Respond to every request by its deadline.
3. Medical assessment (PAS). An assessor meets your parent in person (see below).
4. Decision letter. You'll receive an approval or denial in writing. If your parent is approved, the letter shows any share of cost.
5. Choose a health plan. In Maricopa County: Mercy Care, UnitedHealthcare Community Plan, or Banner – University Family Care.
6. Meet the case manager. The plan assigns a case manager who authorizes services, including placement in a contracted assisted living center.

The medical assessment (PAS)

The Pre-Admission Screening is how ALTCS decides medical eligibility. A nurse or social worker meets your parent, usually where they live, and asks about bathing, dressing, eating, toileting, transfers and walking, plus memory, orientation, behavior and medical conditions. They may review medical records too.

Be there, and be honest about the bad days. Many parents rally and say "I'm fine" for a visitor. Bring notes on falls, wandering, missed medications, incontinence and how much help is really needed. A doctor's letter describing dementia or other diagnoses helps.

How long ALTCS approval takes

AHCCCS aims to decide within about 90 days. Missing paperwork is the most common cause of delay. Many families can't wait that long for care, so they private-pay at an assisted living center during the application and switch to ALTCS once approved. At Fountain, your parent can stay in the same room when that happens.

Mistakes that cause ALTCS denials

• Gifting money or selling property below value within five years of applying
• Missing a document deadline or an interview
• Income over the limit with no Miller trust in place
• A PAS visit on a "good day" with no family present to describe real needs
• Not appealing: you can request a fair hearing if you disagree with a denial

After approval: choosing an assisted living center

ALTCS pays for care in assisted living centers that contract with your parent's plan. The resident contributes a share of cost and room and board from their income. Our share of cost guide explains how that works, and our ALTCS assisted living page covers what we offer.

Fountain Assisted Living in Mesa accepts all three Maricopa County ALTCS plans for assisted living, directed care and memory care, in the same renovated rooms as private-pay residents. Questions about where your application stands? Call (480) 299-3310; we help ALTCS families regularly.

Common questions

General information, not legal or financial advice. Confirm current rules and limits with AHCCCS (azahcccs.gov) or an elder-law attorney.