By Tucson Senior Advisor Care Team · October 8, 2026
In Arizona assisted living, ALTCS pays for care services but the member pays room and board, in an amount the ALTCS health plan sets. Most members cover it from Social Security; family may pay it on their behalf. Confirm a facility contracts with the member's plan before moving.
What exactly does ALTCS leave out?
AHCCCS medical policy states that although assisted living facilities must provide room and board, room and board is not an AHCCCS covered service in those facilities. The amount is determined by the ALTCS contractor and is the member's responsibility, and someone else may pay it on the member's behalf.
Room and board means the housing and meals. Everything on the care side, such as help with bathing, dressing, medications and supervision under the member's service plan, is what ALTCS pays the facility for.
How does the money flow in a typical month?
Here is an illustrative example, not a quote. Imagine a widowed Tucson resident with Social Security and a small pension that together fall under the ALTCS income limit of $2,982 a month a month, living in a ten-bed directed care home that contracts with her ALTCS health plan.
| Piece of the bill | Who pays | How the amount is set |
|---|---|---|
| Room and board | the resident, from her income (or family on her behalf) | set by the ALTCS health plan for that facility |
| Care services | ALTCS, through the health plan | the facility's contracted rate for her assessed needs |
| Share of cost | the resident, if her income exceeds allowances | calculated by AHCCCS after eligibility |
| Personal spending | the resident keeps a personal needs allowance | set by AHCCCS |
The important point is the order. Her income pays room and board first. Whatever ALTCS calculates as her share of cost is then applied toward care, and ALTCS pays the remainder of the care rate. The family's out-of-pocket cost is often zero, but only if the home accepts the plan's room-and-board amount.
Why do some facilities decline ALTCS residents?
Facilities set their own private rates, and the combination of the plan's room-and-board amount and its care rate may be lower than what a community charges privately. Some communities therefore do not contract with ALTCS plans at all, some reserve a few beds, and many small homes rely heavily on ALTCS.
AZ Care Check does not show which facilities contract with which plans, so the only way to know is to ask the facility and the plan.
What if a resident starts private pay and later needs ALTCS?
Ask before move-in whether the facility will let a resident convert to ALTCS after a period of private pay, and get the answer in the residency agreement or a signed addendum. Without that promise, a resident who runs out of money can receive 14 days' written notice for nonpayment under Arizona's rules.
Start the ALTCS application months before savings run out. Eligibility requires both a nursing home level of care and the financial tests, and both take time to document.
How is this different from a nursing home?
In a nursing home ALTCS pays the full daily rate, which already includes room and board, and the member contributes a share of cost from income. That is why some families with very limited income find a nursing home is fully covered while assisted living is not.
For families who can cover room and board, assisted living under ALTCS often gives a parent a smaller, more home-like setting for a similar out-of-pocket cost.
Where can you get help with the numbers?
Call ALTCS at (888) 621-6880, attend Pima Council on Aging's free ALTCS workshop on the fourth Wednesday of each month (register at (520) 790-7262), or consult an elder law attorney if the finances involve a house, a spouse at home or recent gifts.
Bring a list of income sources and monthly amounts. Most of the room-and-board question can be answered once those numbers are on paper.
What should you ask a facility about ALTCS before touring?
Ask four things on the first call: which ALTCS health plans the facility contracts with, the room-and-board amount it accepts from ALTCS members, whether it reserves beds for ALTCS residents or accepts them only after private pay, and whether directed care is available to ALTCS members or only private-pay residents.
Write the answers down with the name of the person you spoke to. When a family is comparing four or five homes, these four answers usually narrow the list faster than any tour.
ALTCS in assisted living: covered and not covered
| Covered | Not covered | |
|---|---|---|
| Care services | yes, under the service plan | |
| Room and board | paid by the member or family | |
| Facility | one contracted with the member's plan | any facility you choose |
Frequently asked questions
Does ALTCS pay anything toward assisted living?
Yes. ALTCS pays for the care services an eligible member receives in an assisted living facility that contracts with the member's health plan. It does not pay room and board, which the member or family pays.
Who sets the ALTCS room-and-board amount?
The member's ALTCS health plan determines the room-and-board amount under its contract with the facility, according to AHCCCS policy. Ask the plan and the facility for the figure before moving.
Can family pay room and board for an ALTCS member?
Yes. AHCCCS policy says it is permissible for someone to pay room and board on behalf of the member. Family members often do this to keep a parent in a preferred facility.
What is the ALTCS income limit in 2026?
AHCCCS lists the ALTCS gross monthly income limit as $2,982 a month gross for an individual, effective January 1, 2026. People over the limit may still qualify through a special treatment trust.
Does ALTCS pay a facility's community fee or deposit?
No. One-time community fees and deposits are not ALTCS covered services. Ask whether the facility waives them for ALTCS members; some do, and the residency agreement must state the refund policy for any deposit.
