Living Choices Arkansas: The Assisted Living Medicaid Waiver Explained

Your parent needs more supervision than you can safely provide at home, but a nursing home feels premature — and costs roughly $6,400 per month in Arkansas. The Living Choices Assisted Living waiver sits between those two extremes: it funds care services inside a licensed assisted living facility through Medicaid.

Here's what it covers, how it differs from the ARChoices in Homecare waiver, and whether your parent qualifies.

What Living Choices Covers — and What It Doesn't

Living Choices is a Medicaid waiver that pays for care services delivered within a licensed Level II Assisted Living Facility (ALF) in Arkansas. The waiver covers:

• Personal care assistance (help with bathing, dressing, grooming, toileting)
• Medication management and administration
• Skilled nursing services available on-site
• Social and recreational activities
• Care coordination

The critical distinction: Living Choices does not cover room and board. The resident or their family must pay for the room, meals, and basic housing costs separately. The waiver only covers the care-service layer on top of the housing. This out-of-pocket room and board cost typically runs $1,500 to $2,500 per month depending on the facility and location, while the waiver covers the clinical and personal care services that push private-pay assisted living into the $3,376 to $4,433 per month range across Arkansas.

Living Choices vs. ARChoices: Which Waiver Fits?

Arkansas has two primary Medicaid waivers for older adults, and they serve different living situations:

ARChoices in Homecare is for people staying in their own home or a family member's home. It funds attendant care, adult day services, respite, home-delivered meals, environmental modifications, and PERS equipment — everything needed to age in place safely.

Living Choices is for people moving into a licensed Level II ALF. It funds the care services within that facility but not the housing itself.

Both waivers require an intermediate Nursing Facility Level of Care, the same $2,982 monthly income limit (2026), and the same $2,000 asset limit for a single applicant. Both use the ARIA assessment conducted by Optum to determine functional eligibility.

The key decision point: can your parent safely remain at home with community-based supports, or do they need the 24/7 supervised environment of an assisted living facility? If the answer is home-based care, ARChoices is the pathway. If they need facility-level supervision, Living Choices covers the care costs while the family handles room and board.

Eligibility Requirements

The requirements mirror ARChoices with one additional element:

• Age: 65 or older (or 21-64 with a physical disability)
• Functional: Must meet intermediate Nursing Facility Level of Care as determined by the ARIA assessment
• Financial: Gross monthly income at or below $2,982; countable assets at or below $2,000 (single applicant). A Miller Trust can resolve over-income situations.
• Facility: Must reside in a state-licensed Level II Assisted Living Facility

The Living Choices waiver also has enrollment caps. When full, applicants join a waitlist. Priority routing applies if the applicant has been in a nursing home for at least six months (compared to 90 days for ARChoices priority routing).

How to Apply

1. Contact your regional Area Agency on Aging or call the Choices in Living Resource Center at 1-866-801-3435 to discuss whether assisted living or home-based care is the better fit.

2. Tour Level II ALFs in your parent's area. Not all assisted living facilities in Arkansas participate in the Living Choices waiver — you need a facility that holds a Level II license and accepts Medicaid waiver residents. Ask directly about Medicaid acceptance before committing.

3. Submit Form DCO-0004 to the local DHS Division of County Operations. On Page 1, check "Assisted Living Assistance" (not the ARChoices box). Include the standard documentation: photo IDs, Social Security cards, three months of financial statements, and Miller Trust documents if applicable.

4. Complete the ARIA assessment through Optum. The process is identical to the ARChoices assessment.

When Home Care Is the Better Path

Many families explore Living Choices because they assume home care isn't enough. But the ARChoices waiver covers a surprisingly comprehensive set of services: attendant care hours for daily assistance, adult day programs for daytime supervision, respite care for caregiver relief, home modifications for safety, and emergency response systems.

If the primary concern is that you can't be there 24/7, the combination of ARChoices attendant care plus adult day services plus PERS monitoring often provides sufficient coverage — without the room and board cost burden of assisted living.

The Arkansas Home Care Navigation Guide helps families compare both pathways side by side, with cost worksheets, eligibility flowcharts, and provider vetting checklists for both home-based and facility-based care options.

See more Arkansas guides →