Filing without an attorney for Arizona Long Term Care

marier

Hello:  I live  in Arizona and would like to know if anyone out there applied for Arizona Long Term Care(ALTC-Medicade) with out the help of an attorney and were you successful in obtaining ALTC?  Any down side in applying without the help of an attorney and if turned down then pay for the service?

My current Elderly Law Attorney wants $9,000 to complete the application and of course follow up if my DH is rejected etc..  $9,000 is a flat fee.  

There of course is no guarantee that DH will be accepted for Medicade.  Placement is not possible without ALTC.  

If we were not married DH would be eligable  for ALTC. My retirement makes him outside the income guidelines.  However if I use my retirement/savings for placement the funds would be depleted in a few years.  

Any suggestions would be great!

DJnAZ

YES! I applied for ALTCS myself after several attorneys quoted fees that were simply out of my budget. I filed the original application online February 10 and received approval April 1. Everything I read about the process suggested it would take 3-4 months for a decision. The AHCCCS/ALTCS coverage is through United Healthcare. Coverage is county based (I'm in Yavapai) with three insurance carriers covering Arizona.

The process is relatively straight forward and is comprised of interviews with AHCCCS representatives covering the financial and medical aspects of your particular situation. There is a lot of documentation required as well as an in-depth interview with a financial specialist and a medical specialist.

They ask a lot of questions concerning the documents you send (either uploaded via the Internet or mailed hard copies) and are very picky about having the documents thoroughly explained. If you have a very good financial record keeping and can provide your husband's complete medical records they will advise during the interview process if they need additional documentation.

I found both representatives professional and patient, but when they set an appointment if you are late or miss the appointed time, you have to start over from the beginning with a new application.

With my wife's dementia deteriorating rapidly I decided to file an application with minimal hope that it would be accepted. When I received calls from the two reps telling me she was approved it was a very good day. After approval in April she was placed in memory care facility at the end of May.

I would be happy to answer any questions if you want to contact me. The ALTCS website is reasonably helpful and fairly easy to understand. The process just takes organization and patience.

 Being approved for ALTCS is a life saver for me financially. It can be done without an attorney.

Jo C.

Hello marier; reading that an attorney wanted $9,000 to apply to ALTC was such a startling amount that it made me gasp out loud.  ALTC appears to be Arizona's Long Term Medicaid program.  It does not require an attorney to make application.  (I am not an attorney, so it is best to have all information provided be validated/confirmed by your Elder Law Attorney.)

I am in California, not Arizona, but applications and the process in each state are somewhat similar. I did indeed apply for Long Term Medicaid, (in our state, Medi-Cal), for two different elderly Loved Ones.  I did not use an attorney in either case.   If you fill out the  application in full without skipping anything and include the documents asked for, then it appears that it makes no difference who applies for the benefits; as I found out, having an attorney apply does not make processing any faster.

In fact, the only thing an attorney's staff member would do would be to fill in the blank spaces on the form; you will still be responsible for providing the information that is needed to do so and also your finding any documents needed to be included with the application.

In making application for Medi-Cal; I actuially printed off the application and filled it out long hand just to, "practice," it also helped when I filled out the actual application as all infomation was there - that is not necessary; it is just me being me.  You will have to provide some supportive documentation such as proof of birth or citizenship, we also had to provide social security number, a state ID, and for my step-dad his papers from his leaving the military . . . had to also provide marriage certificate and a few other items.  Some of that I had to look hard to find, but did.

Anyway; if you decide to do this,  you will need to fill out the application in full - do NOT skip anything, and when finished; go over it again to ensure  you have all required information and blank lines filled out.  That coupled with having the required documentation will be all that is usually needed.  I think I had a couple of lines that did not apply and did not leave them blank - I simply entered, DNA - for, "does not apply."  No blanks were what I had been told by a Med-Cal caseworker.

In most states, once the application is submitted and approved, Medicaid or Medi-Cal, etc. will usually pay retrospectively up to three months of facility care back to the date when the application was received. We had personally paid for two months of care while waiting for the application to receive approval, and since Medi-Cal did the retrospective reimbursement up to three months, we got that two months of private pay back.  You will want to check this if you are going to pay out of pocket for NH care for one to three months.  Many of  the MemoryCare Units do not accept Medicaid; there may be a few that do, but it would be pretty scant. If using a facility placement, be sure that the desired facility does indeed have a contract with Medicaid for the unit your Loved One will be admitted to. If the application is not approved, then of course there is no reimbursement.

I do feel that getting advice from a Certified Elder Law Attorney is the best move that one can make.  The CELA can advise how to position yourself to save your finances as much as possible. It is pricey, but should be nowhere as expensive as you mention the cost for application could be. Elder Law specialty is truly the best way to protect yourself; a generalist most often will not have the depth and breadth of necessary expertise.

Here is a valid good link for Arizona for year 2022:

https://www.medicaidplanningassistance.org/medicaid-eligibility-arizona/

Within the body of this information is the statement:

"When only one spouse of a married couple applies for nursing home Medicaid or long-term home and community based services, only the income of the applicant is counted. This means the income of the non-applicant spouse is disregarded." 

You will absolutely want to have your attorney confirm and validate that information for you to ensure accuracy.  It appears that the savings of what the the couple has together are divided 50/50 up to the amount of $137,400 left to the non-applicant spouse. If you have retirement accounts such as an IRA, or Pension or other such account, IF it is in your name ONLY, then according to the information in the link, it appears not to be counted. NOTE:  Have this confirmed by your Elder Law Attorney.  Never take anyone else's word for it.  Also ask about a Trust - if you have one or if you should make one prior to Medicaid application. In some states, some items in a Trust are not counted.  Just have to ask for such information if it has  not been mentioned to you.

Also, if an applicant's personal income (not the spouses) is too high to qualify for benefits, Arizona is one of the many states that permits a "Miller Trust," also known as a "Qualifying Income Trust."  In this, the income of only the applicant goes into an established Trust.  Each month when the bill from the care facility is received (providing the facility has a contract with Arizona's Medicaid), a check is written out of the Trust to the care facility - Medicaid then pays  forthe rest of the shortfall.

If you are more comfortable paying the fee for application that the attorney has quoted to cover application and possible appeals if anything goes awry, then it is of course up to you which way you will decide to go; it is whatever is best for you; that is what is important. 

J.

marier

Thank You so much for responding and for the helpful information on filing for ALTC.  I will start the process myself and if I have questions I will take you up on your offer to help.  Again Thank You.  I will keep you all posted.  Marie