Long term care insurance pays for care provided in assisted living and nursing home facilities and for skilled care provided at home. Basically, there are two ways to obtain coverage. One way is by purchasing a traditional insurance policy or insurance product with long term care benefits. The other way is to qualify for coverage under the Arizona Long Term Care System (ALTCS).

Traditional Long Term Care Insurance

Traditional long term care insurance covers home care, assisted living, adult daycare, respite care, hospice care, nursing home and Alzheimer’s facility expenses. Most policies also cover home modifications that help manage disabilities.

Two things you need to know about traditional coverage are:

  1. It is expensive. As of November,2020, Genworth Life Insurance Company reported that the average annual premium for an Arizona policy providing $125 per day for up to five  years is $2,239 for a female (age 65) and $3,583 for a male (age 65).
  2. You need to purchase this insurance before you have been diagnosed with a serious medical condition. A pre-existing condition may exclude you from securing any coverage at all.

If traditional long term care insurance is unaffordable, or if you cannot enroll because of a pre-existing condition, coverage through the Arizona Long Term Care System (ALTCS) may be an alternative.

The Arizona Long-Term Care System

In Arizona, ALTCS provides long term benefits for seniors who satisfy medical and financial requirements. In contrast to private insurance, ALTCS coverage can come at little or no cost to qualifying members. And, also contrary to private insurance, ALTCS coverage is only available to people who already require long-term care.

ALTCS provides coverage in a variety of settings, including group homes, assisted living communities, and skilled nursing facilities.   What many people don’t know is that ALTCS also covers in-home services, as well as respite care for family caregivers. Benefits that may be available include:

  • Full Coverage of Acute Care Services, including doctors, hospitalization, reduced prescription costs, lab work, x-rays, tests, and specialist treatments.
  • Alternative Facility Care, including care provided in a licensed nursing facility, residential care facility, rehabilitation care facility, assisted living center, or group home.
  • Home and Community Based Services, including home day care, personal and respite care, medical transportation, mental health services, homemaker services, attendant care, and home health aides.
  • Services for Developmentally Disabled Adults and children, including specialized care for developmentally disabled adults and children.

ALTCS Eligibility

The majority of ALTCS applications are denied for lack of proper planning. With foresight, however, many applicants can both qualify for ALTCS and preserve their hard-earned resources.  ACCESSMed has partnered with the Elder Law Team at JacksonWhite, P.C., to help seniors navigate this path.

JacksonWhite provides ACCESSMed clients with no-cost consultations. Learn more about ALTCS by visiting the JacksonWhite website. And, to find out more about ALTCS Medicare Advantage options, click on the GET AHCCCS MEDICAID HELP link at the bottom of this page.

 

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