Arkansas Medicaid Long Term Care Eligibility

Arkansas Medicaid Long Term Care Programs

arkansas-medicaid
In Arkansas, even if you are receiving Medicaid benefits you will have to reapply for long term care Medicaid. Listed below are the four main types of long term care available in Arkansas. Each one has different requirements and offers different services.

Arkansas is an income cap state, meaning that in order to be eligible for Medicaid long term care benefits there is a hard income limit. Non income cap states allow applicants to spend down money for their care, whereas income cap states require the amount to be no higher than their limit at time of application.

Types of Care:

Program of All-Inclusive Care for the Elderly (PACE):

PACE is a program for people 55 and older who have been certified by the state for nursing home care. PACE allows them to live as independently as they can. PACE provides all needed services to those enrolled in the program, in all health care settings, 24 hours a day, every day of the year.

Nursing Home Care

Medicaid certified nursing homes are covered by Medicaid. For Medicaid to pay for nursing home care, a doctor must prescribe it. You or a representative will need to apply for nursing home care in the Department of Human Services office in the county where the nursing home is located. While in a nursing home, co-payments for medical care and prescription drugs are covered.

LivingChoices Assisted Living

LivingChoices assisted living pays for housing to people who need extra care and supervision. For people who are healthy enough to remain independent, LivingChoices is the program for them. Specially licensed assisted living facilities provide care and housing. Staff members are there when the residents need them, but try to let them live as independently as possible. To qualify for LivingChoices a person must:

  • be aged 65 or older OR
  • be aged 21 or older and declared disabled by Social Security/SSI or the DHS Medical Review Team

  • meet income and asset limits (listed below)
  • meet requirements for nursing home admission at the “intermediate” level of care
  • have a medical need and receive one or more of the services provided

ElderChoices

arkansas-long-term-care ElderChoices provides home-health services to people aged 65 years or older who need special care, but wish to remain at home. If the person needs a more skilled level of care, they won’t qualify. A nurse or counselor reviews each patient file and prepares the best care plan for that individual. The recipient’s personal doctor must also approve the care plan.

Other Qualifications:

INCOME: Includes Social Security, Veteran’s benefits, railroad retirement, pensions, annuities, dividends, rental income, withdrawals from IRA, etc. The monthly income cap is $2,199. Income of spouse and children not counted. Persons applying for the Assisted Living waiver may establish eligibility through an income trust. There is a personal needs allowance of $40.00 per month that is not factored into the countable income.

  • The institutionalized spouse’s income may be added to the community spouse’s income if the community spouse’s income falls below $1,967. In certain conditions the community spouse may have income raised to a maximum of $2,981.

RESOURCES: Resources include real property, cash, checking and/or savings accounts, certificates of deposit, promissory notes, mortgages, stocks, mutual fund shares, bonds, trusts, automobiles, life insurance policies with a cash value, IRA’s, Revocable burial funds, etc. The state looks back 60 months to see that resources meet, or were spent down, in a way that is accordant with their financial restrictions. Selling an asset below fair market value will result in a period of ineligibility determined by the worth of the asset.

Exempt Resources: Your home if the equity interest of the home is less than or equal to $552,000. The home is also exempt if your spouse, your child under age 21, or your blind or disabled child resides in the home. One car is exempt. Burial spaces for any member of your immediate family and prepaid burial plans are exempt.

  • The resource limit for the covered individual is $2,000. If there is a spouse living at home, special protection is available based on the total resources of the couple. In 2015, if the community spouse’s total resources fall below the amount of $23,844 then they can retain some of the institutionalized spouse’s resources. The maximum amount of resources that may be kept by the community spouse is $119,220.

NOTE: Individuals who exceed these requirements might still be able to qualify by creating what is known as a qualified income trust. Contact your county Department of Human Services office for more information.

Arkansas long term care insurance partnership:

This is a program between the state and private insurance companies. Partnership policies protect assets by matching dollar for dollar what policy holders pay into their policies. For example, if you bought a Partnership Policy with a maximum benefit payout of $155,000 then you are able to protect $155,000 of your assets. For married couples each spouse needs to purchase their own policy. Once the $155,000 worth of long term care coverage is used you may apply for Medicaid with $155,000 worth of assets exempted.

Further Reading:

1-800-482-8988 for information on eligibility and enrollment

1-800-482-5431 for information on services covered by Medicaid

Long Term Care application: http://humanservices.arkansas.gov/dco/dco_docs/DCO-777.pdf

LivingChoices Assisted Living Waiver information: http://www.daas.ar.gov/assistedlivingchoices_waiver.html