Arkansas Medicaid for seniors and long-term care
Last verified: June 2026
Long-term care Medicaid rules are complex
Arkansas Medicaid (not ARHOME) covers long-term care — ARHOME is for working-age expansion adults only
Financial eligibility for Arkansas Medicaid long-term care
To qualify for Medicaid-funded long-term care, an Arkansas applicant must meet income and asset limits under non-MAGI rules, plus satisfy a functional need assessment. These are different from the MAGI rules used for ARHOME.
| Factor | Standard (2025) | Details |
|---|---|---|
| Income limit | $2,901/mo (300% SSI) | Income above limit may qualify with an income trust (Miller Trust) |
| Countable asset limit — individual | $2,000 | Home, primary vehicle, burial funds up to set amount are exempt |
| Asset limit — community spouse | Up to $154,140 (2025 CSRA) | Federal spousal impoverishment protections apply |
| Level-of-care requirement | Nursing facility level of care | Functional assessment required; determines nursing vs. HCBS eligibility |
ARChoices in Homecare — HCBS as an alternative to nursing homes
ARChoices is Arkansas's main Medicaid HCBS waiver for seniors and adults with physical disabilities. Per DHS/DAABHS, ARChoices allows eligible individuals to receive long-term support at home or in community settings rather than a nursing facility. Services available through ARChoices include:
- Personal care attendant services
- Home health aide visits
- Adult day services
- Respite care for family caregivers
- Skilled nursing and therapy services in the home
- Assistive technology (medical equipment, devices)
- Home environmental accessibility modifications (ramps, grab bars)
- Transition assistance for moving out of a nursing facility
- Case management and service coordination
ARChoices has a limited number of enrollment slots. A waiting list may apply. Apply through DHS at humanservices.arkansas.gov or by calling your local DHS county office to be assessed and placed on the waiting list if slots are not immediately available.
Spousal protections
Arkansas follows federal spousal impoverishment rules (42 USC 1396r-5). The community spouse — the one remaining at home — is protected from being forced into poverty by their spouse's Medicaid eligibility. Key protections include:
- The community spouse may retain up to $154,140 in countable assets (2025 CSRA)
- A Minimum Monthly Maintenance Needs Allowance ensures the community spouse retains at least approximately $2,555/month in income (federal floor, 2025)
- The primary home is exempt while the community spouse occupies it
Arkansas Medicaid estate recovery — DMS may recoup costs from an estate
Medicaid as the primary payer for long-term care
Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay. Private long-term care insurance covers only those who purchased it. For the majority of Americans who need extended nursing home care, Medicaid ends up as the payer — after they have spent down their own assets to the program's limit.
Nationally, Medicaid pays for roughly two-thirds of all nursing home residents, per CMS data. Arkansas's share of that population is administered through Arkansas Medicaid (Arkansas Works). The rules that determine eligibility — income, assets, lookback periods, and exempt property — differ from the MAGI-based rules used for standard Medicaid.
Long-term care Medicaid also includes home and community-based services (HCBS), which allow people to receive care at home or in assisted living rather than a nursing facility. These programs operate through Section 1915(c) waivers and have waiting lists in most states.
Nursing facility coverage
Arkansas Medicaid (Arkansas Works) covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.
Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance (which varies by state but is often $30–$50 per month). Medicaid covers the gap.
If income exceeds the institutional Medicaid limit, Arkansas may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible. Not all states allow this; verify whether Arkansas uses this approach with Arkansas Medicaid (Arkansas Works).
Home and community-based services (HCBS)
HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Section 1915(c) of the Social Security Act authorizes these waivers. Each state designs its own waiver programs, so what's available through Arkansas Medicaid (Arkansas Works) differs from what's available in neighboring states.
Common HCBS services include personal care assistance, home health aide visits, adult day health care, respite care for family caregivers, and modifications to make a home accessible. Some states cap the number of waiver slots, creating waiting lists that can run for months or years.
Contact Arkansas Medicaid (Arkansas Works) to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.
Asset limits for long-term care Medicaid
Unlike MAGI-based Medicaid, long-term care Medicaid has an asset test. Countable assets — bank accounts, investments, second vehicles, vacation property — must fall below the state's limit. The specific threshold varies by state and is updated periodically; it is not a figure this page can reliably publish.
Exempt assets are not counted. The primary home is exempt while the applicant lives there or intends to return, as well as when a spouse, minor child, or disabled adult child lives there. One vehicle is typically exempt. Personal belongings and a prepaid funeral arrangement are also generally exempt.
Medicaid has a 60-month (5-year) lookback period for asset transfers. Transfers of assets for less than fair market value within those 60 months can result in a penalty period during which Medicaid will not pay for care. Consult Arkansas Medicaid (Arkansas Works) or a Medicaid planning attorney before transferring assets.
Spousal protections
When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — called the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income.
The CSRA allows the community spouse to keep between a federal minimum and maximum, with the exact amount varying by state and updated annually. Arkansas's current CSRA is set by Arkansas Medicaid (Arkansas Works) and published on their website.
The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).
Estate recovery applies to long-term care recipients age 55 and older
What long-term care Medicaid typically covers
- Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
- Physical, occupational, and speech therapy provided in a nursing home
- Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
- Home health aide visits for those receiving care at home
- Adult day health care programs
- Respite care to give family caregivers temporary relief
- Durable medical equipment prescribed by a physician
- Transportation to and from medical appointments