Medicaid programs, including long-term care assistance, are governed by individual state regulations, leading to variations in rules, benefits, and even program names across the US. This guide specifically focuses on Arkansas Long Term Care Programs under Medicaid, designed to support seniors in the state. Administered by the Arkansas Department of Human Services, these programs offer financial aid for long-term care services in various settings: nursing homes, private residences, assisted living facilities, and more. Funding is channeled through three primary pathways: Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers, and Aged, Blind, and Disabled (ABD) Medicaid. It’s important to distinguish these specialized programs from standard Medicaid, which caters to individuals of all ages with limited financial resources.
Understanding Arkansas Medicaid Long Term Care Options
Nursing Home Care / Institutional Medicaid in Arkansas
For Arkansas seniors with financial constraints requiring a Nursing Facility Level of Care, Arkansas Nursing Home Medicaid provides crucial financial support to cover long-term care within a nursing home environment. This comprehensive coverage extends to essential services and provisions such as:
- Assistance with Activities of Daily Living (ADLs): including mobility, bathing, dressing, eating, and toileting.
- Professional skilled nursing care.
- Regular physician consultations.
- Prescription medications and their management.
- Mental health support and counseling.
- Engaging social activities.
It is important to note that while comprehensive, Arkansas Nursing Home Medicaid does not cover certain amenities such as private rooms, specialized dietary requests, non-essential comfort items (like tobacco, sweets, or cosmetics), or care services deemed medically unnecessary. For more details about private room coverage limitations, you can refer to resources on private room benefits in nursing homes.
Beneficiaries of Arkansas Nursing Home Medicaid are expected to contribute the majority of their income towards nursing home costs, retaining only a small personal needs allowance of $40 per month. This allowance is intended for personal expenses such as snacks, reading materials, personal grooming, and small treats. Exceptions are made for those who are dually eligible for Medicare and Medicaid, allowing them to retain income to cover Medicare premiums. Additionally, income can be allocated for spousal income allowance payments if the non-applicant spouse has financial needs.
Arkansas Nursing Home Medicaid operates as an entitlement program. This designation guarantees that all applicants who meet the eligibility criteria are legally entitled to receive benefits without facing wait times for enrollment. However, it’s crucial to understand that not all nursing homes in Arkansas accept Medicaid, and those that do may have limited availability. While eligibility ensures coverage, it does not guarantee placement in a preferred facility.
Nursing Home Transition Support: For individuals currently benefiting from Arkansas Nursing Home Medicaid who wish to transition back to community living, Arkansas offers the Money Follows the Person (MFP) program. This initiative aids beneficiaries in their move from a Medicaid-approved facility back to their own home, a family member’s home, or a small group home (up to four unrelated residents). Support can include financial assistance for moving expenses and ongoing long-term care services in their new residence.
Home and Community Based Services (HCBS) Waivers in Arkansas
Home and Community Based Services (HCBS) Waivers offer an alternative to nursing home placement for eligible Arkansas seniors. These waivers are designed to financially support seniors who require a Nursing Facility Level of Care to continue living in a community setting. This includes their own home, the home of a relative, or a licensed Level II assisted living facility. It’s important to note that while HCBS Waivers cover a range of long-term care services and supports in these settings, they do not cover the costs of room and board.
Unlike Nursing Home Medicaid, HCBS Waivers are not entitlement programs. This means that even if an applicant meets all eligibility requirements for an Arkansas HCBS Waiver, benefit receipt is not guaranteed. These programs operate with a limited number of enrollment slots. Once these slots are filled, eligible applicants are placed on a waitlist.
Arkansas offers two primary HCBS Waivers for seniors needing long-term care: the ARChoices in Homecare Waiver and the Living Choices Assisted Living Waiver. The key distinction lies in the care setting: ARChoices supports care at home or in a relative’s home, whereas the Living Choices Waiver is for those residing in approved Level II assisted living facilities.
1. ARChoices in Homecare Waiver: Often referred to simply as ARChoices, this waiver program is tailored for Arkansas seniors who require a Nursing Facility Level of Care but live at home or with family. Aimed at preventing or delaying nursing home admission, ARChoices benefits include:
- Adult day care services.
- Home-delivered meals.
- Home modifications for accessibility.
- Personal Emergency Response Systems.
- Personal care assistance with ADLs (mobility, bathing, dressing, eating, toileting) and Instrumental Activities of Daily Living (IADLs) like shopping, cooking, cleaning, and managing appointments.
Care services can be delivered through licensed agency caregivers. However, ARChoices also offers self-directed care options via the Independent Choices program. This empowers beneficiaries to choose their caregivers, including friends and certain family members (excluding spouses and legal guardians).
The ARChoices Waiver has an annual enrollment cap, accommodating approximately 11,400 participants. When this limit is reached, further eligible applicants are placed on a waiting list.
2. Living Choices Assisted Living Waiver: Known also as the Living Choices Program or ALW, this Arkansas waiver supports seniors aged 65 and over who need a Nursing Facility Level of Care and reside in a Level II assisted living facility approved as a Living Choices Program provider. Medicaid coverage through this waiver applies to specific services within the assisted living setting but excludes room and board costs.
Benefits under the Living Choices Program include:
- Nursing services.
- Medication management.
- Social and therapeutic activities.
- Non-medical transportation assistance.
- Personal care assistance with both ADLs and IADLs.
The Living Choices Program is designed to foster independence and postpone the need for nursing home care among its participants. This waiver has around 1,725 enrollment slots available annually.
Aged, Blind, and Disabled (ABD) Medicaid in Arkansas
Arkansas’s Aged, Blind, and Disabled (ABD) Medicaid program provides fundamental healthcare coverage to Arkansas residents with limited income and resources who are aged (65+), blind, or disabled and live within the community. Sometimes called state Medicaid or regular Medicaid for seniors, it should not be confused with standard Medicaid for all age groups. ABD Medicaid is an entitlement, ensuring guaranteed benefits for all eligible applicants without wait times.
For ABD Medicaid recipients in Arkansas who also have long-term care needs, additional services and supports are available through the state’s Medicaid Personal Care program or the Program of All-Inclusive Care for the Elderly (PACE).
1. Medicaid Personal Care: This Arkansas program delivers long-term care benefits to seniors living at home, in a relative’s home, a residential care facility, or a Level I assisted living facility. Eligibility requires needing assistance with at least one Activity of Daily Living (ADL). While Medicaid covers long-term care services in these environments, it does not cover room and board expenses.
To assess eligibility and the required level of care, Arkansas conducts evaluations including the Arkansas Independent Assessment (ARIA). This assessment is carried out by an independent nurse and subsequently reviewed by a nurse from the Arkansas Department of Human Services’ Office of Long Term Care, who makes the final determination. Cognitive impairments, including Alzheimer’s disease and related dementias, are also considered in this assessment.
Medicaid Personal Care benefits can include up to 14.75 hours of weekly personal care assistance with ADLs and IADLs. Care can be provided by licensed caregivers, and participants have the option to self-direct their care through the Independent Choices program, allowing them to choose caregivers (excluding spouses and legal guardians).
Similar to ABD Medicaid, the Medicaid Personal Care Program is an entitlement, guaranteeing benefits to all eligible applicants.
2. Program of All-Inclusive Care for the Elderly (PACE): Arkansas residents aged 55 and older who are ABD Medicaid beneficiaries can access comprehensive medical, social, and long-term care services through the Program of All-Inclusive Care for the Elderly (PACE). PACE participants must require a Nursing Facility Level of Care but are required to live in the community. Arkansas PACE integrates and manages both Medicaid and Medicare benefits for seniors who are “dual eligible.” PACE programs also offer vision and dental care, and PACE day centers provide meals, social activities, exercise programs, and routine health services. Arkansas PACE programs are located in North Little Rock (Baptist Health PACE), Springdale (PACE of the Ozarks), and Jonesboro (Total Life Healthcare). Further information about PACE can be found here.
Arkansas Medicaid Long Term Care: Eligibility Requirements
Eligibility for Arkansas Medicaid hinges on meeting specific financial and functional (medical) criteria. Financial requirements vary based on marital status, whether a spouse is also applying, and the specific program being applied for (Nursing Home Medicaid, HCBS Waivers, or ABD Medicaid).
Find Personalized Eligibility Information: The most accurate way to determine current Arkansas Medicaid eligibility for your specific situation is to use a Medicaid Eligibility Requirements Finder. Individuals exceeding these limits or with complex financial situations should seek guidance from a Medicaid planning professional.
Financial and Functional Criteria for Nursing Home Medicaid in Arkansas
Financial Requirements:
To qualify financially for Arkansas Nursing Home Medicaid, seniors must adhere to both an asset limit and an income limit. For single applicants in 2025, the asset limit is capped at $2,000, meaning countable assets must not exceed this amount. Countable assets include checking and savings accounts, retirement funds, stocks, bonds, certificates of deposit, cash, and other easily liquidated assets. The applicant’s primary residence is often exempt under certain conditions (see Medicaid’s Home Treatment in Arkansas section below), and certain assets like Irrevocable Funeral Trusts and Medicaid Compliant Annuities are considered non-countable.
In 2025, the monthly income limit for Arkansas Nursing Home Medicaid for a single applicant is $2,901. Almost all forms of income are counted, including IRA distributions, pensions, Social Security benefits, rental income, alimony, wages, salaries, and stock dividends. However, recipients are required to allocate most of their income to cover nursing home expenses, retaining only $40 monthly as a personal needs allowance, plus allowances for Medicare premiums for dual eligible individuals and potential spousal income allowance payments for financially dependent non-applicant spouses.
For married couples where both spouses are applying, the combined asset limit for 2025 is $3,000, and the income limit is $2,901 per spouse monthly. If only one spouse is applying, the 2025 asset limits are $2,000 for the applicant spouse and $157,920 for the non-applicant spouse due to the Community Spouse Resource Allowance. The applicant spouse’s income limit remains $2,901 monthly, while the non-applicant spouse’s income is not considered. Similar to single applicants, married Arkansas Nursing Home Medicaid recipients must contribute most of their income to care costs, keeping $40 for personal needs, Medicare premiums if applicable, and any approved spousal income allowances.
Important Note on Asset Transfers: Nursing Home Medicaid applicants must be aware of the Look-Back Period. In Arkansas, this is 60 months. Medicaid reviews financial transactions during this period to identify asset transfers made to become eligible. Asset disposals below fair market value can lead to application denial and a penalty period of ineligibility.
Functional Requirements:
The functional eligibility for Arkansas Nursing Home Medicaid requires a Nursing Facility Level of Care (NFLOC). This means the applicant needs care typically provided in a nursing home setting due to physical or cognitive health needs. The state assesses an applicant’s ability to perform Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), along with cognitive and behavioral health. Conditions like Alzheimer’s disease and dementia are considered, but a diagnosis alone does not automatically qualify an individual for NFLOC.
Financial and Functional Criteria for HCBS Waivers in Arkansas
Financial Requirements:
Financial eligibility for Arkansas HCBS Waivers mirrors Nursing Home Medicaid. In 2025, single applicants must have countable assets valued at $2,000 or less, including similar asset types as mentioned for Nursing Home Medicaid. The treatment of a primary residence and non-countable assets also aligns with Nursing Home Medicaid rules. Consult the Home Treatment by Medicaid in Arkansas section for details.
The 2025 monthly income limit for HCBS Waivers for a single applicant is also $2,901. Income sources considered are the same as with Nursing Home Medicaid. For personalized advice on income and asset implications for Medicaid eligibility, consulting a Certified Medicaid Planner is recommended.
For married applicants with both spouses applying for HCBS Waivers, the 2025 combined asset limit is $3,000, with an income limit of $2,901 per spouse. For single-applicant married couples, the asset split and income rules follow the same structure as Nursing Home Medicaid, utilizing the Community Spouse Resource Allowance.
Asset Transfer Caution: Similar to Nursing Home Medicaid, HCBS Waiver applicants are subject to a Look-Back Period of 60 months in Arkansas. Asset transfers made to meet eligibility criteria can result in application denial and penalty periods.
Functional Requirements:
Functional eligibility for HCBS Waivers also requires a Nursing Facility Level of Care (NFLOC). The assessment process is similar to Nursing Home Medicaid, evaluating ADLs, IADLs, and cognitive status to determine if the applicant’s care needs align with the NFLOC standard.
Financial and Functional Criteria for ABD Medicaid in Arkansas
Financial Requirements:
Arkansas ABD Medicaid has different financial thresholds. In 2025, single applicants must have countable assets of $9,660 or less. Countable assets are generally the same as with other Medicaid programs. Home exemptions and non-countable assets like Irrevocable Funeral Trusts and Medicaid Compliant Annuities also apply.
The monthly income limit for Arkansas ABD Medicaid for single applicants is $1,004 (effective April 2024 – March 2025). Income sources counted are consistent with other Medicaid programs.
For married applicants, the 2025 combined asset limit is $14,470. The combined monthly income limit is $1,362.67 (effective April 2024 – March 2025). These limits apply whether one or both spouses are applying.
Notably, the Look-Back Period does not apply to ABD Medicaid. However, it is crucial to be mindful of asset transfers, as future transitions to Nursing Home Medicaid or HCBS Waivers would trigger a Look-Back review and potential penalties based on past asset disposals.
Functional Requirements:
Functional eligibility for basic healthcare coverage under Arkansas ABD Medicaid is primarily based on age (65+), blindness, or disability. For ABD Medicaid applicants needing long-term care services, Arkansas Medicaid will assess their ability to perform ADLs and IADLs to determine necessary benefits and state-covered services.
Home as an Exempt Asset in Arkansas Medicaid Eligibility
A primary residence is often a significant asset, but Arkansas Medicaid provides exemptions to prevent individuals from being disqualified due to homeownership. The home is typically non-countable under these conditions:
- If the applicant lives in the home and the home equity interest is $730,000 or less (in 2025).
- If a spouse, minor child, or blind or disabled child resides in the home, regardless of the applicant’s residency or home equity value.
- If none of the above residents live in the home, the home may still be exempt if the applicant declares an “intent to return” home and the equity interest is at or below $730,000.
For ABD Medicaid, the home equity limit is waived, making the home exempt regardless of its value.
For Nursing Home Medicaid applicants, protecting the home from Medicaid Estate Recovery Programs (MERPs) is an important consideration. Arkansas, like all states, has a MERP to recoup long-term care costs from Medicaid recipients’ estates after death. Learn more about Medicaid Estate Recovery in Arkansas and strategies to protect your home.
Medicaid Planning Strategies for Arkansas Residents
Even if initial financial eligibility criteria are not met, options exist to qualify for Arkansas Medicaid through Medicaid planning. These strategies are often complex, and professional guidance from a Certified Medicaid Planner or Elder Law Attorney is highly recommended.
For those exceeding asset limits, strategies include “spending down” assets or utilizing a Medicaid Asset Protection Trust. While direct gifting of the home is restricted by the Look-Back Period, the Child Caregiver Exemption or Sibling Exemption may allow home transfer to qualified family members, thus exempting it from asset calculations.
For Arkansas Nursing Home Medicaid or HCBS Waiver applicants over the income limit, a Qualified Income Trust (QIT) can be used to reduce countable income. ABD Medicaid applicants exceeding income limits may use the Medically Needy Pathway to maintain eligibility.
Applying for Arkansas Medicaid Long Term Care
The first step in applying for Arkansas Medicaid Long Term Care is to identify the most appropriate program: Nursing Home Medicaid, HCBS Waivers, or ABD Medicaid.
Next, assess if the applicant meets the financial and functional criteria for the chosen program. Applying without meeting financial eligibility will lead to application denial.
Gathering comprehensive financial documentation is crucial. This includes tax returns, Social Security statements, property deeds, life insurance policies, and quarterly statements for all financial accounts. Refer to a Medicaid Application Documents Checklist for a detailed list.
Once eligibility is confirmed and documentation is prepared, Arkansas residents can apply online via Access Arkansas or in person at their county’s Department of Human Services office.
Comprehensive guides for each program application are available: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.
Expert Assistance: Navigating Medicaid Long Term Care can be complex. Consulting a Certified Medicaid Planner can provide invaluable support with rules, benefits, and the application process.
Selecting an Arkansas Medicaid Nursing Home
Upon approval for Arkansas Medicaid nursing home coverage, the next step is choosing a Medicaid-accepting facility that best suits individual needs. While Arkansas Medicaid nursing home coverage is an entitlement, facility availability can vary, and not all nursing homes accept Medicaid.
Arkansas has approximately 220 Medicaid-accepting nursing homes statewide, distributed to meet population needs. Concentrations include around Little Rock, Northwest Arkansas (Springdale, Rogers, Fayetteville), Fort Smith, and the Upper Delta region (Jonesboro).
Resources for Nursing Home Selection: Utilize Nursing Home Compare, a CMS tool with data on over 15,000 nursing homes nationwide, and the Arkansas Department of Health’s Long Term Care Facilities Search tool.
Compare facilities based on overall ratings, health inspections, staffing, and quality measures on Nursing Home Compare. Contact your local Area Agency on Aging for additional information.
Visiting potential nursing homes is crucial. Schedule visits and prepare questions regarding staff doctors, social activities, transportation, healthcare services (oral, eye), and food quality. Use the CMS “Nursing home checklist” during visits.
Data from 2018-2023 indicates Arkansas nursing homes averaged more health deficiencies than the national average but had significantly fewer residents per facility, potentially allowing for more personalized care. Resident-reported depressive symptoms were also notably lower than the national average.
Professional Guidance for Medicaid Eligibility
For individuals needing Medicaid long-term care who do not meet financial criteria, working with a Medicaid Planning professional is advisable. These experts assist families in structuring finances to achieve Medicaid eligibility, simplify the application process, and protect assets for spouses and family members.
For a free initial consultation with a Medicaid Planner, consider filling out the form provided.
