Medicaid, the nationwide health insurance program for low-income Americans, was launched in 1965 by the federal government. Arizona was the last state to adopt it’s own version of the joint federal-state program when the state government established the Arizona Health Care Cost Containment System (AHCCCS) in October, 1982. Prior to 1988, Medicaid in the state was limited, and there were no long-term care services for seniors.
Today approximately 21 percent of Arizona residents are covered under Medicaid. Although the elderly and disabled only make up 19 percent of all Medicaid enrollees in the state, half of the total annual expenditures go towards care and services for seniors and people who are permanently disabled.
In Arizona, low-income seniors seeking Medicaid coverage who also need a nursing home level of care need to apply to the Arizona Long Term Care System (ALTCS), a program operated by the AHCCCS that specifically deals with adults who are 65 and older and people with disabilities.
The ALTCS provides medical coverage and long-term care using a managed care model rather than Medicaid waivers, which ensures that all eligible seniors who need services, such as assisted living placement, are covered. Seniors who are deemed to be eligible for ALTCS services will be assisted a case manager who will assign services, which may include placement in an assisted living facility supplemented by additional care from a homemaker, personal care aid or registered nurse.
Residents of Surprise, AZ who are covered under the ALTCS can choose from one of three acute health plans available in Maricopa County. Plan members have the option to change their acute health plan provider every 12 months upon providing at least 60 days notice to the current provider.
Coverage for both Medicaid and the ALTCS is available for seniors who:
- Are permanent residents of Arizona
- Are either a U.S. citizen or a qualified immigrant
- Have a valid Social Security number
- Income limit is under $2,313 a month as an individual, or have a combined income of $4,626 or less when applying with a spouse
- Countable asset limits are $2,000 (individual) or $4,000 (couple) per month
If Medicaid applicants gave away or sold any assets below fair market value during the 60 month period immediately preceding their request for Medicaid coverage, they may be levied a penalty in the form of a Medicaid ineligibility period.
Seniors in Arizona who are excluded from Medicaid/ALTCS coverage due to excess income have the option of establishing a non-revocable Miller Trust, naming the State of Arizona as the beneficiary. All excess monthly income, minus a personal needs allowance up to 15 percent of the maximum federal SSI benefit, must be diverted to the trust for use towards the seniors’ care. Upon death, the balance of the trust becomes property of the state.