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Does Arizona Medicaid pay for Assisted Living?

This is a common question, Does Arizona Medicaid pay for Assisted Living? This is an excellent question because every state is different in what service their state Medicaid pays for, and many only pay for Nursing Home costs. Others pay for Homecare and Home Health Care and Nursing Home costs, and some pay for all three. Homecare,  assisted living facilities, and nursing home costs.

What is Medicaid or ALTCS?

Medicaid was created for low-income people who require health care services, under title 42 U.S.C. §1396. The law was enacted in 1965 as an amendment to the Social Security Act 1935.

This act provides a hospital insurance program for the aged under the Social Security Act with a supplementary health benefits program and an expanded medical assistance program. And because of this, states must provide the minimum benefits mandated in this act, and they can not offer less than what the federal law requires, but they can offer more.

Arizona’s Medicaid is called the Arizona Health Care Cost Containment System or AHCCCS, and the program under it that provides long-term care for the aged, blind, and disabled is called Arizona Long Term Care System (ALTCS). ALTCS, pronounced as “All”, “Tex” was officially put into place in 1987 to provide long-term care for the elderly and individuals with physical and developmental disabilities. Since then, ALTCS has been there to assist those individuals in need of long-term care who have a hard time paying for the services.

Several strategies can allow someone to be qualified for ALTCS even if their assets exceed the limits. Consult a Certified Medicaid Planner for more information and guidance. 

What is Assisted Living?

People grow old, and our bodies and minds deteriorate. Sometime in the future, we will no longer be able to do things that we do today. Simple tasks called “Activities of Daily Living, or A.D.L.s” which are bathing, toileting, transferring, walking, eating or dressing, can no longer be done without the assistance of another individual.

An assisted living facility, community or residential group home is a place that basic help with A.D.L.s can be provided.

Does Arizona Medicaid or ALTCS cover the cost of Assisted Living?

Under Title 42 states are given the liberty to conceptualize and implement programs that will benefit the welfare of the people in need of care.

Arizona is a “Waiver State,” and its Medicaid program for individuals with long-term care needs, which is the ALTCS operates under Section 1115 of the Social Security Act of 1935.

Under the Home and Community Based Waiver Program or HCBS Program, states can provide benefits for both in-home care and assisted living facilities.

Because of the Home and Community Based Waiver Program and Section 1115 of the Social Security Act, Arizona residents can enjoy assisted living even under home care or in long-term care facilities. This allows many individuals that need the care to stay in their homes.

Read: What are qualifications for a VA Pension?

The HCBS services include:

  • Personal Care – Individuals may need help with dressing, bathing, toileting, and eating. Arizona Medicaid, through HCBS(Home and Community based Services) covers these services.
  • Respite Care – Sometimes called a “short term break” for caregivers. Caring for someone who needs long-term care can be very tiring. Taking a short break to relieve your stress will be a great help. This is so by bringing someone with special needs in a temporary care facility while the caregiver spends their time off.
  • Adult Day Care is designed for older adults who require supervision care during the day, it is also intended for adults that are isolated and lonely.
  • Adult Day Health Care – The specialized facilities that offer fun activities, Nursing Services, Therapeutic Services, Meal Options for dietary needs or preferences and so much more. 
  • Housekeeping – Basic housekeeping and running some errands are services that greatly ease the everyday activities of individuals.
  • Transportation – Many individuals under assisted living conditions need transport when they go to doctors’ appointments, do some groceries, or run errands. With the waiver program, it may be covered; and
  • Visiting nurse – When individuals with special needs undergo special medical procedures that don’t need to be in a medical facility, a visiting nurse can come and administer them.

Conclusion

Yes, Arizona Medicaid covers assisted living as long as the assisted living facility or group care home is approved by ALTCS or is ALTCS certified. I hope you got your question “Does Arizona Medicaid pay for assisted living” answered.

If you need help to qualify for ALTCS or help to find an ALTCS Approved or Certified ALTCS Assisted living provider, you can contact us.

Read: ALTCS Covered Services

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