One of the first questions families ask when considering home care is: How do we pay for it? The good news is that many Arizona families have more options than they realize. Depending on your situation, home care services may be paid for through the Arizona Long Term Care System (ALTCS), VA benefits, long-term care insurance, private pay, or a combination of programs.
Understanding your payment options can help you plan for care and find the support your loved one needs while remaining safely at home. This guide explains the most common ways to pay for home care in Arizona, including who may qualify for each program and what types of services may be covered.
This article focuses on non-medical home care services, such as assistance with bathing, dressing, meal preparation, medication reminders, mobility support, light housekeeping, and companionship. Skilled nursing and medical home health services have different eligibility and coverage requirements and may be covered by Medicare for a limited period when certain conditions are met.
In This Article
- The Cost of Home Care in Arizona
- Ways to Pay for Home Care
- ALTCS: Arizona's Medicaid Long-Term Care Program
- VA Benefits for Veterans and Surviving Spouses
- Long-Term Care Insurance
- Private Pay and Family Contributions
- How to Combine Funding Sources
- Planning Ahead Matters
- Arizona Resources
- Frequently Asked Questions
The Cost of Home Care in Arizona
The cost of home care in Arizona varies based on several factors, including your location, the number of care hours needed, and the level of assistance required. On average, many home care agencies in Arizona charge between $28 and $32 per hour, although rates can vary by provider and region.
Below are examples of common monthly home care costs:
| Care Level | Estimated Monthly Cost |
|---|---|
| Companion care Approximately 20 hours per week | $2,400 to $2,800 |
| Personal care Approximately 40 hours per week | $5,000 to $6,000 |
| Full-time home care 12 hours per day | $10,000 to $12,000 |
| Live-in care Depending on schedule and care needs | $8,000 to $10,000 |
Home care costs can also differ throughout Arizona. Areas such as Phoenix and Scottsdale often have higher care rates, while Tucson, Mesa, and some smaller communities may be slightly more affordable. In rural areas, caregiver availability and travel distances can sometimes affect pricing.
When comparing home care providers, it is important to ask what services are included in the hourly rate, whether there are minimum-hour requirements, and if additional fees may apply for specialized care needs.
It is important to remember that many families do not pay the full cost of home care out of pocket. Depending on their situation, they may use a combination of ALTCS benefits, VA benefits, long-term care insurance, retirement income, personal savings, and family support to help cover the cost of care.
For many older adults, home care is often a more affordable alternative to assisted living or nursing home care. In addition to potentially lowering overall care costs, home care allows seniors to remain safely and comfortably in their own homes while receiving the support they need.
Ways to Pay for Home Care in Arizona
Most Arizona families use one or more of the following funding sources to pay for home care services.
ALTCS (Arizona Long Term Care System)
ALTCS is Arizona's Medicaid long-term care program. For individuals who meet both the medical and financial eligibility requirements, ALTCS may help cover a variety of in-home care services and long-term care support.
VA Benefits
Veterans and surviving spouses may qualify for programs that help pay for care at home. Benefits such as Aid and Attendance and Veteran Directed Care can provide financial assistance for eligible veterans who need help with daily activities.
Long-Term Care Insurance
If your loved one purchased a long-term care insurance policy, it may help cover the cost of home care, assisted living, memory care, or other long-term care services. Coverage varies by policy, so it is important to review the benefits and eligibility requirements.
Private Pay
Many families pay for home care using personal savings, retirement income, Social Security benefits, pensions, or financial support from family members. Private pay remains one of the most common ways to fund home care, especially during the early stages of care planning.
Other Funding Sources
Depending on the family's financial situation, additional resources may be available. Some families use home equity, life insurance benefits, annuities, trust funds, or other assets to help cover the cost of long-term care.
In many cases, the best approach involves combining multiple funding sources. For example, a family may use private funds while waiting for ALTCS approval or combine VA benefits with personal savings to help reduce monthly home care costs.
ALTCS: Arizona's Medicaid Long-Term Care Program
The Arizona Long Term Care System (ALTCS) is one of the most important programs available to Arizona families who need help paying for home care. ALTCS is administered through AHCCCS (Arizona Health Care Cost Containment System), Arizona's Medicaid program.
Unlike traditional Medicaid, ALTCS is specifically designed to cover long-term care services for individuals who require ongoing assistance with daily activities. Depending on a person's needs and eligibility, ALTCS may help pay for in-home care, assisted living, memory care, and nursing home care. For many families, it can provide significantly more home care coverage than other funding options.
What Does ALTCS Cover?
For eligible members, ALTCS may cover a variety of long-term care services, including:
- In-home personal care services, such as bathing, dressing, grooming, mobility assistance, and meal preparation
- Home health aide services
- Respite care for family caregivers
- Care coordination and case management services
- Assisted living and other approved long-term care settings, when needed
- Home modifications to improve safety and accessibility
- Medical equipment and supplies
The specific services available will depend on the member's needs, care plan, and eligibility determination.
Who Qualifies for ALTCS?
To qualify for ALTCS, applicants must meet three main requirements: medical eligibility, financial eligibility, and Arizona residency.
Medical Eligibility
The applicant must require a nursing facility level of care. This generally means they need assistance with multiple activities of daily living (ADLs), such as bathing, dressing, toileting, transferring, or mobility, or they have a cognitive impairment, such as dementia, that requires ongoing supervision. An ALTCS representative will conduct an in-person assessment to determine whether the applicant meets the medical criteria.
Financial Eligibility (2026 Guidelines)
ALTCS also has income and asset limits that applicants must meet.
Source: AHCCCS 2026 ALTCS eligibility guidelines. Amounts are adjusted periodically.
Excluded assets: Certain assets are not counted when determining eligibility, including a primary residence (subject to equity limits), one vehicle, personal belongings, and certain prepaid burial or funeral arrangements.
Arizona Residency Requirements
Applicants must be Arizona residents and either U.S. citizens or qualified non-citizens who meet Medicaid eligibility requirements.
How to Apply for ALTCS
The ALTCS application process involves several steps:
- Contact your local ALTCS office or call 1-888-621-6880 to request an application.
- Gather required documents, including birth certificate, Social Security card, proof of citizenship or residency, income verification, insurance information, medical records, and bank and financial statements used for eligibility review.
- Submit the application online, by mail, or in person.
- Complete the in-person medical assessment.
- Wait for the eligibility determination, which typically takes 30 to 60 days but may take longer in some cases.
- If approved, you will be assigned a case manager who will help develop a personalized care plan and coordinate services.
Understanding the 5-Year Look-Back Period
ALTCS reviews certain financial transactions made during the five years before an application is submitted. Transfers of assets, gifts to family members, or selling assets for less than fair market value during this period may affect eligibility and could result in a penalty period before benefits begin.
Because these rules can be complex, many families benefit from speaking with an elder law attorney or ALTCS planning professional before applying.
VA Benefits for Veterans and Surviving Spouses
Arizona is home to a large veteran population, and the U.S. Department of Veterans Affairs (VA) offers several programs that can help pay for home care. Unfortunately, many eligible veterans and families never apply because they are unaware of the benefits available or find the application process overwhelming.
Aid and Attendance Benefit
The VA Aid and Attendance benefit provides additional monthly income to eligible wartime veterans and surviving spouses who need assistance with daily activities such as bathing, dressing, mobility, or personal care. This tax-free benefit is paid directly to the veteran or surviving spouse and can be used to cover a wide range of care expenses, including home care services.
Many families assume their income is too high to qualify. However, the VA allows applicants to deduct qualifying unreimbursed medical expenses, including home care costs, when determining financial eligibility. As a result, some veterans who initially appear over the income limits may still qualify for benefits.
Veteran Directed Care (VDC)
Veteran Directed Care is a program that gives eligible veterans greater control over their long-term care services. Participants receive a flexible monthly budget that can be used to arrange and manage their own care. Depending on the program guidelines, veterans may be able to hire family members or friends as paid caregivers. Eligibility is generally based on the veteran's care needs and enrollment in VA health care rather than wartime service requirements.
In Arizona, Veteran Directed Care is available through the Phoenix VA Health Care System and the Southern Arizona VA Health Care System.
Program of Comprehensive Assistance for Family Caregivers
The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides support for family members who care for eligible veterans with serious service-connected conditions. Benefits may include:
- A monthly caregiver stipend
- Caregiver training and education
- Mental health counseling and support services
- Respite care
- Health insurance through CHAMPVA for qualifying caregivers
This program can provide valuable financial and practical support for families caring for a veteran at home.
How Arizona Veterans Can Apply
Veterans and surviving spouses can apply for VA benefits directly through the VA, but many families find it helpful to work with a Veterans Service Organization (VSO). These organizations provide free assistance with applications and can help families understand which programs they may qualify for. Helpful Arizona resources include:
- Arizona Department of Veterans' Services
- American Legion Department of Arizona
- Veterans of Foreign Wars (VFW) Department of Arizona
- VA Caregiver Support Program
Because VA eligibility rules can be complex, working with a VSO or accredited veterans benefits advisor can often make the application process easier and help families avoid common delays.
Long-Term Care Insurance
Long-term care insurance is designed to help cover services that are not typically paid for by Medicare or standard health insurance, including home care, assisted living, and nursing home care. These policies are usually purchased years before care is needed and begin paying benefits once specific eligibility requirements are met.
What Does Long-Term Care Insurance Cover?
Coverage varies by policy, but many plans help pay for:
- In-home personal care services
- Home health aide services
- Adult day care programs
- Assisted living communities
- Nursing home care
- Home safety modifications
- Caregiver training and support services
How to Use a Long-Term Care Insurance Policy
Most policies include an elimination period, often between 30 and 90 days, before benefits begin. Once that period is satisfied, the policy may pay a daily or monthly benefit toward eligible care expenses. Some insurance companies pay home care providers directly, while others reimburse the policyholder after claims are submitted.
If You or Your Loved One Has a Policy, Start By:
- Locating the policy documents
- Contacting the insurance company to verify benefits and coverage details
- Confirming the elimination period and eligibility requirements
- Asking whether care must be provided through a licensed home care agency
- Requesting the claim forms needed to begin the approval process
Many professional home care agencies can assist families with insurance paperwork and claims once a policy is activated.
Private Pay and Family Contributions
Even when other benefits are available, many Arizona families pay for at least a portion of home care out of pocket. Private pay is often used while waiting for ALTCS approval, VA benefits, or long-term care insurance claims to be processed. Common funding sources include:
- Retirement income: Social Security, pensions, and retirement account distributions
- Personal savings: Checking accounts, savings accounts, and certificates of deposit (CDs)
- Family contributions: Adult children and relatives sharing the cost of care
- Home equity: Home equity loans, home equity lines of credit, reverse mortgages, or the eventual sale of a home
- Life insurance benefits: Certain policies offer accelerated death benefits or long-term care conversion options
- Annuities: Some annuity products can provide income specifically for long-term care expenses
For many families, private pay serves as a bridge until other programs and benefits become available.
How to Combine Funding Sources
One of the most common questions Arizona families ask is whether they can use more than one program to pay for home care. In most cases, the answer is yes, but it often requires careful coordination.
Common Funding Combinations
- VA Aid and Attendance plus private pay: Very common. The VA benefit helps cover part of the monthly cost, while the family pays the remaining balance.
- Long-term care insurance plus ALTCS: Long-term care insurance typically pays first. Once benefits are used or the elimination period is met, ALTCS may help cover remaining eligible costs if the individual qualifies.
- VA benefits plus ALTCS: Possible in some situations, but benefits must be coordinated carefully. Depending on the program, ALTCS may treat certain VA payments differently when calculating income.
- Private pay first, ALTCS later: One of the most common paths. Families use personal funds while spending down assets to meet ALTCS eligibility requirements, then ALTCS begins coverage once approved.
Important Things to Watch For
- ALTCS may count most income, but some VA benefits may be treated differently depending on the program type
- ALTCS requires applicants to apply for any benefits they may be eligible for, including VA programs
- Some long-term care insurance policies have elimination periods that are not covered by ALTCS
- Timing matters, especially when transitioning from private pay to public programs
Because these programs can interact in complex ways, many families choose to work with an elder law attorney or certified Medicaid planner. Experienced home care agencies in Arizona can also often refer families to professionals who specialize in this type of planning.
Planning Ahead Matters
In most cases, the biggest difference between families who manage care costs successfully and those who struggle is early planning. The families who start exploring options before a health event forces a decision consistently end up with better coverage, less stress, and more choice about who provides care.
Arizona Resources for Home Care Funding Help
If you need help navigating home care funding options, the following organizations offer free or low-cost support for Arizona families.
ALTCS / AHCCCS
Arizona's Medicaid long-term care program.
Arizona Department of Economic Security (DAAS)
Provides support for older adults and caregivers, including benefits guidance and community services.
Area Agencies on Aging (AAA)
Eight regional offices across Arizona offering caregiver support, benefits counseling, and local resources. Find your local office through DAAS.
Arizona Caregiver Coalition
Offers caregiver support, training, and respite resources.
Arizona Department of Veterans' Services
Helps veterans access federal VA benefits.
Pima Council on Aging (Southern Arizona)
Serves Tucson and surrounding areas with aging and caregiver services.
Area Agency on Aging, Region One (Phoenix Metro)
Serves Maricopa County, including Phoenix, Mesa, Tempe, Scottsdale, and Glendale.
Frequently Asked Questions
Does Medicare cover home care in Arizona?
Medicare only covers short-term skilled home health care, such as nursing or physical therapy, when ordered by a doctor and the patient is homebound. It does not typically cover non-medical home care, such as help with bathing, meals, or companionship. Most families use ALTCS, VA benefits, long-term care insurance, or private pay for ongoing home care.
Can I qualify for ALTCS if I own a home?
Yes, in many cases. ALTCS does not count the primary residence as an asset up to certain equity limits (about $713,000 in 2026 for a single applicant). The home is usually exempt if the applicant or spouse lives there or intends to return. However, the state may pursue estate recovery after death, which can include the home.
How long does the ALTCS application take?
Most applications take about 30 to 60 days once all documents are submitted. Delays usually happen when paperwork is missing or financial records need additional review. The medical assessment is typically scheduled within a few weeks of applying.
What if income is just above the ALTCS limit?
Arizona is an "income cap" state. If income is above the limit (about $2,901 per month in 2026 for a single applicant), a Qualified Income Trust (Miller Trust) may allow eligibility. This requires legal setup and is commonly used for ALTCS qualification.
Can family members be paid caregivers in Arizona?
Yes, in many programs. ALTCS, VA Veteran Directed Care, and some long-term care insurance policies may allow family members to be paid caregivers, depending on eligibility and program rules. Requirements vary.
Is private pay home care tax deductible?
In some cases, yes. If a doctor certifies that care is medically necessary, home care costs may qualify as medical expenses on federal taxes. You must itemize deductions and meet IRS thresholds. A tax professional can confirm eligibility.
What is the difference between ALTCS and regular Medicaid?
Regular Medicaid (AHCCCS) covers general medical care for low-income individuals. ALTCS is specifically for long-term care services, including home care, assisted living, and nursing home care for individuals who need a nursing facility level of care.
Navigating home care funding options?
Towne Home Care helps Arizona families work through the options, from ALTCS coordination to VA benefits applications. Free in-home assessments, no obligation, no long-term contracts.
Serving Phoenix, Scottsdale, Tucson & the entire Valley of the Sun
Sources
- Arizona Health Care Cost Containment System (AHCCCS). "Arizona Long Term Care System (ALTCS)." azahcccs.gov/altcs
- Genworth. "Cost of Care Survey, Arizona." genworth.com
- Arizona Department of Economic Security, Division of Aging and Adult Services. "Programs and Services." des.az.gov/daas
- U.S. Department of Veterans Affairs. "Aid & Attendance and Housebound Benefits." va.gov
- U.S. Department of Veterans Affairs. "Veteran Directed Care Program." va.gov/geriatrics
- Internal Revenue Service. "Publication 502: Medical and Dental Expenses." irs.gov/publications/p502
- Arizona Department of Veterans Services. dvs.az.gov
- Arizona Caregiver Coalition. azcaregiver.org
