Arkansas Waiver Programs: Eligibility, Level of Care, and Applying

Arkansas offers four Medicaid waiver programs that pay for long-term care in your home or community instead of a nursing facility: ARChoices in Homecare, the Community and Employment Supports (CES) Waiver, Living Choices Assisted Living, and the Autism Waiver. To qualify for any of them, you must meet the waiver’s population criteria, pass Medicaid’s financial test, and be assessed as needing an institutional level of care. For 2026, the monthly income cap for a single applicant is $2,982, which is 300% of the federal SSI benefit rate.¹

Which Waiver Fits Your Situation

Each waiver serves a different group. Start by identifying which one applies to you or your family member, because that determines where you apply and what services are available.

ARChoices in Homecare

ARChoices is the largest waiver. It serves adults ages 21 to 64 with a physical disability, and adults 65 and older, who need an intermediate level of nursing facility care.² Covered services include attendant care, adult day health, respite care, home-delivered meals, personal emergency response systems, environmental modifications, and adaptive equipment.³

Community and Employment Supports (CES) Waiver

The CES Waiver serves Arkansans of any age with an intellectual or developmental disability who would otherwise need care in an Intermediate Care Facility. Qualifying diagnoses include cerebral palsy, epilepsy, autism, Down syndrome, and spina bifida, along with other conditions that cause a person to function as though they have an intellectual disability.⁴ Services include supported employment (job coaching and placement), supported living, prevocational training, and personal care.⁵

Living Choices Assisted Living

Living Choices pays for apartment-style housing in a licensed assisted living facility. The age criteria mirror ARChoices: 21 through 64 with a physical disability, or 65 and older. You must meet nursing home admission criteria at the intermediate level and need at least one of the services the waiver covers.⁶ Extended prescription drug coverage beyond the standard state plan is included.

Autism Waiver

The Autism Waiver funds intensive early intervention for young children with autism spectrum disorder. The DHS fact sheet lists the current operational age range as 18 months through 5 years,⁷ though the underlying statute authorizes coverage through age 7.⁸ The child must have a formal autism diagnosis from a team of professionals and meet the institutional level of care criteria.

Financial Eligibility

Every waiver applicant has to pass Medicaid’s financial test, which looks at both monthly income and countable assets. Applicants are evaluated individually for income purposes, even if married.⁹

Income Cap

The monthly income limit is 300% of the SSI Federal Benefit Rate. With the 2026 individual SSI rate at $994, the waiver income cap works out to $2,982 per month.¹

If Your Income Is Too High: The Miller Trust

Being over the income cap doesn’t automatically end things. Arkansas allows applicants to set up an Irrevocable Income Trust, commonly called a Miller Trust. You sign the trust document, open a dedicated bank account, and deposit all your countable income into it each month. The trustee then distributes the money according to a DHS-approved worksheet that covers your personal needs allowance, any spousal or dependent allowances, non-covered medical expenses, and your share of care costs.¹⁰

The trust has to be run correctly every month. Miss a month, and you lose Medicaid eligibility for that month. Allowed trust expenses are limited to bank service charges and commercially reasonable trustee fees charged by a commercial institution. When you die, any funds left in the trust go to DHS to reimburse Medicaid.¹⁰

Asset Limits

Countable assets are capped at $2,000 for an individual and $3,000 for a couple. Your primary home (up to a state equity limit) and one vehicle are excluded.⁹

Spousal Protections

When only one spouse applies, federal spousal impoverishment rules protect the other. The community spouse can keep a portion of the couple’s combined resources up to $157,920 under the Community Spouse Resource Allowance, plus a Monthly Maintenance Needs Allowance for living expenses.⁹ These thresholds adjust annually, so confirm the current figure with your county office or the DHS quick reference guide before planning around it.

The Level of Care Assessment

Financial qualification is only half of it. A nurse or caseworker also has to assess you and confirm you need an institutional level of care. For ARChoices, Living Choices, and the Autism Waiver, that means the level of care a nursing facility provides. For the CES Waiver, the standard is care at the level of an Intermediate Care Facility for individuals with intellectual or developmental disabilities.⁴

The assessor evaluates how much help you need with daily activities like bathing, dressing, eating, and managing medications, along with cognitive functioning and behavioral health needs. You also have to need at least one of the services the specific waiver covers.¹¹

How to Apply

Where you start depends on the waiver. For ARChoices or Living Choices, contact your local DHS county office or call the Choices in Living Resource Center at 1-866-801-3435.¹² You can also begin the financial eligibility application online at access.arkansas.gov. For the CES Waiver, start with the Division of Developmental Disabilities Services (DDS) Intake and Referral unit.⁵

Two things run in parallel after you apply. DHS reviews your income and assets while a nurse or caseworker conducts the functional assessment. Both have to result in approval before you move forward, and slow financial documentation is where most delays come from. Send everything DHS asks for promptly.

Expect a Waiting List

Meeting every eligibility test doesn’t mean services start right away. Most Arkansas HCBS waivers cap enrollment, so approved applicants go on a waiting list. The CES Waiver waitlist is particularly long, with some people waiting several years.

Slots generally open in the order people were added to the list.¹³ People in crisis situations, such as the loss of a primary caregiver, may get priority placement. When a slot opens, DHS notifies you by mail and you complete updated assessments to confirm you still qualify. Keep DHS informed of address changes and any significant change in your health or finances so you don’t lose your place.

If You’re Denied: Appeal Rights

If your application is denied, your services are reduced, or your enrollment is terminated, you can request a fair hearing. Federal regulations give you up to 90 days from the date the notice is mailed to file the hearing request.¹⁴

If you already receive services and act quickly, you can keep them running during the appeal. The state has to give you at least 10 days’ advance notice before reducing or terminating services. Request a hearing inside that 10-day window and your services generally continue until a decision comes down. Miss the window and services may stop while you wait, so file fast even if you’re still pulling documents together.

The Estate Recovery Rule You Should Know Going In

Federal law requires Arkansas to seek recovery from the estates of deceased Medicaid recipients who were 55 or older and received waiver services.¹⁵ The state’s claim equals what Medicaid paid for your long-term care after age 55. If the claim is larger than the estate, heirs are not on the hook for the balance.¹⁶

Arkansas will not pursue a claim if the deceased is survived by a spouse, a child under 21, or a blind or disabled child of any age. The family home may also be protected if a qualifying sibling lived there for at least one year before the recipient entered care, or if an adult child lived there for at least two years before and provided care that delayed institutionalization. Assets that pass outside probate, such as retirement accounts, life insurance proceeds, and pension plans, are exempt from recovery.¹⁶

When recovery would cause undue hardship, heirs can ask for a waiver from the DHS Hardship Waiver Committee. The committee looks at factors like whether the estate asset is the heirs’ sole income-producing asset, whether an heir would qualify for government benefits without the inheritance, and whether the home’s value is at or below 50% of the average home price in that county.¹⁶

1
Social Security Administration. SSI Federal Payment Amounts for 2026
2
Arkansas Department of Human Services. ARChoices In Homecare Waiver Eligibility
3
Medicaid. Arkansas Waiver Factsheet
4
Arkansas Department of Human Services. CES Waiver Detailed Fact Sheet
5
Arkansas Department of Human Services. CES Waiver
6
Arkansas Department of Human Services. Living Choices
7
Arkansas Department of Human Services. Autism Waiver Simple Fact Sheet
8
Justia. Arkansas Code 20-77-124 – Medicaid Waiver for Autism
9
Arkansas Department of Human Services. Health Care Eligibility – Quick Reference
10
Arkansas Department of Human Services. Income Trust Fact Sheet
11
Arkansas Department of Human Services. ARChoices in Homecare
12
Arkansas Department of Human Services. Apply For Services
13
Arkansas Department of Human Services. The Community and Employment Support Waiver
14
eCFR. 42 CFR 431.221
15
Medicaid. Estate Recovery
16
Arkansas Department of Human Services. Medicaid Estate Recovery