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ALTCS – the Arizona Long Term Care System
- is a program under AHCCCS (Arizona’s Medicaid
Project)ALTCS provides institutional, community-based and
home-based care, along with medical care for those who qualify.
To be eligible for ALTCS, a person:
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must be a resident of Arizona and a U.S.
Citizen (or a qualified alien)
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must meet age or disability requirements
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must be medically and functionally in
need of long-term care services at a level comparable to
that provided in a licensed nursing facility. This is
evaluated through a Pre-Admission Screening (PAS) process.
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can’t have an income of more than $1,635
a month, but make sure to check the income guidelines
because they are readjusted every year, and this amount
may be inaccurate -
must meet some asset
requirements. In doing so, some assets may be counted,
others may not. For example, the value of the
home where a person or a person’s spouse or dependent
loved one lives is not counted. Additionally, a home that a
person intends to return to after receiving
long-term care services also is not counted.
ALTCS recommends that a person not try
to self-qualify himself or herself, but rather go through the
eligibility process because there are many exclusions and other
variables that may be taken into consideration. A person may
need to pay a share of the cost of care received through ALTCS.
The amount is determined according to the person’s income and
may be reduced to provide an allowance for a spouse or loved one
who lives in the community. An ALTCS applicant or representative
must complete and submit an application and have a face-to-face
interview with an ALTCS eligibility specialist. An assessment –
called the Pre-Admission Screening - by an ALTCS nurse or social
worker is also required. For the phone number of the ALTCS
eligibility office closest to you, please call 602-417-4330, or
review a list of eligibility offices by visiting the web site
http://www.ahcccs.state.az.us/contacts/altcs.asp.
If you do not need help at the nursing
home level of care, AHCCCS may be still be able to provide
health insurance or help with your Medicare expenses. If you are
an Arizona resident with a countable monthly income of up to
100% of the federal poverty limit, you may qualify for AHCCCS
Health Insurance at no cost. The 2002 Federal Poverty level is
$739 a month for an individual, and changes according to
household size. The poverty level is readjusted each year in
April, so since this information is at least two years old, find
out what the readjusted poverty level is for 2004. For example,
the Household Size 2002 Income Limit looked something like this:
1 occupant - $739
2 occupants - $995
3 occupants - $1,252
4 occupants - $1,509
For household sizes above four
occupants, add $257 for each additional member (remember that
this figure is reflective of the year 2002, and is only being
used as an example; you’ll need to find out what the
corresponding readjustment is for 2004). Even if your income is
as much as 175% of the federal poverty level, you or your loved
one may still qualify for help with your medical care. You can
download an application from online, fill it out and mail it in.
The on-line address is:
www.ahcccs.state.az.us.
If you are scheduled for an interview, an eligibility specialist
will contact you by phone or mail.
Arizona Department of Economic Security (DES)’s
State Health Insurance Assistance Program (SHIP) - provides
health and long-term care insurance information to Medicare
eligible Arizonans, their families and caregivers. SHIP’s fact
sheet on Prescription Assistance Programs may be accessed at
State Health Insurance Assistance Program (SHIP) or by
contacting (800)-432-4040.
The Arizona Health Care Cost Containment
System - offers several Medicare Cost Sharing Programs. First,
the Qualified Medicare Beneficiary (QMB) program provides
beneficiaries AHCCCS Medical Benefits, including prescription
coverage, and reimburses beneficiaries for their Medicare
Premiums with state dollars. Second, the Specified Low-Income
Beneficiary and Qualified Individual (SLMB and QI-1) programs
reimburse beneficiaries for their Medicare Part B Premium,
therefore, increasing their monthly income, allowing them to
better afford some of their prescriptions. These programs can be
found at Medicare Cost Sharing.
Arizona Prescription Drug Discount Program -
for questions regarding the Arizona Prescription Drug Discount
Program, call the RxAmerica Help Desk at 800-770-8014, or visit
their website, http://www.rxamerica.com/.
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