ALTCS share of cost and protecting a spouse at home

Last verified: October 2026

What is the ALTCS share of cost?

The share of cost is the part of an ALTCS member's monthly income that goes toward the cost of nursing home or home and community based services after eligibility is approved, calculated from gross income minus allowed deductions.

AHCCCS lists the deductions as a personal needs allowance, a community spouse allowance for a spouse still at home, a family allowance for dependents at home, and a home maintenance allowance in some cases, among others.

Sources: AHCCCS ALTCS application guide (DE-828).

How do ALTCS rules protect a spouse who stays at home?

When one spouse applies and the other stays home, ALTCS lets the couple set aside resources for the at-home spouse and lets part of the applicant's income go to that spouse as a community spouse allowance, so the at-home spouse is not left without money.

AHCCCS provides a Community Spouse Information Sheet on request with the current figures. Because the numbers change each January and depend on the couple's situation, get that sheet or an elder law attorney's calculation before moving money.

Can you give money to children before applying for ALTCS?

Gifts and transfers can delay ALTCS eligibility, because Medicaid reviews transfers made before the application; AHCCCS provides an information sheet on transfers, and families should get advice before giving assets away.

The safest rule is to keep records of every large withdrawal and payment in the years before applying. Paying a family caregiver can be legitimate, but it needs a written agreement to avoid being treated as a gift.

Does the house count against ALTCS eligibility?

A home is treated differently from cash and investments, and in many cases is not counted while the applicant or a spouse lives there or intends to return, but home equity rules and estate recovery after death can still apply.

Because the home is often the largest asset, it is the most common reason Tucson families talk to an elder law attorney before applying.

Where can Tucson families get help with these calculations?

Call ALTCS at (888) 621-6880 for program questions, attend Pima Council on Aging's free monthly ALTCS workshop, or hire an elder law attorney for a plan; PCOA's resource line is (520) 790-7262.

Be cautious of anyone who charges a large fee to fill out the application itself; the application is free.

ALTCS income and resources: what counts and what does not