ALTCS Resources
Income Eligibility & Application Planning
Can You Qualify for ALTCS If Your Income Is Too High?
By Katie Brenneman, Founder of Stronghold Financial
Reviewed against current AHCCCS policy. Last reviewed September 17, 2026.
Direct answer
Yes, you may still be able to qualify for ALTCS even when monthly income is above the published limit. For 2026, AHCCCS lists a gross monthly income limit of $2,982 for an individual applicant. AHCCCS also says an applicant over the limit may still qualify through a special trust. In Arizona, it is officially an Income Only Trust, often called a Miller Trust.
Being over the limit is not always the end of the conversation
A family may look at a Social Security check, pension, or retirement income and assume ALTCS is impossible. That conclusion can be wrong. The published limit tells you when additional income planning may be needed. It does not automatically tell you that the person cannot qualify.
The important question is not simply whether income is over the number. The family also needs to know whose income it is, what type of income it is, whether the applicant is married, and how income eligibility fits with the ALTCS application and the family's broader circumstances.
The limit uses gross monthly income
AHCCCS generally starts with gross income, which means the amount before deductions. Social Security, wages, disability income, and retirement pensions are common examples of income that may count.
The amount deposited into a bank account may be lower because Medicare premiums, taxes, or other deductions came out first. Families should not compare that smaller deposit to the ALTCS limit and assume the calculation is finished.
A Miller Trust has a specific job
A Miller Trust is another name commonly used for an Income Only Trust. Its purpose is to address an income-eligibility issue when the applicant's counted income is above the ALTCS limit. It does not make income disappear, and it is not a general account the family can use however it wants.
AHCCCS treats an Income Only Trust as a Special Treatment Trust. The trust must meet applicable rules, so a generic online trust or an account with the words Miller Trust on it is not enough by itself.
Income planning and asset protection are different
An Income Only Trust addresses an income-eligibility issue. It does not automatically solve excess resources, protect a valuable home, preserve retirement accounts, or determine how much a healthy spouse can keep. Those questions require a separate review.
This distinction matters for married couples with substantial assets. A family may need income planning, asset-protection planning, or both. Solving only the income issue can leave the rest of the family's financial exposure untouched.
Support for families with significant assets · Retirement accounts and ALTCS
Approval does not mean the applicant keeps every dollar
After someone qualifies, AHCCCS calculates whether the member must contribute part of the member's income toward long-term-care services. AHCCCS calls this the Share of Cost.
The calculation depends on counted income, living arrangement, and allowed deductions. Depending on the applicable rules, deductions may include a personal-needs allowance, certain health costs, and, in some married cases, an allowance for the spouse living in the community. An Income Only Trust does not promise that the member's entire income stays available to the family.
Married couples need a spouse-specific review
When one spouse needs ALTCS and the other remains at home, the applicant's income and the healthy spouse's needs should be reviewed together. The healthy spouse may be entitled to an income allowance under the community-spouse rules, but the amount is not automatic and should not be guessed from a general chart.
The same couple may also need planning for assets, retirement accounts, the home, and future estate exposure. Income eligibility is only one part of keeping the healthy spouse financially secure.
ALTCS planning for married couples · Healthy-spouse protection
Do not wait for a denial before reviewing income
A family does not need to submit an application, receive an over-income denial, and then start over. Reviewing income before the application can help identify whether a trust may be needed and coordinate the timing with the rest of the plan.
Earlier review usually makes the process smoother, but an active care crisis does not automatically make it too late. Stronghold can evaluate income and the broader financial picture when someone is already in memory care, assisted living, a nursing facility, or paying privately for care.
Why a do-it-yourself trust can create problems
A trust can look simple on paper while still failing the rules that matter to AHCCCS. Problems can arise from the document itself, the account, timing, missing income, or the way money is handled after the trust is created.
Public information should help a family recognize the issue, not attempt the solution alone. Stronghold explains what needs attention and why. Customized planning and qualified legal work determine how the trust and application should be handled for that person.
What Stronghold reviews
Stronghold Financial reviews the applicant's gross income, income sources, marital status, spouse needs, resources, care setting, medical readiness, and application timing. We also look for connected issues that an income-only review would miss, including retirement assets, the home, and the broader estate.
Every plan is based on the family's actual facts. An Income Only Trust may be important in one case and unnecessary in another. ALTCS approval and identical outcomes are never guaranteed.
What to do next
If your family believes someone's income is too high for ALTCS, schedule one complimentary 30-minute consultation with Stronghold Financial before filing an application or creating a trust from an online form. If medical eligibility is uncertain, Stronghold may recommend a Medical Readiness Review before financial planning. If the person appears medically appropriate, the next stage is customized asset-protection planning. Implementation and application services are addressed through a separate service agreement.
Frequently asked questions
What is the ALTCS income limit for 2026?
AHCCCS lists a gross monthly income limit of $2,982 for an individual ALTCS applicant effective January 1, 2026. Married applicants require a community-spouse review rather than a conclusion based only on one number.
Can someone qualify for ALTCS with income over the limit?
Potentially. AHCCCS states that an applicant over the income limit may still be able to qualify through a special type of trust. The person's income, marital status, and full eligibility picture still need to be reviewed.
Is a Miller Trust the same as an Income Only Trust?
In this context, yes. Miller Trust is the common name many families use. AHCCCS uses the term Income Only Trust and treats it as a type of Special Treatment Trust.
Does a Miller Trust protect savings and the house?
Not by itself. A Miller Trust addresses an income-eligibility issue. Savings, retirement accounts, the home, and other resources require their own analysis and may need separate planning.
Does all income in the trust go to the nursing home?
Not necessarily. AHCCCS calculates a Share of Cost after allowed deductions, which may include certain personal, medical, and spouse allowances. The result depends on the member's circumstances.
Should we create a Miller Trust before applying?
Do not create one solely because income appears high. First confirm how AHCCCS will count the income, whether the trust may be needed, and how it fits with the application and the family's broader plan.
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.