2026 ALTCS Home Care Benefits

The author of the information is Certified Medicaid Planner™, Steve Dabbs, CMP™.  You can call him at 480-967-8477 at no charge to learn more or complete the Contact Form.

Most know that Medicaid is a federal program; most don’t understand that the qualification requirements and benefits vary slightly from state to state.

This is because it is partially funded by the states and administered by the state.

A state’s qualification requirements can be less stringent than the federal rules but not more stringent.  This means that a state’s financial caseworker must follow federal law as well as state rules.

Unfortunately, caseworkers or Benefit Eligibility Specialists (BES) often make mistakes, including denying cases that shouldn’t be denied.  Unless you are thoroughly familiar with the law and how it works, you will not know that they have made a critical error.  This is why you should hire a 

Again, in Arizona, the HCBS program—home care—is provided by our Medicaid, or ALTCS, but this is not true for all states.

As I said, the qualifications are the same, whether in a care home, an assisted living community, or receiving care in your own home.

Here are the three qualifications you must meet to be eligible for ALTCS.

First, you must be:

A US citizen or a resident with a Social Security Number.

And be an Arizona resident.

Need nursing home level or custodial level of care as determined by AHCCCS.

If you are a wartime veteran or the surviving spouse of a qualified veteran, you must prove that you have applied for the Veteran’s Pension with Aid and Attendance benefit.  I’m a VA Accredited Claims Agent, so if needed, I can legally prepare, present, and prosecute a claim for a veteran or surviving spouse.

Unless someone is accredited, it is illegal to do so.

See Veterans Long-Term Care Benefits for more information on the VA Pension with Aid and Attendance.

So, what are the ALTCS medical qualification requirements?

An ALTCS medical assessor, who is a social worker or nurse, uses a tool called the Pre-Admission Screening (PAS).  The PAS’s purpose is to determine if the applicant has an intermediate or custodial level of care need.

They review medical records and conduct a face-to-face or over-the-phone interview.  The applicant must score 60 points or higher to qualify.

Since the assessment is somewhat subjective, it can be redone at any time if the applicant’s score is less than 60 points, and the decision can also be appealed.  Undw

The assessment takes about an hour and covers a full range of medical and cognitive questions.

PAS assessments are valid for 180 days but can be retaken at any time if the applicant does not score the required 60 points.

The assessor looks at the person’s need for assistance with activities of daily living or ADLs.  These ADLs include:

• Bathing
• Dressing;
• Grooming and Personal Hygiene
• Eating and Drinking
• Toileting
• Mobility; and
• Transferring;

Someone who has been diagnosed by a neurologist with dementia can receive up to 20 of the 60 points needed to be approved, though having dementia alone is not enough to qualify; it goes a long way. 

One of the most significant issues with the PAS assessment process is that during the live assessment, the applicant is questioned. The applicant has a natural tendency to hide their health issues.

For instance, someone who is incontinent may not admit it to a stranger. But incontinence scores points on the PAS—like dementia—and will go a long way toward reaching the 60 points needed.

To avoid being denied, consult a Certified Medicaid Planner for assistance with the PAS process. It may also be helpful to have an RN or a board-certified patient advocate review your records and be at the assessment to ensure that the assessor doesn’t mis-score your level of care. 

If we are representing you, it will help you appeal a negative decision at no charge.

Next,  what are the Financial Qualification Requirements?

The financial qualification requirements for ALTCS are reasonably straightforward on one hand, yet they can be very complicated and confusing on the other. In other words, even if your income and assets are too high, several strategies can still be considered to help you qualify financially.

Seek the help of a Certified Medicaid Planner before you apply—or if you’ve been told your income or assets are too high to qualify.

Furthermore, someone who is not familiar with the application process may find it difficult, and ALTCS information requests can be hard to satisfy. Being able to meet the ALTCS-required deadlines is another reason why working with a competent and knowledgeable Certified Medicaid Planner is essential.

Now, keep in mind that regardless of marital status, the most an applicant can have in countable assets is $2,000. Please note that the $2,000 is a hard limit; any amount above it will cause a denial.

Arizona is an “income cap” state. If the applicant’s income exceeds the income cap, the application will be denied. See our website for the current income cap. However, Arizona’s ALTCS allows the use of an “Income Only Trust,” also known as a Miller Trust. The Income Only Trust enables the income to flow through the trust, making your income eligible for approval.

To use an Income Only Trust for 2026, your gross income must be below the “Gross Income Cap” of $2,984 per month for individuals and $5,964 for married couples.

If married, the $5,964 can be confusing because at the same time, the well spouse, at-home spouse, or non-institutional spouse, which is synonymous with the term or name, “Community Spouse,” can have unlimited income.

See our video on our website: “What is an Income Only Trust?”

Now, here is an important rule pertaining to married couples: “All assets are jointly owned, and all income is separate.”

What that rule means is that the community spouse can have unlimited income.

This is critical to understand, so let me repeat it: “All assets are jointly owned, and all income is separate.” Therefore, the well spouse or community spouse can have unlimited income!

This is important because one of the strategies that can be employed—if the total countable assets exceed the current 2026 Maximum Resource Allowance of $162,660 plus the institutional spouse’s personal needs allowance of $2,000 or $164,660 total— the excess can be converted to income with the use of a Medicaid Compliant Annuity. This income is then paid to the Community Spouse, who can have unlimited income. See the book by Steve Dabbs, Medicaid for Millionaires and Everyone Else, found on Amazon.com.

So, with the help of a Medicaid Compliant Annuity, regardless of marital assets, an applicant’s countable assets can be converted to non-countable income.

Note that the MCA conversion strategy is usually impractical for single individuals with assets of greater than $500,000. In those cases, a Medicaid Asset Protection Trust (MAP Trust) may be a better solution, assuming other factors, such as life expectancy, that exceed five years.

See Legal Document Solutions for more information on MAP Trusts.

Please see our website for details on the MCA and how it may work for you.

So, now that you have a basic understanding of the qualification requirements for ALTCS, let’s look at the Home Care benefit and how it works.

As I mentioned earlier, the qualification requirements for home care are the same; the difference lies in how the care is provided and how ALTCS handles the applicant’s income.

So, how is care provided, and how many hours of home care will ALTCS pay for? During the approval process, you are asked to choose a program manager. Currently, there are three program managers approved to provide this service; they are:

See ALTCS.org for up-to-date 2026 Medicaid-assisted living providers.

Mercy Care Providers

United Health Care Providers 

Banner Health Providers 

Arizona Complete Health – Long-Term Care

Once you are approved and chosen as your Program Manager, you are assigned a case manager who will determine your level of care and how many hours a week of care will be allowed.

Hours approved can be as little as 10 hours a week to as many as 54 hours a week. The average is 25 hours per week. 

It is important to note that a family member can be the actual caregiver, and they will be paid to provide the necessary care.  Call us for details on how to have your family member be your PAID caregiver.

We have several ALTCS-approved home care agencies that we can recommend that will hire you to be the caregiver for your loved one.  They pay minimum wage or $15.15 per hour for 2026 (January 1, 2026), with the exception of Tucson which is $15.45 and Flagstaff at $18.35 per hour.  I realize this is not much, but if you are a family member helping a loved one (including spouses, too), this would be a raise over your current pay of $0 per hour, you are currently receiving for providing care. 

And YES, with ALTCS, the community spouse or loved one can be a paid caregiver. 

You can also have an approved home care agency provide care, too.

Now, what about your income, and if married, your spouse’s income, how does ALTCS handle that?

If you are in a care facility, ALTCS takes all of the applicants’ income, leaving them with money to pay for any Medicare Premiums and unreimbursed medical expenses and their Individual Resource Allowance.

But if you are in your own home, you can keep 100% of your income up to the “Income Cap” (The ALTCS 2026 maximum income is $2,982 for one person applying for ALTCS and $5,964 for total household income.)

Any income that exceeds this amount is applied to the cost of care or can be shifted to the community spouse as part of their Monthly Needs Allowance.

Now you can stay in your home, avoid being exposed to “THE BUG,” and get the care you need.

Every case is slightly different. Call or text Steve Dabbs, CMP, or Cecilia Dabbs, CMP.   And if your family primarily speaks Spanish,  Cecilia Dabbs is fluent in Spanish, so she can communicate with a loved one in Spanish so they can better understand.

“Se Habla Español.”

So call Care Funding Solutions at 480-967-8477 today.

See “What is  (Arizona Long-Term Care System) Medicaid Explained”

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