Arkansas Medicaid Living Choices Assisted Living Waiver

What is a Medicaid Waiver?
Medicaid is an entitlement program for persons with limited financial resources.  Medicaid pays for nursing home care when an elderly individual requires it and cannot afford it. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers" which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.

Waiver Description

The Living Choices Assisted Living Waiver (ALW) is managed by the Arkansas Department of Human Services’ (DHS) Division of Aging and Adult Services (DAAS). This waiver provides 24-hour personal care services in a congregate or community setting (state licensed assisted living residences) to avoid the unnecessary institutionalization of the elderly and disabled in a nursing home. In most cases, this program can provide services at a lower cost than in an institutional nursing home setting. This program covers the cost of care at the assisted living residence, but the program participant is required to cover the room and board portion. It is worth noting that Arkansas has some of the least expensive assisted living room & board costs of any state in the nation. Families are not permitted to supplement the room and board portion, but can help pay for other essentials the individual may require.

While this community living Medicaid waiver offers an alternative to nursing home care, the state may set enrollment limits. This means that statewide demand may exceed the cap and a waiting list will form. Prioritization is usually by date of application, but the severity of need may also be considered.

 Did You Know?  Assisted living communities in Arkansas are some of the least expensive in the country.   Average monthly fees are 15% lower than the national average. 

2018 Eligibility Guidelines

This information is current for the year 2018. Arkansas Medicaid considers a variety of different criteria when determining eligibility. This can be confusing, so be aware that assistance options are available.

Age – Living Choices Assisted Living Waiver is open to all state residents 65 years of age or older. Persons 21-64 years of age can participate if they have been designated as physically disabled or blind by Social Security.
Residency – Program participants must be residents of the state of Arkansas. The assisted living community into which they are moving must be within the state borders.

Functional Ability – Applicants must require a level of care that is consistent with that of an intermediate level of nursing home care. In addition, one must have a medical need for one of the services that is offered via this Medicaid Waiver. For example, one may have a medical condition that requires assistance to perform activities of daily living such as eating, toileting, or transferring, or be diagnosed with Alzheimer’s or another form of dementia, where their level of impairment requires regular supervision.

Income – Applicants cannot have monthly income exceeding 300% of the Social Security Income (SSI) Federal Benefit Rate (FBR). In 2018, this is equivalent to $2,250 per month for a single individual. For married couples (both spouses applying), the income limit remains the same, $2,250 / month per spouse, as income is not looked at as a couple. It is strictly looked at on an individual basis.

Assets – for widowed, divorced or unmarried applicants, they are permitted $2,000 in countable assets. Married couples, with both spouses as applicants, are each allowed up to $2,000 in assets. Countable assets include cash, bank accounts, and mutual funds. Normally, one’s home is excluded as a countable asset if it is lived in. However, since a single applicant, or married applicants, cannot live in their home and concurrently reside in an assisted living residence, homes are not considered exempt assets, for single or married applicants.

However, if just one spouse of a married couple is an applicant, the assets criteria are different and vastly more complicated. To prevent a healthy spouse from becoming destitute, a non-applicant spouse is permitted to have up to $123,600 in countable assets. Furthermore, a home, vehicle, home furnishings, and personal items are all excluded from being counted towards the asset limit. Many jointly held assets may be allocated to the spouse as long as the total does not exceed the limit.

In addition, if one is over the income limit, countable assets can be “spent down” in order to reduce the amount of one’s countable assets. For instance, one may pay off debt, such as medical bills and credit cards, or improve a non-countable asset, such as upgrading the plumbing and heating of one’s home, given a spouse continues to live in the home.

 Other Pathways to Eligibility
Fortunately, and unfortunately, Medicaid eligibility is complex. While this creates confusion, it also creates opportunities to find alternative approaches to becoming Medicaid eligible. It can be compared to filing taxes. There are strategies and techniques that can help families reduce their taxes that are not obvious to the average person, but by working with a tax advisor, families can take advantage of those tax breaks. Medicaid is similar, by working with a professional, families can find creative ways to become eligible. Learn more


Benefits and Services
  • Assisted living services
  • Attendant care (Assistance with daily living activities, such as eating, dressing, using the bathroom, light housecleaning, and shopping for groceries, etc.)
  • Extended prescription drug coverage
  • Medication oversight and administration
  • Non-medical transportation
  • Nursing evaluations and some nursing services
  • Pharmacist consultant services
  • Social, therapeutic, and recreational activities


How to Apply / Learn More

The Living Choices waiver is administered by the Arkansas Department of Human Services, Division of Aging and Adult Services (DAAS). More information is available in a downloadable pamphlet and on their webpage.

To apply one should contact their Department of Human Services County Offices or contact their local DHS county office by calling 501-682-2441.