Arkansas Living Choices Assisted Living Waiver
Living Choices is Arkansas’s Medicaid waiver that pays for care services in approved assisted living facilities (Level II assisted living). It is meant for people who need a nursing-home level of care but can live safely in an assisted living apartment with help. This page is part of our Arkansas Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Medicaid waiver for care in assisted living |
| Who runs it | Arkansas Department of Human Services (DHS) |
| Age | 65 and older, or 21 to 64 with a physical disability |
| Care need | An intermediate nursing home level of care |
| Arkansas 2026 income rule (long-term care) | $2,982 a month (nursing facility, ARChoices, PACE) |
| Arkansas 2026 asset limit (single applicant) | $2,000 |
| Waiting list | Yes. The waiver has a cap on participants and a waitlist when full |
Living Choices in brief
In short, Living Choices is run by Arkansas Department of Human Services (DHS). Its target group is 65 and older, or 21 to 64 with a physical disability; on care need, the rule is: An intermediate nursing home level of care. As for waiting: Yes. The waiver has a cap on participants and a waitlist when full. Each of these points is covered in more depth below, alongside the general Arkansas rules from our state guide. Families weighing Living Choices against other Arkansas options can use the related pages at the end to compare programs side by side.
What the program is
Living Choices pays an approved Level II assisted living facility for personal care, medication help, supervision and other services the resident needs. The resident keeps an apartment and pays the facility for room and board from their own income. A DHS nurse assesses the person and approves a plan of care, and the facility delivers the services. Only facilities that are licensed as Level II and enrolled as Living Choices providers can take part.
Room and board in assisted living is never a Medicaid expense. The program covers care services, including personal care, medication oversight and supervision. Residents pay rent and meals themselves, usually from Social Security and pensions. See Assisted living and Medicaid and Room and board.
Who qualifies in 2026
Eligibility for Living Choices comes down to these points. The person:
- Is 65 or older, or 21 to 64 and disabled under Social Security rules
- Needs an intermediate level of nursing home care
- Qualifies for full Medicaid under Arkansas’s long-term care financial rules (see the money test below)
- Lives in, or will move to, an approved Level II assisted living facility
- Lives in Arkansas and is a U.S. citizen or qualified non-citizen
Financial eligibility. Applicants for Living Choices must meet Arkansas’s long-term care Medicaid financial rules. Figures shown above are the 2026 Arkansas long-term care limits from our state guide. Arkansas DHS’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. When one spouse applies for Living Choices and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.
How the care assessment works. The care test looks at how much help a person needs with everyday activities such as bathing, dressing, eating, using the toilet, moving around and taking medicines, and at memory problems and supervision needs. For Living Choices, an assessor, usually a nurse or social worker, visits the person at home, in the hospital or in the facility. Before a Living Choices assessment, it helps to line up a family member who can describe a typical bad day, and to have a list of diagnoses and medications ready. See Nursing home level of care and Activities of daily living.
What services it can pay for
What a participant receives under Living Choices follows the care plan. Possible services include:
- Attendant care and personal care
- Medication assistance and oversight
- Periodic nursing evaluations
- Homemaker and chore services within the facility
- Therapeutic social and recreational activities
- Supervision and help in emergencies
No program pays for everything. Living Choices services are based on assessed need, and a family caregiver who is already helping is usually counted when the plan is written. A change in health is a reason to request a reassessment.
How to apply
Getting Living Choices means passing a money test and a care test. Step by step:
- Find a Level II assisted living facility that takes Living Choices with an opening.
- Apply for Long-Term Care Medicaid with DHS, online or at a county office.
- DHS completes a functional assessment for the level of care.
- If slots are full, the person is placed on the waiting list.
- Once approved, the facility and DHS put the plan of care into effect.
Our documents checklist and Applying for a waiver guide list the paperwork.
Waiting lists
Living Choices has a yearly cap on participants. When it is full, DHS keeps a waiting list and tells applicants their place. Arkansas rules give priority to certain groups, such as nursing home residents who have been in a facility for a period of time and want to move to assisted living.
General advice is in Waiver waiting lists.
How it relates to nursing home Medicaid
The money rules for Living Choices are the same as for nursing home Medicaid, including the 2026 income rule ($2,982 a month) and asset limit, the look-back and estate recovery. The difference is where care is given and who pays for housing. In a nursing home, Medicaid pays room, board and care, and the resident keeps only a personal needs allowance. In Living Choices, Medicaid pays only for care, and the resident must have enough income to pay the facility’s room and board.
Where the nursing home rules still apply. As in nearly every state, Arkansas’s financial rules for home and community programs follow its nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. Arkansas DHS can also use estate recovery to seek repayment for long-term care services received after 55. People who keep income above a set allowance may have to pay part of it toward their care each month.
Income in a nursing home. In 2026, Arkansas lets a nursing home resident keep $40 a month for personal needs; the rest of their income mostly pays toward care. The state guide explains the nursing home side.
Tips for families
- Begin before it is urgent. Every step of Living Choices takes time, and an early request protects your place.
- Document everything, from forms and letters to who you spoke with at Arkansas DHS and when.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Report changes promptly, including income, assets, a move or a new living arrangement.
- Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
- Protect a spouse at home. Spousal protections must be claimed; a certified Medicaid planner or legal aid office can explain them for your family.
Common questions
Does Living Choices pay rent? No. The resident pays room and board. Medicaid pays only for care services.
Can I use Living Choices in any assisted living? Only in Level II facilities enrolled with Arkansas Medicaid as Living Choices providers.
What if the waiver is full? Get on the waiting list. Nursing home residents and some other groups have priority. ARChoices may be an option at home in the meantime.
Related pages
- Arkansas Long-Term Care Medicaid guide
- ARChoices in Homecare
- Assisted living and Medicaid
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.