ALTCS Resources
Married Couples & Healthy Spouse
How Much Can the Healthy Spouse Keep When the Other Spouse Needs ALTCS?
By Katie Brenneman, Founder of Stronghold Financial
Reviewed against current AHCCCS policy. Last reviewed September 17, 2026.
Direct answer
There is no single number that answers this for every couple. ALTCS has separate community-spouse rules for resources and income, but the published allowances do not necessarily establish the maximum amount that lawful planning can protect. The final answer depends on the couple’s entire financial, housing, care and estate picture.
The published resource allowance is not the whole answer
AHCCCS uses a Community Spouse Resource Deduction when determining resource eligibility for certain married applicants. That calculation matters, but it should not be described as the most the healthy spouse may ultimately keep.
Depending on the facts, compliant planning may protect substantially more than the published allowance, including in cases involving couples with several hundred thousand dollars or more than $1 million.
Resource protection and income protection are different
Resources and monthly income are governed by different rules. The healthy spouse may have rights related to income even when the couple also needs resource planning. Housing costs, ownership, sources of income and the applicant’s required contribution toward care can all affect the result.
The home may be treated differently
When the healthy spouse continues to live in the home, an important spouse exception may apply to the published home-equity limit. That can make a high-value residence very different from the same amount held in cash.
Eligibility treatment does not automatically resolve future lien or estate-recovery exposure. Those questions should be reviewed separately as part of the broader plan.
The goal is long-term stability, not merely approval
A plan should account for the healthy spouse’s remaining life expectancy, retirement income, housing, taxes, investment needs and the possibility that the healthy spouse may later need care too. The objective is a workable financial future, not merely getting through an application.
Sam and Yvonne
Yvonne was 61 with dementia and otherwise physically healthy. Sam needed to preserve his own long-term security while arranging appropriate care for her. Stronghold helped Yvonne qualify for ALTCS and protected all $692,705 of the couple’s countable assets for Sam. Their historical post-ALTCS out-of-pocket memory-care cost was approximately $559 per month.
Four years later, Yvonne is still receiving memory care at a community where care now costs approximately $9,500 per month if not on ALTCS. Their result reflects their facts and is not a guarantee of an identical outcome for another family.
Do not make irreversible decisions from an online number
Before selling a home, liquidating retirement accounts, transferring property or privately spending a large portion of the estate, have the couple’s complete situation reviewed. A transaction intended to help can create taxes, penalties or loss of an exclusion when done without a coordinated plan.
What to do next
If your spouse needs care, start with one complimentary 30-minute consultation. Stronghold will identify whether the next appropriate step is a Medical Readiness Review, customized financial planning or another resource.
Frequently asked questions
Can the healthy spouse keep more than the published CSRD?
Potentially. The CSRD is part of the eligibility rules, not necessarily the maximum amount that compliant planning may preserve.
Can the healthy spouse keep the house?
Often the spouse’s continued residence is highly important, but title, equity, home-property status and future lien or estate-recovery exposure should all be reviewed.
Does the healthy spouse’s income count?
Income and resources follow separate rules. Ownership and source of income matter, and the community spouse may have protections that require an individualized calculation.
Official sources
About this resource
Stronghold Financial has helped thousands of Arizona families understand long-term-care planning and ALTCS. This educational content is not individualized legal, tax or investment advice.
Source note: Stronghold reviewed the current AHCCCS guidance that applies to this topic as of the date above. Program rules and published figures can change. A family’s eligibility and planning options depend on its individual circumstances.