Arkansas Medicaid Long Term Care Programs, Benefits & Eligibility Requirements

Summary
Medicaid’s rules, benefits and even its name can all vary by state. This article focuses on Arkansas Medicaid Long Term Care for seniors, which is administered by the Arkansas Department of Human Services and will help pay for care in a nursing home, a recipient’s home and other settings through one of three programs – Nursing Home Medicaid, HCBS Waivers or ABD Medicaid. These programs are different from regular Medicaid, which is for financially limited people of all ages.

 

Arkansas Medicaid Long Term Care Programs

Nursing Home / Institutional Medicaid

Arkansas Nursing Home Medicaid will cover the cost of long-term care in a nursing home for financially limited Arkansas seniors who require a Nursing Facility Level of Care. Coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:

  • Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
  • Skilled nursing care
  • Physician’s visits
  • Prescription medication
  • Medication management
  • Mental health counseling
  • Social activities

Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.

Arkansas Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover the nursing home expenses. They are only allowed to keep a “personal needs allowance” (PNA) of $40/month (as of 2024), which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are dual eligible, and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.

Arkansas Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.

  A Nursing Home Alternative – Arkansas Nursing Home Medicaid beneficiaries who want to leave their nursing home and return to living “in the community” can receive financial and functional help with that transition through Arkansas’s Money Follows the Person (MFP) program. This help can include paying for moving expenses, as well as long-term care services and supports in the new residence. Arkansas MFP beneficiaries must be moving from a Medicaid-approved facility and into their own home, the home of a relative or a small group home with a maximum of four unrelated residents.

 

Home and Community Based Services (HCBS) Waivers

Home and Community Based Services (HCBS) Waivers will pay for long-term care services and supports that help financially limited Arkansas seniors who require a Nursing Facility Level of Care remain living “in the community” instead of moving to a nursing home. The word “waiver” means something like voucher in this instance. Think of it as a voucher that will cover long-term care benefits for Arkansas residents who live in their home, the home of a loved one or a licensed Level II assisted living facility. While Arkansas’s HCBS Waivers will cover some long-term care services and supports in those settings, they will not cover room and board costs.

Unlike Nursing Home Medicaid, HCBS Waivers are not an entitlement. Remember, entitlement means guaranteed by law. So, even if an applicant is eligible for an HCBS Waiver program in Arkansas, they are not guaranteed by law to receive the benefits. Instead, there are a limited number of enrollment spots for each waiver program, and once those spots are full, additional applicants are placed on a waitlist.

Arkansas’s HCBS Waivers that provide long-term care benefits to seniors are the ARChoices in Homecare Waiver and the Living Choices Assisted Living Waiver. The major difference between the two is that ARChoices provides coverage in the beneficiary’s home or the home of a loved one, while the Living Choices Assisted Waiver provides coverage in approved Level II assisted living facilities.

1. ARChoices in Homecare Waiver
The ARChoices in Homecare Waiver, which is often called ARChoices, provides long term care benefits to Arkansas seniors who require a Nursing Facility Level of Care but live in their own home or the home of a loved one. Intended to delay nursing home placement, benefits of the ARChoices Waiver include adult day care, meal delivery, home modifications, Personal Emergency Response Systems and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling).

The state can designate a licensed agency caregiver to provide those benefits, but ARChoices Waiver beneficiaries also have the option to self-direct their care through the Independent Choices programs. This allows them to select caregivers of their choice, including friends and family members. Spouses and legal guardians, however, cannot be hired as caregivers for the ARChoices Waiver.

The ARChoices Waiver has a limited number of enrollment spots (11,350 per year as of 2022). Once those spots are full, additional applicants are placed on a waitlist.

2. Living Choices Assisted Living Waiver
Arkansas’s Living Choices Assisted Living Waiver (also called the Living Choices Program, Living Choices and ALW), provides long-term care services to Arkansas seniors (age 65 and older) who require a Nursing Facility Level of Care but reside in a Level II assisted living facility that is enrolled as a Living Choices Program provider. To be clear, Arkansas Medicaid will cover some services (detailed below) at the Level II assisted living facility, but it will not cover room and board.

Benefits of the Living Choices Program include nursing services, medication management, social activities, therapeutic activities, non-medical transportation assistance and personal care help with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling). The Living Choices Program is designed to help participants live independently and delay nursing home placement.

The Living Choices Assisted Living Waiver had 1,725 enrollment spots as of 2022.

 

Aged, Blind, and Disabled Medicaid

Arkansas’s Aged, Blind, and Disabled (ABD) Medicaid provides basic healthcare coverage to financially limited Arkansas residents who are aged (65 and over), blind or disabled and live in the community. ABD Medicaid can sometimes be referred to as regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for financially needy people of all ages. ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive the benefits without any wait.

Arkansas ABD Medicaid beneficiaries or applicants who have a medical need for long-term care services and supports can receive some of them through the state’s Medicaid Personal Care program or the Program of All-Inclusive Care for the Elderly.

1. Medicaid Personal Care
Arkansas’s Medicaid Personal Care program provides long-term care benefits to Arkansas seniors who live in their own home, the home of a loved one, a residential care facility or a Level I assisted living facility and require help with at least one of the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). While Medicaid will provide long-term care benefits in those settings, it will not cover room and board cost.

To determine if applicants meet the level of care requirement for this program, the state will conduct an assessment that includes the Arkansas Independent Assessment (ARIA) test, which is administered by an independent nurse and then reviewed by a nurse from the Arkansas Department of Human Services’ Office of Long Term Care, who will make the final decision. Cognitive impairments such as Alzheimer’s disease and other related dementias are also considered when determining the required level of care.

Medicaid Personal Care program benefits include 14.75 hours/week of personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling). A licensed caregiver can provide these benefits, and Medicaid Personal Care program participants also have the option to self-direct their care through the Independent Choices programs. This allows them to select caregivers of their choice, including friends and family members, as long as they are not spouses or legal guardians.

Like ABD Medicaid itself, Arkansas’s Medicaid Personal Care Program is an entitlement. This means that all eligible applicants are guaranteed by law to receive benefits.

2. Program of All-Inclusive Care for the Elderly (PACE)
Arkansas residents who are age 55 or older and have ABD Medicaid can cover their medical, social service and long-term care needs with one comprehensive plan and delivery system using the Program of All-Inclusive Care for the Elderly (PACE). PACE program participants are required to need a Nursing Facility Level of Care, but they must live in the community. Arkansas PACE will coordinate the care and benefits of Medicaid and Medicare for “dual eligible” seniors. PACE also administers vision and dental care, and PACE day centers provide meals, social activities, exercise programs and regular health checkups and services to program participants. Arkansas’s PACE programs are located in North Little Rock (Baptist Health PACE), Springdale (PACE of the Ozarks) and Jonesboro (Total Life Healthcare). To learn more about PACE, click here.

 

Eligibility Criteria For Arkansas Medicaid Long Term Care Programs

To be eligible for Arkansas Medicaid, a person has to meet certain financial and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program they are applying for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

 Just For You: The easiest way to find the most current Arkansas Medicaid eligibility criteria for your specific situation is to use our Medicaid Eligibility Requirements Finder.

Arkansas Nursing Home Medicaid Eligibility Criteria

Financial Requirements

Arkansas seniors have to meet an asset limit and an income limit in order to be financially eligible for Arkansas Nursing Home Medicaid. For a single applicant in 2024, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2024 income limit for Arkansas Nursing Home Medicaid for a single applicant is $2,829/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income. However, Arkansas Nursing Home Medicaid recipients are required to give most of their income to the state to help cover the cost of care. They are only allowed to keep $40/month of their income as a “personal needs allowance,” plus enough to make Medicare premium payments if they are “dual eligible”, and they can make any allowable spousal income allowance payments to financially needy, non-applicant spouses.

For married applicants with both spouses applying, the 2024 asset limit for Arkansas Nursing Home Medicaid is $3,000 combined, and the income limit is $2,829/month per spouse. For a married applicant with just one spouse applying, the 2024 asset limit is $2,000 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2024 income limit is $2,829/month for the applicant, and the income of the non-applicant spouse is not counted.

  Plan Ahead: There are alternative pathways to eligibility for Arkansas Nursing Home Medicaid applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Arkansas has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.

Functional Requirements
The functional, or medical, criteria for nursing home coverage through Arkansas Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that can only be provided in a nursing home. To determine if Arkansas Nursing Home Medicaid applicants require a NFLOC, the state will conduct an assessment of the applicants and their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Cognitive impairments such as Alzheimer’s disease and other related dementias are also considered. Plus, a registered nurse employed by an Independent Assessment Contractor will administer the Arkansas Independent Assessment (ARIA) test, and the results from that rest will be reviewed by a nurse from the Arkansas Department of Human Services’ Office of Long Term Care, who will make the final decision on level of care required.

 

Arkansas Medicaid Home and Community Based Services (HCBS) Waivers Eligibility Criteria

Financial Requirements

Arkansas residents have to meet an asset limit and an income limit in order to be financially eligible for Home and Community Based Service (HCBS) Waivers. For a single applicant in 2024, the asset limit for HCBS Waivers in Arkansas is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2024 income limit for HCBS Waivers in Arkansas for a single applicant is $2,829/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income.

For married applicants with both spouses applying, the 2024 asset limit for HCBS Waivers in Arkansas is $3,000 combined, and the income limit is $2,829/month per spouse. For a married applicant with just one spouse applying, the 2024 asset limit is $2,000 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2024 income limit is $2,829/month for the applicant, and the income of the non-applicant spouse is not counted.

  Plan Ahead: There are alternative pathways to eligibility for Arkansas HCBS Waivers applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Arkansas has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.

Functional Requirements
The functional, or medical, criteria for Home and Community Based Services (HCBS) Waivers through Arkansas Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. To determine if a NFLOC is required, the state will conduct an assessment of ARChoices applicants and their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Plus, a registered nurse employed by an Independent Assessment Contractor will administer the Arkansas Independent Assessment test, and the results from that rest will be reviewed by a nurse from the Arkansas Department of Human Services’ Office of Long Term Care, who will make the final decision on level of care required.

 

Arkansas Aged, Blind, and Disabled Medicaid Eligibility Criteria

Financial Requirements

Arkansas residents have to meet an asset limit and an income limit in order to be financially eligible for Aged, Blind, and Disabled (ABD) Medicaid. For a single applicant in 2024, the asset limit is $9,430 which means they must have $9,430 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The income limit for Arkansas ABD Medicaid for a single applicant from April 2024 to March 2025 is $1,004/month. Almost all income is counted, including IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. The only income sources exempt from the limit are things like COVID-19 stimulus checks and Holocaust restitution payments.

For married applicants, the 2024 asset limit for Arkansas ABD Medicaid is a combined $14,130 between the two applicants/spouses. The income limit is a combined $1,362.67/month from April 2024 through March 2025. These limits apply to married couples with both spouses applying and married couples with just one spouse applying.

  Plan Ahead: There are alternative pathways to eligibility for Arkansas ABD Medicaid applicants who are over the asset limit and/or the income limit, such as Medicaid Planning. While Arkansas has a Look-Back Period of five years for Nursing Home Medicaid and HCBS Waivers applicants to make sure they don’t give away their assets to get under the limit, the Look-Back Period does not apply to ABD Medicaid applicants. However, ABD applicants should be cautious about giving away their assets. They might eventually need Nursing Home Medicaid, or an HCBS Waiver, and those programs will deny or penalize the applicant for giving away assets.

Functional Requirements
The only functional requirements to receive basic healthcare coverage through Arkansas’s Aged, Blind, and Disabled (ABD) Medicaid are being disabled, blind or aged (65 or over). For ABD Medicaid applicants who require long-term care services and supports, Arkansas Medicaid will conduct an assessment of their ability to perform the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning and taking medications) to determine what kind of benefits the applicant needs and the state will cover.

 

How Arkansas Medicaid Treats the Home for Eligibility Purposes

One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in many situations the home is not counted against the asset limit:

  • If the applicant lives in their home and the home equity interest (the portion of the home’s equity value that the applicant owns minus any outstanding mortgage/debt) is less than $713,000 (as of 2024) then the home is exempt.
  • If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
  • If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $713,000.

These rules apply to all three types of Medicaid, with one important exception – ABD Medicaid applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status.

Arkansas Nursing Home Medicaid applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about Medicaid Estate Recovery in Arkansas and how you can protect your home from it, click here.

 

Applying For Arkansas Medicaid Long Term Care Programs

The first step in applying for Arkansas Medicaid Long Term Care coverage is deciding which of the three Medicaid programs discussed above you or your loved one wants to apply for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for Arkansas Medicaid coverage when not financially eligible will result in the application, and benefits, being denied.

During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Arkansas Medicaid applicant. These documents will be needed for the official Medicaid application. Necessary documents may include tax forms, Social Security benefits letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.

After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Arkansas residents can apply online at Access Arkansas. They can also apply in person at their county’s Department of Human Services office.

For a comprehensive guide that will take you through the application process for all three types of Medicaid Long Term Care, click on the program you want: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.

 Professional Help: Many seniors need support when it comes to Medicaid Long Term Care’s rules, benefits and application process. These are all complicated, constantly changing and vary by state. The best place to get help with Medicaid Long Term Care is through a professional like a Certified Medicaid Planner or an Elder Law Attorney.

 

Choosing an Arkansas Medicaid Nursing Home

After being approved for nursing home coverage through Arkansas Medicaid, your or your loved one needs to choose which Medicaid-accepting nursing home best meets your needs. Even though Arkansas Medicaid nursing home coverage is an entitlement, not all nursing homes accept Medicaid, and those that do may not have available spaces. Finding the right nursing home can be a chore, especially if you’re looking in a specific area of the state.

There are roughly 220 nursing homes in Arkansas that accept Medicaid. These facilities are spread out across the state to match the population. There are nearly 40 nursing homes within 25 miles of Little Rock, and there are about 25 in Northwest Arkansas, with six each in Springdale and Rogers, and four in Fayetteville. There are a dozen nursing homes around Fort Smith, not including several that are just over the border in Oklahoma (you can not transfer Medicaid between states). And there are 10 nursing homes in the Upper Delta region, including four in Jonesboro.

  TOOLS: To find a nearby nursing home that meets their needs, Arkansas residents can use Nursing Home Compare, a search tool administered by the Centers for Medicare & Medicaid Services (CMS) that has information about more than 15,000 nursing homes across the country. They can also use this Long Term Care Facilities Search tool from the Arkansas Department of Health.

After finding nursing homes in your area that accept Medicaid, you can start comparing them, if there are multiple options. The Nursing Home Compare search can be filtered by overall rating, health inspections, staffing and quality measures, so that can be a good place to start. You can also get information on nursing homes by contacting your local Area Agency on Aging.

Once you’ve done the research and narrowed down your options, you or someone you trust should visit potential options before making a final decision. Call first to make an appointment for the visit, and arrive prepared with a list of questions. Some things you might ask are: Who are the staff doctors? Does the residence organize social activities? Does it offer transportation for medical and non-medical purposes? How does it facilitate oral and eye care? What’s the food like? CMS has a thorough “Nursing home checklist” you can use to evaluate a nursing home while visiting.

Data collected by CMS shows that Arkansas nursing homes averaged 29.1 health deficiencies per facility (although not all facilities had deficiencies), which was above the national average of 25.7. However, only 2.1% of residents in Arkansas nursing homes reported depressive symptoms, which is much better than the national average of 8.1%.