Private Pay vs. Medicaid for Assisted Living in Arizona

Cost is usually the first question and the hardest to get a straight answer on. Here is how paying for assisted living works in Arizona. This is general information, not financial or legal advice, so confirm details with the agencies named below or an elder law attorney.

What Medicare does and doesn't cover

Medicare does not pay for assisted living room, board, or personal care. It continues to cover doctor visits, hospital care, and prescriptions while someone lives in assisted living, and it may cover short-term skilled nursing or home health after a hospital stay.

Private pay

Most assisted living residents pay from their own resources:

• Savings, pensions, and Social Security.
• Proceeds from selling or renting a home.
• Long-term care insurance. If there is a policy, call the insurer early. Most have a waiting period and require a care assessment.
• VA Aid and Attendance. A pension benefit for eligible wartime veterans and surviving spouses who need daily help.
• Family contributions.

Private pay gives you the widest choice of homes, since every licensed facility accepts it.

ALTCS: Arizona's Medicaid long-term care

The Arizona Long Term Care System, or ALTCS, is the state's Medicaid program for people who need a nursing-home level of care. It is run by AHCCCS. To qualify, a person must meet both financial limits and a medical assessment. ALTCS can pay for care in an assisted living facility, but only in facilities that contract with the program, and the resident typically contributes most of their income toward the cost.

• Not every facility accepts ALTCS, and some have limited ALTCS beds.
• Approval can take months. Apply before funds run out.
• The rules on income, assets, and transfers are detailed. Get advice before moving money.

Questions to ask any home

• Do you accept ALTCS? If so, from day one or only after a private-pay period?
• If my parent's money runs out, what happens?
• Is your rate all-inclusive, and how often does it change?

Where to get help in Tucson

Pima Council on Aging offers free guidance for older adults and families. AHCCCS, the state Medicaid agency, handles ALTCS applications. The VA can confirm Aid and Attendance eligibility. Pima Council on Aging, Medicare.gov, and the VA are linked on our Family Resources page.

Heritage Oaks is a private-pay community with all-inclusive monthly pricing. Call 520-999-0797 for current rates, or book a tour.