Get Paid to Care for Your Elderly Parent in Arizona
Arizona families caring for an aging parent at home can tap into a state program that provides real compensation for that work. Through the Arizona Long Term Care System (ALTCS), Medicaid-eligible seniors can hire a family member as their personal caregiver — and pay them $12–$16 per hour through a self-directed care option.
This guide walks you through how ALTCS works, the financial and functional eligibility requirements, the step-by-step application process, and other programs that can support Arizona family caregivers.
Arizona pays family caregivers $12–$16 per hour through the self-directed option within the ALTCS program. Your parent must qualify for ALTCS (Arizona's Medicaid long-term care program) and must be able to direct their own care or have a representative who can. Background checks and basic training are required.
Arizona's Main Program: ALTCS Self-Directed Option
ALTCS is Arizona's Medicaid program for individuals who require a nursing facility level of care. Unlike standard Medicaid, ALTCS covers long-term services and supports — including in-home personal care — for seniors who need ongoing help with daily activities.
ALTCS is administered through managed care organizations (MCOs) contracted with the Arizona Health Care Cost Containment System (AHCCCS). The primary MCO serving elderly ALTCS members is Mercy Care Plan, with UnitedHealthcare Community Plan covering select counties.
Within ALTCS, the Self-Directed Attendant Care option allows the member to act as the employer — hiring, scheduling, and supervising their own personal care attendant. That attendant can be you, an adult child, rather than an agency worker.
What ALTCS Pays Family Caregivers to Do
- Personal care: bathing, grooming, dressing, oral hygiene
- Toileting and continence care
- Transfer and mobility assistance
- Meal preparation and dietary support
- Light housekeeping (health and safety related)
- Medication reminders
- Transportation to medical appointments
- Supervision for members with cognitive impairment
- Companion services (depending on care plan)
Pay Rates by Region
| Area | Typical Hourly Rate | Notes |
|---|---|---|
| Phoenix Metro (Maricopa County) | $13–$16/hr | Most active ALTCS market |
| Tucson (Pima County) | $13–$15/hr | Second-largest metro |
| Rural Arizona | $12–$14/hr | Lower COL; fewer agency alternatives |
ALTCS Eligibility Requirements
Medical / Functional Eligibility
Your parent must require a nursing facility level of care — meaning they need substantial assistance with at least two Activities of Daily Living (ADLs) such as bathing, dressing, eating, or transferring. ALTCS conducts a clinical assessment to determine whether this threshold is met.
Financial Eligibility (2026 Estimates)
- Income limit: Approximately $2,742/month (300% of the SSI Federal Benefit Rate). Income above this level may still qualify through a special income trust (Miller Trust).
- Asset limit: $2,000 in countable assets for a single individual
- Exempt assets: Primary home (with intent to return), one motor vehicle, household furnishings, irrevocable burial plans
- Medicaid estate recovery: Arizona may seek repayment from the estate after the member's death — consult an elder law attorney
If your parent's assets exceed ALTCS limits, an Arizona elder law attorney can help with legal strategies such as Miller Trusts and caregiver agreements that may enable eligibility without disqualifying asset transfers. The 5-year lookback period applies to gifts and transfers.
You (the Caregiver) Must:
- Be 18 years of age or older
- Pass an Arizona DPS background check and adult protective services registry check
- Complete required caregiver training (varies by MCO, typically 4–8 hours)
- Complete a personal care attendant application with the MCO's fiscal agent
- Not be the participant's spouse (in most cases)
- Be legally eligible to work in the United States
How to Apply: Step-by-Step
- Confirm your parent meets medical eligibility criteria. Review ALTCS clinical criteria at azahcccs.gov or call 1-888-621-6880. Your parent's physician can also help document medical need.
- Submit an ALTCS application. Apply online at azahcccs.gov or in person at your county AHCCCS office. Include all required financial documentation: bank statements, asset records, Social Security income verification, and property documents.
- Complete the clinical assessment. An ALTCS assessor will visit your parent to conduct a functional evaluation. Be present during this assessment to accurately describe your parent's care needs — the number of authorized care hours depends on this evaluation.
- Get enrolled in an ALTCS managed care plan. After approval, AHCCCS will assign your parent to a contracted MCO (typically Mercy Care or UnitedHealthcare). You may request a plan change if preferred.
- Request self-directed attendant care. Contact your parent's MCO case manager and request the self-directed option. Explain that you (an adult child) want to serve as the personal care attendant. The case manager will send you the required employer enrollment paperwork.
- Complete your attendant enrollment. Submit your background check authorization, complete caregiver training, and sign your attendant contract with the MCO's fiscal agent.
- Begin care and submit timesheets. Once approved, provide care per the authorized plan and submit timesheets through the MCO's portal. Paychecks are typically issued bi-weekly.
Arizona's ALTCS application is one of the more complex Medicaid applications in the country. Working with a State Health Insurance Assistance Program (SHIP) counselor or elder law attorney can significantly reduce processing time and increase approval rates. Call the Arizona SHIP at 1-800-432-4040.
Other Arizona Programs That Pay Family Caregivers
Arizona Caregiver Coalition Support Programs
The Arizona Caregiver Coalition partners with local Area Agencies on Aging to provide supplemental support for family caregivers including training, respite grants, and care coordination services. While these are not wage programs, they can reduce the financial burden on caregiving families. Visit azcaregiver.org or call 1-888-737-7494.
VA Veteran-Directed Care in Arizona
If your parent is a veteran, the VA Veteran-Directed Care program available through the Phoenix VA Health Care System, Southern Arizona VA Health Care System (Tucson), or Northern Arizona VA Health Care System provides a monthly budget to hire family caregivers. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers a monthly stipend for primary caregivers of eligible veterans.
Personal Care Agreement (Private Pay)
If your parent does not qualify for ALTCS, a written Personal Care Agreement allows them to pay you from private funds at fair market rates. This contract must be prospective, in writing, and drafted by an elder law attorney. It is especially important if your parent plans to apply for ALTCS in the future — payments under a valid agreement are not treated as gifts during the lookback period.
Area Agency on Aging Programs
Arizona has six Area Agencies on Aging that administer Older Americans Act programs including caregiver support, respite care, and home-delivered meals. These do not pay ongoing wages but reduce caregiving costs. Call the Eldercare Locator at 1-800-677-1116 to find your local AAA.
Check Your Parent's ALTCS Eligibility
Use our free tool to see if your parent likely meets Arizona's ALTCS medical and financial requirements before starting the full application.
Check Eligibility NowTax Implications for Arizona Family Caregivers
Federal Taxes
- W-2 income: Your ALTCS attendant wages are reported on a W-2. Federal income tax and FICA (Social Security and Medicare) are withheld.
- IRS Notice 2014-7: If you live in the same home as your ALTCS parent, Medicaid waiver wages may qualify for the Difficulty of Care federal income tax exclusion. Confirm with a CPA before claiming this exclusion.
Arizona State Taxes
- Arizona imposes a flat 2.5% state income tax on all wages as of 2026.
- Arizona does not currently conform to the federal Difficulty of Care exclusion for in-home Medicaid caregivers.
- Keep documentation of all caregiving hours and services to support any potential audit.
Estimated Annual Earnings for Arizona Caregivers
At 30 hours per week and $14 per hour, you would earn approximately $1,820/month or $21,840 per year. At 40 hours per week and $16 per hour, annual earnings reach $33,280. These figures are before tax withholdings. Given Arizona's low 2.5% flat income tax and the potential federal Difficulty of Care exclusion for live-in caregivers, net take-home pay can be favorable.
Contact Information
- AHCCCS / ALTCS: 1-888-621-6880 | azahcccs.gov
- Mercy Care Plan (ALTCS): 1-866-386-5794 | mercycareplan.com
- Arizona SHIP (benefits counseling): 1-800-432-4040
- Arizona Caregiver Coalition: 1-888-737-7494 | azcaregiver.org
- Eldercare Locator: 1-800-677-1116 | eldercare.acl.gov
Frequently Asked Questions
Arizona's ALTCS program pays family caregivers who are hired as personal care attendants between $12 and $16 per hour. The exact rate depends on the contracted managed care organization, the county, and the care level authorized in the member's care plan.
ALTCS stands for Arizona Long Term Care System. It is Arizona's Medicaid program for individuals who require a nursing facility level of care but choose to receive services at home or in a community setting. ALTCS is administered through managed care organizations contracted with the Arizona Health Care Cost Containment System (AHCCCS).
ALTCS managed care plans offer a self-directed option that allows members to hire their own caregivers, including family members. Under self-direction, the ALTCS member or their representative acts as the employer, choosing who provides their care and managing their schedule. This is the pathway for adult children to be paid as caregivers in Arizona.
Yes. If your parent has dementia and cannot self-direct their care, a legal representative — such as a power of attorney holder or legal guardian — can manage the self-directed arrangement on their behalf. Arizona's ALTCS program allows authorized representatives to handle employer functions for cognitively impaired members.
ALTCS has strict financial eligibility rules. As of 2026, the income limit is approximately $2,742 per month and the countable asset limit is $2,000 for a single individual. Certain assets are exempt, including a primary home (with intent to return), one vehicle, and household goods. An elder law attorney can assist with Medicaid planning if your parent's assets exceed the limit.
ALTCS applications can take 45 to 90 days or longer to process due to the required medical and financial reviews. Applications that are complete and well-documented tend to move faster. If your parent has an urgent need, an elder law attorney or benefits counselor can help expedite the process.
As of 2026, the main ALTCS managed care organizations are Mercy Care Plan (covering most of the state), UnitedHealthcare Community Plan, and the Department of Economic Security Division of Developmental Disabilities for individuals with developmental disabilities. The plan serving your parent depends on their county of residence.
Yes. Wages paid to family caregivers through ALTCS's self-directed option are subject to federal income tax and FICA taxes. A W-2 is issued by the fiscal management service. If you live in the same home as your parent, you may qualify for the federal Difficulty of Care exclusion under IRS Notice 2014-7 — consult a tax professional.