When an Arkansas nursing home resident becomes Medicaid-eligible, their care will be fully covered by the state long-term care Medicaid program, run by the Department of Human Services. However, most of their monthly income will be paid to the nursing home to assist with their health care. This includes Social Security income as well as any pensions. This payment can be thought of as a co-pay by the Medicaid recipient to contribute to the cost of their long-term care services. When Social Security payments are raised yearly for the cost-of-living adjustment, the co-pay amount increases accordingly.
Medicaid recipients are permitted to keep a small amount of their monthly income, known as a personal needs allowance (PNA). Arkansas’s PNA amount is $40.00. The PNA can be used to purchase items or services the nursing facility does not provide, such as snacks, haircuts, personal care items, and other personal expenses. Arkansas Medicaid recipients are also able to pay Medicare premiums and other healthcare premiums out of their income prior to paying the nursing home. State Medicaid recipients must keep their assets under a certain amount, and the PNA is no exception. If a Medicaid beneficiary saves up their PNA so as to exceed the asset limit, they must spend down the amount to avoid incurring a penalty.
When a Medicaid beneficiary is married and their spouse remains in the community, the spouse is permitted to keep their own income. In some cases, if the community spouse earns under a certain amount, they are able to keep a portion of the Medicaid recipient’s income under the Community Spouse Resource Allowance, also known as a Monthly Maintenance Needs Allowance. This ensures that the spouse does not become impoverished as their family member receives care.
It should be noted that these rules and regulations only apply to Medicaid services at the nursing home level of care. Other Arkansas Medicaid services, such as home and community-based services (HCBS) and skilled caregiving in assisted living facilities are covered under separate Medicaid waivers.