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The Medicaid program in Arizona is
called AHCCCS (the Arizona Health Care Cost Containment System). AHCCCS is
jointly federal and state funded and helps to support low-income individuals
who are younger than 65 (though some who are older might be eligible). You
might qualify for benefits through this program if you earn 138 percent of the
FPL (Federal Poverty Level) or less. As of 2019,
this is $35,535 for a household with four family members and $17,236 for an
individual.
If you’re over 65, you’ll need to
apply for Medicaid benefits through the ALTCS (Arizona
Long Term Care System). Unlike other Medicaid services, which place a limit on
how many participants can enroll, ALTCS offers benefits as an entitlement. In
other words, if you meet the requirements for eligibility, you can access
services.
The income and asset limits for ALTCS is can be tricky to
navigate. We’ll go into detail on that soon, in addition to ways you can
qualify even if you don’t meet the requirements.
Points to Keep in Mind
on Medicaid Eligibility
·
AHCCCS typically covers state
residents who are younger than 65
·
Residents who are older than 65 or
disabled should apply for ALTCS
·
If you have children, they may be
entitled to Medicaid services, too
·
The application processing period is
usually between 60 and 90 days
·
If you don’t meet the financial
requirements for ALTCS, a lawyer might be able to help
AHCCCS for Arizona
Residents
When you apply to receive AHCCCS
benefits, an associate will review your application and help you figure out
which Medicaid coverage is best for your situation. To qualify for AHCCCS, you
usually must be younger than 65 (though you can be 65 or older if you’re the
caretaker or parent of a child). You must be either on Medicare as a pregnant
woman or caretaker/parent of a child or be ineligible for Medicare services.
You also need to earn below a certain limit and be a citizen of the U.S. or
a qualified noncitizen.
Income-based AHCCCS will count most
of the unearned and earned income you have. Some income doesn’t count, though,
such as Supplemental Security Income.
Medicaid for Disabled
and Elderly Residents
ALTCS is a state Medicaid program
that can help certain individuals afford their medical care. This system
provides specifically for the long-term medical needs of qualifying disabled, blind, or aged
residents in the state. This program pays for the services you require once
you’ve already exhausted your savings. To qualify, you must undergo a financial
assessment to determine whether you are able to cover the costs yourself. The
next component is a functional assessment to determine your current medical
state and care needs.
The financial eligibility requirements to receive ALTCS
benefits can be complicated and will be affected by whether or not you’re
married. As a single applicant, you can earn $2,313 or less in monthly income
to qualify. If you’re married and applying for benefits on your own, your
income is limited to the same amount and your spouse’s income doesn’t count. If
you and your spouse are applying for ALTCS together, you may not earn more than
$4,626 monthly.
If your income is higher than these
numbers, don’t let that deter you from pursuing ALTCS services. You might still
be able to qualify for benefits by using a Miller Trust. Like other trusts, this type of
trust must be legally sound in order to be considered valid.
How Working With an
Attorney Can Help
Getting approved for AHCCCS benefits
can prove tricky for some people. Many residents are denied ALTCS benefits
because they have too many resources to meet the eligibility requirements.
Fortunately, this doesn’t mean that you can’t qualify later once you do. You
may be able to get around being over the resource limit by “spending down” on your assets in order to meet
the financial requirements.
However, the way you go about this is extremely important.
Working with a lawyer can ensure that you spend down in the way that will
increase your odds of approval.
FAQs on Medicaid in
Arizona
Here are some common queries that applicants may have about
Medicaid services in the state:
Q: Will I owe any
costs if I get Medicaid services?
For most of your needed medical services, you’ll either
cover a small copayment when you visit a medical professional or pay nothing.
In most cases, you’ll just have to show your coverage card to prove you have
Medicaid and the state will pay your doctor for the costs.
Q: Can I get coverage
for my children’s medical needs?
Medicaid and a program called CHIP
(the Children’s Health Insurance Program) work
together to offer low-cost coverage to Arizona residents with children. If your
income meets the eligibility requirements, your children can access these
services. If you give birth while you’re covered by Medicaid, your child will
also automatically be enrolled for the first year of their life.
Q: What factors can
slow down the processing period for my application?
To qualify for the program, you must submit your
application, which can take up to 90 days to get approved. Your application
processing period might take longer than average if your income is too high for
eligibility in the month you apply and the month after but might be low enough
during the third month. If more proof is needed to determine your eligibility,
or you request extra time to gather the necessary documents, your processing
period might also be longer than 90 days.
What to Do if You Need
Help
The Medicaid application process can
be complex, and many applicants are denied coverage each year. Thankfully, even
if you’ve been denied before, all hope is not lost. Give us a call so we can
work with you to apply and give you a better shot at approval for AHCCCS
benefits. We also might be able to help you appeal the decision if your
application for help with medical coverage was previously denied. Speak with
one of our Elder Law attorneys today.
Need Help Applying for
ALTCS in Arizona?
If you need help setting up
Medicaid, speaking with a lawyer is a good place to
start. The application process itself can be complex and confusing, and making
mistakes can set you back in attaining benefits and services. If your situation
is complicated or you need help meeting the eligibility requirements, one of
our attorneys can answer your questions.
Contact the
JacksonWhite Elder Law team today at (480)467-4337 and learn how we can help
to ensure you receive the maximum ALTCS benefits available, while preserving as
many of your assets as possible.
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