ALTCS Eligibility in Arizona: 2026 Income and Asset Limits
Qualifying for ALTCS — the Arizona Long Term Care System that pays for nursing home, assisted living, and in-home care — comes down to passing two tests: a medical test (you need a nursing-facility level of care) and a financial test (your income and countable assets fall under the limits). The financial limits are strict and the numbers are specific, but being over them is not the dead end most families assume. This page lays out the 2026 figures and the lawful tools that let applicants who are technically “over” still qualify. Available 24/7 • Free confidential consultations • (480) 725-2257
ALTCS Eligibility – Arizona 2026: The two eligibility tests
ALTCS applicants must pass both a medical and a financial test. Failing either one means no benefits.
The medical test
An applicant must need a nursing-facility level of care — though the care itself can be delivered in a nursing home, an assisted living facility, or at home through home- and community-based services. The medical determination is made through a Pre-Admission Screening (PAS) that evaluates the applicant’s diagnosis, cognitive function, orientation, continence, and need for help with activities of daily living. Applicants who qualify medically typically demonstrate a need for assisted living, memory care, or skilled nursing; regular medical monitoring; cognitive impairments such as Alzheimer’s or dementia; or physical disabilities requiring hands-on assistance.
The financial test
The financial test has two parts — income and assets (resources) — and the rules differ significantly between single applicants and married couples.
2026 ALTCS financial limits
| Standard | 2026 Figure | Notes |
|---|---|---|
| Income cap (single applicant) | $2,982 / month gross | Equal to 300% of the SSI Federal Benefit Rate. Over the cap? Use a Miller Trust (below) |
| Countable asset limit (single) | $2,000 | Arizona uses the long-standing federal figure |
| Countable asset limit (both spouses applying) | $3,000-4,000 | Each applicant generally limited to $2,000 |
| Community Spouse Resource Allowance (CSRA) | $32,532 min / $162,660 max | What a non-applicant spouse may keep — see our community spouse guide |
| Monthly Maintenance Needs Allowance (MMNA) | up to $4,066.50 / month | Income a community spouse may keep, including income diverted from the applicant |
| Home equity limit | $603,000 | Primary residence is exempt up to this equity figure under most circumstances |
| Personal Needs Allowance | $149.10 / month | What a nursing-facility resident keeps for personal expenses |
These numbers change every year. The figures above are current for 2026 and adjust each January. Several are tied to the federal SSI benefit rate and the federal spousal-impoverishment range. Never rely on a single number you found online without confirming it against the current AHCCCS Eligibility Standards or with a planner who works with the live figures — a stale number can produce a costly mistake.
Exempt vs. countable assets
Not everything an applicant owns counts toward the $2,000 limit. Arizona, following federal Medicaid rules, treats certain assets as exempt.
Generally exempt (not counted)
- The primary residence, up to the $603,000 equity limit, when the applicant or their spouse lives in it (or a single applicant intends to return)
- One vehicle, with no value limit
- Personal and household belongings — clothing, furniture, electronics
- Burial plots and irrevocable burial or funeral plans
- Term life insurance, and up to $1,500 cash value in a whole life policy
Generally countable (counts toward the limit)
- Bank accounts, CDs, money market accounts
- Stocks, bonds, mutual funds, brokerage accounts
- Retirement accounts (treatment varies; sometimes countable, sometimes structured)
- Cash value in most life insurance over $1,500
- Real estate that is not the primary residence
- Second vehicles
- Cash and other liquid assets
Being over the income cap: the Miller Trust
Arizona is an “income-cap” state, not a “spend-down” state for income. That means an applicant whose gross monthly income exceeds $2,982 cannot simply spend the excess to qualify — being even a dollar over the cap makes them ineligible unless they use the right tool.
That tool is the Income-Only Trust, commonly called a Miller Trust. Each month, the applicant deposits enough of their income into the Miller Trust to bring their countable income under the $2,982 cap. ALTCS then treats the applicant as under the cap and approves eligibility. The trust money is paid toward the applicant’s cost of care alongside the rest of their income, less the Personal Needs Allowance and any amount diverted to a community spouse.
The Miller Trust is not optional planning — it’s a mechanical requirement. An over-cap applicant in Arizona without a Miller Trust is simply ineligible, no matter how modest their assets. The trust must be set up correctly, with the right bank account structure and the right monthly deposits, or the eligibility fails. This is one of the most common places do-it-yourself ALTCS applications break down.
Not sure if you’re over the limits?
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Start Free Evaluation (480) 725-2257Being over the asset limit
An applicant over the $2,000 countable-asset limit is not automatically disqualified forever — but the path to eligibility has to be navigated carefully. Improper “spend down” (especially gifting assets away) can trigger the five-year lookback penalty, which creates a period of ineligibility far more painful than the original excess.
Lawful approaches to excess assets can include spending down on exempt assets (home repairs, a newer exempt vehicle, prepaid irrevocable funeral arrangements), paying off legitimate debt, certain annuity structures, and — for married couples — maximizing the community spouse’s protected share. Each of these has rules, and the wrong move creates a penalty. This is the heart of what ALTCS planning attorneys do. See our guide to the five-year lookback and asset protection.
How to apply
Applications for ALTCS (and AHCCCS generally) can be submitted online through Health-e-Arizona Plus or by paper application. After applying, the applicant goes through the Pre-Admission Screening for the medical determination and a financial eligibility review that examines income, assets, and any transfers during the lookback period.
Self-applications are common but frequently denied or delayed for fixable reasons — missing documentation, an unaddressed income-cap problem, or a lookback transfer that wasn’t planned around. Many families work with an ALTCS planning attorney or a Certified Medicaid Planner specifically to get the application approved the first time and to avoid an inadvertent penalty.
Frequently asked questions
What is the ALTCS income limit for 2026?
$2,982 per month in gross income for a single applicant, equal to 300% of the federal SSI benefit rate. An applicant over this cap can still qualify by routing the excess through a Miller Trust (Income-Only Trust) each month.
What is the ALTCS asset limit for 2026?
$2,000 in countable resources for a single applicant. Certain assets — the home (up to $603,000 equity), one vehicle, personal belongings, and irrevocable burial arrangements — are exempt and don’t count toward this limit.
Does my income disqualify me if I’m even slightly over the cap?
By itself, yes — Arizona is an income-cap state, so being over $2,982 makes you ineligible unless you use a Miller Trust. The good news is the Miller Trust fully solves the over-cap problem when set up correctly. The amount you’re over doesn’t matter; what matters is having the trust in place.
Can I keep my house on ALTCS?
Often yes during the applicant’s lifetime — the primary residence is generally exempt up to the $603,000 equity limit, especially when a spouse lives there. But estate recovery rules can affect the home after death, so transferring or planning around the home should be done only with attorney advice.
What’s a Miller Trust and do I need one?
A Miller Trust (Income-Only Trust) is the tool an over-income applicant uses to qualify. You deposit your excess income into it each month so that your countable income drops under the cap. If your gross monthly income exceeds $2,982, you need one. If you’re under the cap, you don’t.
How are a married couple’s assets counted?
All of a married couple’s countable assets are combined as of the “snapshot” date (the first day the applicant spouse met the medical criteria). The community spouse can keep a protected share (the CSRA — between $32,532 and $162,660 in 2026), and the applicant can keep $2,000. See our community spouse protection guide for the details.
Related Elder Law Resources
- Arizona Elder Law and ALTCS Planning — Overview
- The ALTCS Five-Year Lookback and Asset Protection
- Protecting the Community Spouse Under ALTCS
- Arizona Healthcare Power of Attorney and Living Will
- Special Needs Trusts in Arizona
Find out if you qualify for ALTCS
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