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How to Fill out the Arizona Long-Term Care Application

How to Fill out the Arizona Long-Term Care Application

Most people are familiar with the Medicaid program that provides health coverage for millions of Americans. Funded jointly by the federal and state governments, the states are responsible for administering the program while abiding by federal regulations.

In Arizona, the Medicaid program is known as the Arizona Health Care Cost Containment System or AHCCCS. For seniors who meet certain income and health requirements, AHCCCS offers health insurance known as the Arizona Long Term Care System (ALTCS).

Who Is Eligible for ALTCS Coverage?

The ALTCS program has been designed to help low or fixed-income seniors and others afford much-needed long-term medical care. To be eligible to receive ALTCS coverage, individuals must meet several requirements, some general, some financial, and others related to medical and health needs. In general, ALTCS coverage is for U.S. citizens or qualified immigrants who:

  • Live in Arizona
  • Are age 65 or over OR who are blind or disabled
  • Have a social security number or apply for one
  • Require a certain level of care or assistance as determined by AHCCCS
  • Live in an approved living arrangement (including AHCCCS-certified assisted living community, nursing facility, or their own home)
  • Apply for all available cash benefits, including Veterans’ Assistance benefits, unemployment, social security, etc.
  • Have a gross monthly income under the limit set by AHCCCS. The income limits vary for different eligible groups.

How to Apply for ALTCS

You can start the application process if you meet the eligibility requirements outlined above. There are three easy ways to fill out the ALTCS application form.

  1. Call ALTCS toll-free at (888) 621-6880.
  2. Visit one of ALTCS’ offices in person.
  3. Fill out and submit a form electronically by emailing it to

You can apply for yourself or have another person, such as a close family member, act on your behalf throughout the process. The application process takes about 45 days.

How To Prepare for the Review of Your Eligibility

AHCCCS provides a helpful guide online to better understand the type of information you will need to provide. In addition, ALTCS representatives can help you determine the appropriate documentation for eligibility requirements, but the following are some tips to help you prepare:

  • Prepare a list of all your medical providers with relevant medical records they can supply to AHCCCS about your health and medical needs, including any official diagnoses or recommendations for long-term care.
  • Have copies of your medical records or request them ahead of time.
  • Make copies of legal documents such as those granting power of attorney or guardianship to others.
  • Where possible, include financial records of your monthly income and benefits.
  • Have a family member or other person with relevant knowledge participate in your interview so they can discuss how you benefit from assistance in activities of daily living.
  • Provide a list of everyday activities you need assistance with, such as cooking, transportation, grooming, bathing, medication management, etc.

Gathering this information beforehand will make the interview process smoother and more efficient.

ALTCS-Certified Assisted Living

If you are considering assisted living communities in Arizona, look for those that are ALTCS-certified, like Solterra Senior Living communities. When you choose communities that work with ALTCS, you can use your benefits toward your care. If you have questions, please contact us to find out more!

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