How to Apply for Arkansas Medicaid for Dementia Care: Step-by-Step Process

Applying for Medicaid in Arkansas to cover dementia care isn't a single form — it's a coordinated process involving two separate applications, a clinical assessment, and potentially setting up a legal trust structure. Most families don't realize they're submitting to multiple agencies simultaneously until they're already deep in the process.

Here's the complete sequence, in the order it should happen.

Step 1: Secure Legal Authority First

Before you sign contracts or trust documents on your parent's behalf, confirm that you have accepted legal authority. If your parent still has cognitive capacity, get a Durable Financial Power of Attorney acknowledged before a notary and a Healthcare Power of Attorney notarized or signed by two adult witnesses. If capacity is already lost, you may need court-supervised adult guardianship or another accepted authorization.

Do not skip this step. Confirm with DHS what authorization it requires when a family member signs or communicates for the applicant.

Step 2: Schedule the ARIA Assessment

Contact the Choices in Living Resource Center at 1-866-801-3435 or your regional Area Agency on Aging. Submit a Personal Care Referral Form to initiate the Arkansas Independent Assessment (ARIA).

An independent registered nurse will conduct the ARIA in your parent's home, using a standardized evaluation with over 300 questions covering physical limitations, daily living ability, and cognitive impairment. The assessment determines whether your parent meets the nursing-facility level of care required for waiver programs.

Tier 2 supports ARChoices in Homecare or Living Choices when the applicant also meets the financial and other eligibility rules. For dementia, this means a documented diagnosis plus constant supervision because of health or safety risks (such as wandering, medication mismanagement, or other hazards). Tier 3 indicates skilled nursing care and nursing-facility placement rather than home-based waiver eligibility.

The assessment is typically scheduled within 14 to 30 days of the referral. It's free.

Preparation tip: Don't coach your parent to perform differently from their actual daily functioning. Keep a daily care log for at least two weeks before the assessment and describe what happens every day. If they wander at night, can't manage medications, or need hands-on help with bathing and dressing, make sure those details are clearly communicated to the evaluator.

Step 3: Handle the Income and Asset Problem

Before submitting the financial application, you need to know whether your parent's numbers work.

Income check: If gross monthly income exceeds $2,982, your parent needs a Miller Trust (Qualified Income Trust). This is a written, irrevocable trust with a dedicated checking account at an Arkansas bank. All income (or the excess above the cap) flows through this account monthly and is disbursed in a strict order: $40 personal needs allowance, spousal maintenance (if applicable), insurance premiums, then facility payment. Who may establish and sign it should be confirmed for the applicant's specific case with an elder-law attorney.

The Miller Trust must be executed, the bank account opened, and income deposited in the same month as the Medicaid application. Retroactive coverage isn't available before the trust's operational date.

Asset check: Countable assets must be at or below $2,000 for a single applicant. Arkansas counts IRAs, 401(k)s, checking/savings accounts, CDs, stocks, bonds, and real estate beyond the primary home. The home, one vehicle, and personal belongings may receive exempt treatment under DHS rules; discuss a prepaid irrevocable burial contract as a possible compliant spend-down option.

If assets exceed $2,000, discuss possible compliant spend-down options such as paying existing debts, purchasing a prepaid irrevocable burial contract, or making necessary home modifications. Do not give assets away or transfer property below fair market value without checking an applicable exemption — a transfer within 60 months can trigger a look-back penalty.

Step 4: Submit the Dual Application

Two separate submissions happen in parallel:

Financial application: Submit Form DCO-0004 (Application for Healthcare) to the county DHS Division of County Operations office. This form establishes financial eligibility. Bring:

• Completed application form
• 60 months of bank statements for every account
• Social Security award letters and pension statements (proof of all gross income)
• Medicare card copies
• Health insurance premium statements
• Signed Miller Trust agreement (if applicable)
• Proof of all asset transfers in the past 60 months

Medical determination: Your parent's primary physician must submit Form DMS-703 (Medical Need Determination) directly to the Office of Long Term Care. This certifies clinical necessity. If your parent is entering a facility, the facility completes Form DMS-787 (PASRR screening) as well.

Step 5: Wait (and Plan)

DHS has up to 45 days to issue a determination. During this period:

• If your parent needs immediate placement, you'll be paying private rates until Medicaid kicks in
• If waiver slots are full (the Living Choices Waiver is capped at 1,725 statewide), your parent goes on a centralized waitlist with priority based on clinical criteria, not chronological order
• Nursing facility Medicaid is an entitlement — no waitlist for financially and medically eligible applicants

Use the waiting period to tour facilities, verify licensing (use the OLTC Facility Search tool), and prepare for the admission process.

Step 6: Verify and Sign

Once approved, DHS issues an eligibility determination. If your parent is entering a memory care facility under the Living Choices Waiver, remember that the waiver covers services only — room and board is private pay ($2,500 to $5,000+/month). Sign the admission agreement and verify the facility's ASCU certification and compliance history.

Common Application Mistakes

• Applying before the Miller Trust is active — the trust must be funded in the same month as the application
• Missing the 60-month documentation — DHS will request full bank statements; gaps or missing accounts delay the determination
• Not listing all income sources — VA benefits, retirement distributions, and investment income all count
• Assuming the online Access Arkansas portal is the full application — it's a submission interface, not a guided process. You still need all supporting documentation

The Arkansas Dementia & Memory Care Guide includes a complete application packet checklist, ARIA preparation worksheet, and Miller Trust setup instructions — everything organized in the order you need it, with the specific Arkansas forms and contacts for each step.

See more Arkansas guides →