Medicaid for nursing home and home care in Arkansas

Who qualifies

All of Arkansas's long-term care Medicaid groups use the same money rules. You must also need the level of care the program gives.

Who each program is for

• Nursing facility: People who are 65 or older, blind, or disabled and live in a nursing home, and who meet the medical need rules.
• Living Choices (assisted living): People 65 or older, or 21 or older and blind or physically disabled, who live in a licensed Level II Living Choices assisted living facility.
• ARChoices in Homecare: People 65 or older, or 21 to 64 with a physical disability, who need nursing home level care but want to stay at home.
• PACE: People 55 or older who need nursing home level care. It is offered only in some counties.

If your income is over the limit: the income trust

If your income is more than three times the SSI amount, you may still qualify by setting up an income trust. This applies to the nursing facility, Living Choices, ARChoices and PACE. DHS has its own rules for setting up and running the trust, so ask your county DHS office before you sign anything.

What counts and what does not

• Income that counts includes Social Security, pensions and other money paid to you.
• Savings that count include cash, bank accounts and other things you could turn into cash.
• Your home usually does not count, but Medicaid will not pay for long-term care if your equity in the home is above the home equity limit. Under federal rules, that limit is at least $752,000 in 2026. Ask DHS for the exact Arkansas limit. A hardship waiver may be possible.
• Giving things away for less than they are worth can cause a period when Medicaid will not pay for your care. For PACE, this rule applies only if you move into a nursing home.

If you are married and your spouse stays at home

Arkansas has "spousal impoverishment" rules that protect the spouse at home.

• Savings: In 2026, the spouse at home can keep up to $162,660 of the couple's savings. The exact amount is worked out with a formula.
• Income: If the spouse at home has low income, some of your income may go to them each month. DHS figures this amount.
• These rules apply to PACE whether you live at home or in a facility.

What you pay

In a nursing home, you pay part of the cost of your care based on your income and certain expenses. DHS works out the amount. You keep a small amount each month for personal needs; ask DHS for the current amount. Nursing home residents on Medicaid generally do not pay copays for medical care or prescriptions.

Programs that pay for care

ARChoices in Homecare

ARChoices can pay for:

• Attendant care (help with bathing, dressing and other daily tasks)
• Adult day services and adult day health
• Respite care to give a family caregiver a break
• Home-delivered meals
• An emergency response button
• Home changes for safety
• Case management

Through the Independent Choices option, you may be able to hire your own personal care workers. On ARChoices you also get full Medicaid health coverage.

Living Choices

Pays for services in a licensed Living Choices assisted living facility so you can stay as independent as possible.

Nursing home care

Medicaid pays a Medicaid-certified nursing home. A doctor must recommend this care.

How to apply

1. Call the Choices in Living Resource Center at 1-866-801-3435 or email [email protected]. They can explain your choices for care at home, assisted living, or a nursing home.
2. Apply for Medicaid online at access.arkansas.gov, by phone through Access Arkansas at 855-372-1084, or at your DHS county office.
3. Have a nurse assessment. For ARChoices and Living Choices, a DHS nurse checks whether you need the level of care and helps set your start date.
4. Send proof of income, savings and your home as DHS asks.

When coverage starts: For long-term care, coverage usually starts on the date you apply. For a nursing home, Medicaid can also look back to months before you applied, if you were in the nursing home in those months. ARChoices and assisted living coverage is not made retroactive by the caseworker. A DHS nurse may allow an earlier start in urgent cases.

After you apply

• Renewals: DHS checks your eligibility every year.
• Report changes within 10 calendar days.
• Appeals: If you disagree with a decision, ask for a hearing within 30 days of the date on the letter. Write to the DHS Office of Appeals and Hearings, P.O. Box 1437, Slot N401, Little Rock, AR 72203-1437, call 501-682-8622, or fax 501-404-4628. For ARChoices, Living Choices, nursing home and long-term care cases, your case usually stays open during the appeal unless you say you do not want it to. If you lose, you may have to pay for services you got during the appeal.

Things people often miss

• High income is not the end. An income trust can open the door.
• Married couples have more protection than many people think. Do not spend down all your savings before you learn the spouse rules.
• Estate recovery. If you were 55 or older and Medicaid paid for nursing home or waiver care, DHS may seek repayment from your estate after death. It waits while a spouse is alive, or if a child is under 21 or blind or disabled.

Free help

• Choices in Living Resource Center: 1-866-801-3435.
• SHIIP (Senior Health Insurance Information Program): Free Medicare counseling at 1-800-224-6330.
• Area Agencies on Aging: Find yours through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov.

See paying for a nursing home, SSI, and all benefits in Arkansas.

Phone numbers: Free help lines for Arkansas agencies

Check what you may qualify for