The Arizona Long Term Care System. ALTCS-EPD serves people who are elderly or physically disabled and need a nursing-home level of care. AHCCCS lists a February 2026 income cap of $2,982 a month and an asset limit of $2,000.

If I am in ALTCS, does my D-SNP choice matter?

Yes. Since January 1, 2025, ALTCS-EPD members who join one of the state's companion D-SNPs must be in the matching ALTCS-EPD health plan, so the two are chosen together.

Is Arizona a FIDE state?

Not yet. AHCCCS describes today's arrangement as exclusively aligned enrollment with companion D-SNPs. It has tentatively planned FIDE D-SNPs for January 1, 2028.

Does Arizona have estate recovery?

Yes. AHCCCS says estate recovery applies to services received after age 55.

Medicare and Medicaid in Arizona: AHCCCS, ALTCS and Aligned D-SNPs

By Alexander James, Licensed Independent Insurance Agent · NPN 19291077

Part of our guide to Medicare and Medicaid together. For general Medicare help in Arizona, see Medicare in Arizona.

Arizona at a glance

Medicaid is run by
Arizona Health Care Cost Containment System (AHCCCS)
Current state programs
AHCCCS; ALTCS-EPD
Published Medicaid figures
4 figures below, each with the date it applies
Federal change, January 1, 2027
One D-SNP per area for full-benefit duals, generally, where a company also offers a Medicaid plan

Sources: the Arizona Health Care Cost Containment System (AHCCCS) (linked below) and 42 CFR 422.514.

Arizona's Medicaid program for people with Medicare

Medicaid in Arizona is run by the Arizona Health Care Cost Containment System (AHCCCS). The state decides who qualifies for Medicaid; a Medicare plan or an agent cannot.

AHCCCS: Arizona's Medicaid program, including full coverage for people 65 and older under its SSI-MAO group.
ALTCS-EPD: The Arizona Long Term Care System for people who are elderly or physically disabled and need a nursing-home level of care.

Aligned enrollment for ALTCS members since 2025

According to AHCCCS, since January 1, 2025, ALTCS-EPD members who choose one of the state's companion D-SNPs must be enrolled in the matching ALTCS-EPD health plan. AHCCCS calls this exclusively aligned enrollment.

This means your Medicare plan and your ALTCS health plan come from the same organization, which is designed to make coordination simpler. If you are in ALTCS and considering a D-SNP, the plan you choose can affect which ALTCS health plan you have.

Looking ahead: FIDE D-SNPs planned for 2028

In a May 26, 2026 procurement decision, AHCCCS said each ALTCS-EPD contractor will be required to have a companion FIDE D-SNP, with a tentative start of January 1, 2028. Members with a FIDE D-SNP would need to align at the start of the next Medicare plan year. For 2027, the current aligned-enrollment arrangement continues, together with the federal one-D-SNP-per-area rule that starts January 1, 2027.

If you have QMB, SLMB or QI only

AHCCCS lists QMB, SLMB and QI as separate coverage groups with their own income limits. Whether a D-SNP in your area accepts partial duals depends on the plan and its state contract, so ask before you decide.

Arizona Medicaid figures, as the state publishes them

These are the figures AHCCCS publishes in its February 2026 eligibility chart. AHCCCS lists no resource limit for SSI-MAO or the Medicare Savings Programs.

Arizona: published Medicaid figures, with the date each applies

ALTCS income cap (300% of the SSI rate)
Amount
$2,982 a month
As of
February 2026
Source
AHCCCS eligibility requirements
ALTCS asset limit
Amount
$2,000
As of
February 2026
Source
AHCCCS eligibility requirements
SSI-MAO full coverage for 65+ (100% of poverty, monthly)
Amount
$1,330 single, $1,804 couple
As of
February 2026
Source
AHCCCS eligibility requirements
QMB / SLMB / QI monthly income (one person)
Amount
$1,330 / up to $1,596 / up to $1,796
As of
February 2026
Source
AHCCCS eligibility requirements

Arizona: published Medicaid figures, with the date each applies
Figure	Amount	As of	Source
ALTCS income cap (300% of the SSI rate)	$2,982 a month	February 2026	AHCCCS eligibility requirements
ALTCS asset limit	$2,000	February 2026	AHCCCS eligibility requirements
SSI-MAO full coverage for 65+ (100% of poverty, monthly)	$1,330 single, $1,804 couple	February 2026	AHCCCS eligibility requirements
QMB / SLMB / QI monthly income (one person)	$1,330 / up to $1,596 / up to $1,796	February 2026	AHCCCS eligibility requirements

Your own eligibility depends on your full situation and is decided by the state. Federal figures that apply in every state are in our guides to the Medicare Savings Programs, Extra Help and Medicaid long-term care.

What works the same in every state

Some rules are federal. Medicare pays first and Medicaid pays last. Since 2025, people with Medicaid or Extra Help have a once-a-month option to change drug coverage, and full-benefit duals have a once-a-month option to join an integrated plan that matches their Medicaid plan. Starting January 1, 2027, federal rules generally limit companies to one D-SNP per area for full-benefit duals where they also offer a Medicaid plan. Our guide to integrated D-SNPs explains each step, and Will I lose my Medicaid if I join a D-SNP? covers what changes when you join one.

Who pays first when you have Medicare and full Medicaid

Step 1
You get a Medicare-covered service
A doctor visit, a hospital stay or a prescription that Medicare covers.
↓→
Step 2
Medicare pays first
Through Original Medicare or your Medicare plan. Your prescription drugs are covered by a Medicare drug plan, not by Medicaid.
↓→
Step 3
Medicaid pays last
After Medicare and any other health insurance you have. Medicaid can also cover some services Medicare does not, depending on your state.

Source: Medicare.gov, “Medicaid” (people who have both Medicare and full-benefit Medicaid).

Before you change anything

FAQ

Medicare and Medicaid questions from Arizona

Sources

Each page was read on October 23, 2026.

Guides for other states

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