How to Avoid This Long Term Care Pitfall

By Katie Brenneman, Stronghold Financial

What if you’re not MEDICALLY eligible for Arizona Long Term Care System (ALTCS)?

“I’m sorry, but your loved one isn’t medically eligible for the ALTCS program at the moment.”

That’s a conversation my firm has with families every single day.

Some families aren’t aware that there’s even a medical eligibility component for the program at all.

Others think it’s enough that they’re loved one needs medication management…

…or their doctor said they need to be in assisted living…

…or they have a dementia diagnosis.

But these circumstances alone won’t cut it.

To qualify medically for the ALTCS program, the applicant must score at least 60 points on a medical assessment.

During the medical assessment, an ALTCS medical assessor asks questions to understand the following areas:

  • The applicant’s need for help with activities of daily living (ADLs):
    • Mobility inside their home
    • Transferring in or out of bed or chairs
    • Bathing
    • Dressing
    • Eating (not meal preparation)
    • Grooming (brushing hair, brushing teeth, and shaving)
    • Toileting
  • If incontinence is occurring and how often
  • The applicant’s ability to correctly answer orientation questions such as the city/state they’re in, what the month/year is, etc.
  • If any behaviors are occurring:
    • Wandering
    • Self-injurious
    • Aggressive
    • Resistive
    • Disruptive

Each area of review earns a score based on how much help is being provided.

And again, the applicant must score 60 points total to qualify medically for the program. 

It’s important for you to know that 60 points is a HIGH level of care.

The ALTCS program is for individuals who need a skilled nursing facility level of care.

This doesn’t mean the applicant needs to live in a skilled nursing facility – they could live in an assisted living community, or even at home. 

But it DOES mean that people need to plan ahead.

Every week we talk with families about their loved one, who spent down their assets on their long term care costs too quickly…

…they’re out of money…

…but not medically eligible for the ALTCS program yet.

Now what are they supposed to do?

Understanding ALTCS medical eligibility is a critical component of planning for long term care costs.

It’s important for you to do your research…

…and engage with a trusted professional in the ALTCS qualification space to ensure the information you’re getting is accurate.

Check out the training video below if you’d like to learn more:

About Katie Brenneman

Prior to starting Stronghold Financial, Katie spent her entire career in estate and retirement planning. She witnessed the stress her dear grandmother “Mimi” experienced when her grandfather moved into a skilled nursing facility for the last 2.5 years of his life, and knew there had to be a better way.

Stronghold now prevents their clients from having to spend down all of their assets in order to be financially eligible for ALTCS, the state’s long term care program. Stronghold can protect 100% of the assets for the healthy spouse in a married couple, and 50-75% of the assets for the kids of an unmarried individual – while qualifying the individual in need of care for the ALTCS program at the same time.