Arkansas Medicaid for Seniors & Long-Term Care

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.

ARChoices has a limited number of enrollment slots (roughly 11,500 as of 2026). A waiting list may apply once slots are full. 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.

Arkansas also operates a second HCBS waiver, the Living Choices Assisted Living Waiver, for seniors age 65+ who need a nursing facility level of care but live in a licensed Level II assisted living facility rather than at home. It has a smaller number of enrollment slots (roughly 1,725 as of 2026) and does not cover room and board.

Arkansas follows federal spousal impoverishment rules. The community spouse — the one remaining at home — is protected from being forced into poverty by their spouse's Medicaid eligibility.

Arkansas operates an estate recovery program. After a Medicaid recipient age 55 or older dies having received long-term care services, DMS may file a claim against the estate for the cost of those services. The home is generally protected while a surviving spouse or dependent minor/disabled child lives there. Arkansas also defers recovery in cases of hardship. Consult an elder law attorney before transferring assets, as Medicaid has a 5-year look-back period for asset transfers. Source: Arkansas DMS Medicaid estate recovery policy at humanservices.arkansas.gov.

Arkansas Medicaid covers skilled nursing facility care for seniors who meet clinical and financial criteria. Once approved, Medicaid pays the nursing home directly, and the resident contributes most of their monthly income toward the cost of care, keeping a personal needs allowance of $40/month plus enough to cover any Medicare premiums or allowable spousal income allowance. 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.

HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Contact Arkansas Medicaid to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.