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2. Home and Community-Based Services (HCBS) Waivers

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

Choosing the Program That is Right for You

Navigating the world of long-term care can be overwhelming, especially when trying to understand the different Medicaid programs available in Arkansas. To help demystify this complex topic, let’s break down the three main types of Long-Term Care (LTC) Medicaid programs in Arkansas: Institutional Medicaid, Home and Community-Based Services (HCBS) Waivers, and Program of All-Inclusive Care for the Elderly (PACE).

1. Institutional Medicaid

Institutional Medicaid, often referred to as Nursing Home Medicaid, provides coverage for seniors and disabled individuals who require a high level of care in a nursing home setting. This program helps cover all necessary medical care, including room and board, nursing services, personal care, therapy, and more.

Eligibility Requirements: To qualify, applicants must meet specific financial criteria, including income and asset limits. They must also require a nursing home level of care, as determined by a medical assessment.
Coverage: Institutional Medicaid helps to cover the cost of nursing home care, including medical and non-medical services, ensuring that residents receive comprehensive support.
Entitlement Program: This is an entitlement program, which means if you meet the requirements, then by law you are guaranteed to receive the benefits without a waiting period.

2. Home and Community-Based Services (HCBS) Waivers

The HCBS Waivers program is designed for individuals who need significant care but prefer to stay in their own homes or community settings rather than moving to a nursing home. Arkansas offers several HCBS Waivers, each tailored to meet the specific needs of different populations, including the elderly, those with physical disabilities, and individuals with intellectual or developmental disabilities.

Eligibility Requirements: Similar to Institutional Medicaid, applicants must meet financial criteria and require a level of care that would typically be provided in a nursing home.
Coverage: The HCBS Waivers cover a variety of services such as personal care, adult day care, respite care, home modifications, and case management, allowing participants to live more independently while still receiving the care they need.
Entitlement Program: This program is not an entitlement, which means that there are a limited number of enrollment spots available in most Waiver programs. After these spots are full, anyone applying for benefits will be placed on a waitlist. These lists will either be prioritized by greatest need or first-come first-serve basis depending on your state.

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

PACE is a comprehensive care program designed to help older adults remain in their homes and communities for as long as possible. It provides a wide range of medical and social services through an interdisciplinary team that coordinates and delivers all aspects of care.

Eligibility Requirements: To qualify for PACE, individuals must be 55 years or older, live in a PACE service area, meet the state’s nursing home level of care criteria, and be able to live safely in the community with the support of PACE services.
Coverage: PACE offers an all-inclusive service package, including primary and specialty medical care, prescription medications, hospital and nursing home care, transportation, social services, and home care, all coordinated by the PACE team.

Choosing the Program That is Right for You

Deciding which Medicaid program is right for you or your loved one depends on individual needs, preferences, and circumstances. If the highest level of care in a nursing home is necessary, Institutional Medicaid may be the best option. For those who wish to remain at home, the HCBS Waivers can provide essential support. And for comprehensive, coordinated care in the community, PACE offers a unique solution.

Understanding these three types of Long-Term Care Medicaid programs in Arkansas can help you make informed decisions and ensure that you or your loved ones receive the care and support needed for a better quality of life. If you have any questions or need assistance with the application process, don’t hesitate to reach out to one of our Benefits Specialists.

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