Effective October 1, 2025, Arizona’s Long Term Care System (ALTCS) updated its average private pay rate (APPR)—the figure the program uses to calculate how long someone is ineligible for benefits after making gifts or other uncompensated transfers during the five-year look-back period.

Why this matters

ALTCS determines a transfer penalty by dividing the total value of gifts/transfers by the APPR in effect on the date ALTCS evaluates eligibility. When the APPR changes, the length of a penalty period can change too—sometimes by months.

• Higher APPR → longer penalty months for the same gift amount
• Lower APPR → shorter penalty months for the same gift amount

October 1, 2026 to September 30, 2026 Private Pay Rates

Maricopa, Pima, Pinal Counties                  $8,666.72

All other AZ Counties                                      $8,132.22

How the penalty works (plain English)

• ALTCS reviews transfers made in the past 60 months.
• Any transfers for less than fair market value may be added together.
• Total uncompensated transfers ÷ APPR = months of ineligibility for long-term care services.
• The penalty does not start until you’re otherwise ALTCS-eligible (meeting medical and financial criteria) and you’re in a care setting where ALTCS would pay.

Example (for illustration only):
If $50,000 was gifted during the 5-year look-back period, ALTCS would calculate the penalty by dividing $50,000 by the current APPR (e.g., $8,666.72 for someone in Maricopa County), resulting in months of ineligibility, (5.77 months). The result? The applicant’s ALTCS application would be approved, effective 5.77 months from the month of application. During the penalty period, the applicant (or his/her family) would continue to be financially responsible for privately paying for the applicant’s long term care expenses.

Who is affected

• Applicants (or spouses) who made gifts, paid family caregivers without a proper agreement, or sold assets below fair value may be impacted.
• Families planning future care who are considering moving, gifting, or re-titling assets.

What to do now

1. Do not transfer assets (including “small” gifts) without guidance.
2. Gather records of any transfers within the last five years.
3. Get individualized advice—the right legal tools (caregiver agreements, promissory notes, spousal planning, etc.) can reduce or eliminate a penalty when used correctly.

A critical warning

Do not gift or transfer assets before speaking with an elder law attorney. Well-intended moves—like helping a child with a down payment or paying a grandchild’s tuition—can unintentionally delay ALTCS eligibility and increase out-of-pocket costs for care.

If you or a loved one may need long-term care, we can review your situation under the October 1, 2025 APPR and outline safe options tailored to your family and timeline.

This post is for general information only and is not legal advice. Consult counsel about your specific facts.

Disclaimer: The information contained in this article is provided for informational purposes only, and should not be construed as offering legal advice or creating an attorney client relationship between the reader and the firm or author. You should not act or refrain from acting on the basis of any content included in this article without seeking appropriate legal advice about your individual facts and circumstances from an attorney licensed in your state. Bivens and Associates, P.L.L.C. expressly disclaims all liability with respect to actions taken or not taken based on any or all information contained in this article.