Funding
Asking ALTCS for a roll-in shower
By Aging Safely Baths · Updated · 8 min read
A step-by-step guide for Arizona Long Term Care System members and the families who help them ask for a safer bathroom.
Direct answer: Arizona's ALTCS program can cover home modifications that have a specific adaptive purpose, based on a needs assessment and written into the member's service plan, under AHCCCS policy AMPM 1240-I. Roll-in showers and walk-in showers with handheld showerheads are the kind of bathroom change the policy lists, while walk-in tubs are not typically listed. Walk In Tubs Arizona can provide an itemized quote and photos to support the request.
What ALTCS is, in plain words
ALTCS stands for the Arizona Long Term Care System. It is part of AHCCCS, Arizona's Medicaid program, and it helps people who need ongoing long-term care. Many ALTCS members live at home rather than in a nursing facility, with services like in-home help, adult day programs and, in some cases, changes to the home itself.
Those home changes are called home modifications. AHCCCS describes them in its medical policy manual, in a section called AMPM Policy 1240-I. The policy explains that a home modification is a physical change to the home that has a specific adaptive purpose. In plain words, the change has to help the member live more safely or independently because of their needs, not just make the home nicer.
Source: AHCCCS Medical Policy Manual, AMPM 1240-I Home Modifications.
The bathroom is one of the most common places where a change helps. Getting in and out of a tub can become unsafe long before someone is ready to leave their home. For ALTCS members, a roll-in shower is often the path that fits the program best.
Showers vs tubs
Why showers usually fit ALTCS better than tubs
The AHCCCS policy lists roll-in showers and walk-in showers with handheld showerheads as the kind of bathroom change it covers. Walk-in tubs are not typically listed. That does not mean every shower request is approved or every tub request is denied, but it does tell you where the program is pointed.
There are practical reasons. A roll-in shower has no step at all, so it works for someone who uses a wheelchair, a shower chair or a walker, and for a caregiver who helps with bathing. A handheld showerhead lets the member or caregiver wash while seated. As needs change, a barrier-free shower usually keeps working.
A walk-in tub still has a low step at the door, and the bather has to sit while the tub fills and drains. For many people that is fine and even a joy, but it is a harder fit with a policy built around adaptive purpose.
If you are curious how barrier-free showers are built to code, our team's article on what makes a shower code compliant explains slopes, thresholds and grab bar backing.
| Feature | Roll-in shower | Walk-in tub |
|---|---|---|
| Step to enter | None or very low | Low step at the door |
| Wheelchair access | Yes, with a shower chair | No, transfer needed |
| Caregiver help | Easy to reach the bather | Harder to reach |
| Listed in AMPM 1240-I | Yes, as a bathroom change | Not typically |
The process
How an ALTCS home modification request works
Each health plan handles details its own way, but the main steps look like this.
- Talk with your case manager. Every ALTCS member has a case manager. Tell them bathing has become unsafe and you would like to ask about a home modification. Be specific: "I cannot step over the tub wall" is clearer than "the bathroom is hard."
- Needs assessment. The plan looks at your needs, often with input from a doctor, nurse or occupational therapist. The assessment connects the change to your health and daily living.
- Service plan. If the modification is approved, it is written into your service plan, the document that lists your ALTCS services. Ask for a copy so you know what was approved.
- Quotes and contractor. The plan explains how contractors are chosen and how many quotes are needed. Do not sign a contract or pay a deposit until your case manager says it is okay.
- Installation and sign-off. After the work, the plan may check that it was done as approved. Keep all paperwork and photos.
Important: starting work before approval can mean the plan will not pay. Always wait for written approval from your health plan or case manager.
Be prepared
What to bring to your case manager
A clear, complete request moves faster than a vague one. Gather these before your meeting or call. A family member can help collect them.
We can help with the quote and photos. Walk In Tubs Arizona provides itemized written quotes that list the shower, the removal of the old tub, plumbing, grab bars and any other work line by line. That kind of detail is what case managers and health plans usually ask to see. Learn more about our roll-in and barrier-free showers, including Bestbath showers made in the USA.
- A short description of what is hard or unsafe about bathing now
- Any notes from your doctor, nurse or therapist about bathing safety
- Photos of the current tub or shower from the doorway and up close
- Measurements of the tub or shower and the bathroom doorway
- An itemized written quote that lists each part of the work
- Whether you own or rent, and landlord permission if you rent
- Your ALTCS member ID and your case manager's name
- A list of questions, and someone to take notes
Good questions
What to ask your case manager
About the process
What are the steps with our health plan? Who does the assessment? How long does each step usually take? Will I get the decision in writing?
About contractors
Does the plan have contractors it works with? Can I suggest one? How many quotes do you need? Does the contractor need an Arizona ROC license number on the quote?
About the shower
Does the plan want a roll-in or a walk-in shower? Should the quote include grab bars, a seat and a handheld showerhead? What about the bathroom door?
If the answer is no
What was the reason? Can I add more information? How do I ask for a review or appeal, and what is the deadline?
Avoid delays
Why some requests stall, and how to keep yours moving
Most delays come from missing pieces. You can head off many of them before you start.
The need is not clear
"The bathroom is old" does not explain an adaptive purpose. Describe what you cannot do safely, like stepping over the tub wall or bathing from a wheelchair.
The quote is too vague
A one-line price makes reviewers ask for more. An itemized quote that lists each part of the work answers their questions up front.
Missing permission
Renters need written landlord approval, and some HOAs want notice. Get those early so they do not hold up the final step.
Lost follow-up
Case managers handle many members. A friendly call every couple of weeks, with your notes in hand, keeps your request from slipping.
Other help
If ALTCS is not the right fit
Not everyone qualifies for ALTCS, and not every request is approved. Other programs may help:
- Veterans may qualify for VA home improvement grants for a bathroom change. A VA physician must prescribe the change.
- Area Agencies on Aging can point you to local help. In Maricopa County, the Region One Senior HelpLine is 602-264-4357. In Pima County, the Pima Council on Aging is 520-790-7262.
- Medicare: Original Medicare generally does not cover walk-in tubs or shower conversions. Some Medicare Advantage plans offer limited home-safety benefits, so ask your plan.
Our Arizona funding guide covers VA grants, ALTCS and local programs in more depth, with a finder that helps you see which ones may apply. For cost basics, read what a walk-in tub or shower costs in Arizona.
Sources: Area Agency on Aging, Region One; Arizona DES Area Agency on Aging directory.
For families
A note for caregivers
If you are helping a parent or spouse through ALTCS, you already know the paperwork can feel endless. Keep one folder, paper or digital, for the bathroom request: notes from each call with the date and the name of the person you spoke with, copies of the assessment and service plan, the quote and the photos. When a question comes up months later, that folder is gold.
Ask for every decision in writing, and keep a copy of every document you hand over.
We are glad to talk with family members and case managers, send a detailed quote, and answer technical questions about the shower. There is no in-home sales pitch and no pressure. When you are ready, contact Walk In Tubs Arizona or call 1-888-779-2284 and tell us your quote is for an ALTCS request.
FAQ
Questions Arizona families ask
Who is eligible for ALTCS?
ALTCS is Arizona's Medicaid long-term care program for people who meet both medical and financial requirements, such as needing a nursing-home level of care. AHCCCS decides eligibility, not a contractor. If you are not yet enrolled, AHCCCS or your local Area Agency on Aging can explain how to apply.
Can ALTCS pay for a walk-in tub instead of a shower?
Walk-in tubs are not typically listed as a covered home modification in the AHCCCS policy, while roll-in and walk-in showers with handheld showerheads are. Your case manager and health plan make the final decision, so ask them directly. If a tub is what you want, ask whether other funding such as a VA grant could help.
How long does an ALTCS home modification take?
It varies by health plan and by how complete the request is. The assessment, approvals, quotes and scheduling each take time, so it is wise to start early. Ask your case manager for the expected steps and timeline in your plan.
Does my contractor need to be approved by the health plan?
Health plans often work with specific contractors or have rules about who can do covered work. Ask your case manager before you sign anything or pay a deposit. Starting work before approval can mean the plan will not pay for it.
Bathe safely again, without leaving home.
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