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Healthcare (Medicaid) Program | Eligibility and Enrollment

Overview

Healthcare reimburses healthcare providers for covered medical services provided to eligible needy individuals in certain categories. Eligibility is determined based on income, resources, Arkansas residency, and other requirements. Covered services also vary among categories. Categories are summarized below under the two headings of "Aged, Blind and Disabled" and "Children and Family".

Aged, Blind and Disabled

Individuals aged 65 and older who meet income, resource and other requirements are eligible for full Healthcare coverage.
 
Individuals who are determined blind or disabled based on Social Security Administration criteria who meet income, resource and other requirements are eligible for full Healthcare coverage.
 
Medicare Savings Program provides limited coverage to supplement Medicare recipients. Coverage varies based on income, ranging from payment of the Medicare premiums, deductibles and co-insurance for low-income individuals to paying only a portion of the Medicare Part B premium for individuals with higher incomes.
 Social Security Administration Offices

Long Term Services and Supports | More Information

Nursing Facility (Long Term Care) -  Individuals who are residents of nursing homes may qualify for Healthcare if the care in the facility is medically necessary and they meet income, resource and other criteria.

Living Choices (Assisted Living)- Individuals who are aged (aged 65 or older), or 21 years of age or over and blind or have a physical disability and who meets the income resources and other criteria.  Services are provided to eligible individuals to allow them to maintain their independence and dignity while receiving a high level of care and support.

ARChoices-  A Healthcare program that includes home and community-based services for adults age 21 through 64 with a physical disability OR age 65 and older AND who meet nursing facility functional needs criteria, income resource, and other criteria.
 
DDS Alternative Community Services- Individuals of any age who are determined to be developmentally disabled. Who would be eligible for Healthcare if they were in a nursing facility, but choose to remain at home.

PACE- A comprehensive health and social services program that provides and coordinates primary, preventive, acute, and LTSS for individuals in need of nursing facility care to individuals 55 years of age or older.  The individual must also meet the income, resource and other criteria.
 
Workers with Disablities program-  Provides full coverage to disabled individuals age 16 to 65 who are working. Individuals with lower income pay the normal Healthcare co-pays. Individuals with higher income pay higher co-pays.

Children and Family

Newborn- Provides coverage to children up to age 1 whose mothers were eligible for Healthcare provided by the State at the time of their births.  Children approved in the Newborn category are guaranteed Healthcare for the first year of life regardless of income changes that may occur during that first year.  Newborn category is a full range of Healthcare coverage

ARKids A- Provides coverage to children under age 19 with family income under 142% Federal Poverty Level for the applicable household size.  ARKids A provides full range of Healthcare services.

ARKids B (CHIP)- Provides coverage to otherwise uninsured children under age 19 with family income equal to or over 142% but under 211% of the Federal Poverty Level for the applicable household size.  CHIP(ARKids B) a more limited range of services with limited co-pays for some services.

TEFRA- Individuals age 18 or younger with disabilities that must meet the medical necessity requirement for institutional placement in a hospital, a skilled nursing facility, Intermediate Care Facilities for individuals with intellectual Disabilities (ICF/IID) or be at risk for future institutional placement.  Must also meet the income, resource and other criteria for eligibility.

Autism Waiver- Individuals age 18 months through seven (7) years who have a diagnosis of autism.  In addition to the diagnosis of autism, the waiver participant must meet the income, resource and other criteria.
 
Parent or Other Caretaker Relative- Adults who have related minor children in the home for whom they exercise care and responsibility who meet income and other requirements are eligible for full Healthcare coverage.

Full Pregnant Woman-  Women age 19 and above who are pregnant at time of application, who are at or below the Federal Poverty Income Limit for the applicable household size and who meet other requirements are eligible for full Healthcare coverage.
 
Limited Pregnant Women- Women age 19 and above who are pregnant at the time of application, who are at the income limit up to 200% of Federal Poverty Level may be eligible for limited coverage including: prenatal, delivery, postpartum and conditions which may complicate the pregnancy. Coverage continues through the pregnancy and until the end of the month that the 60th day postpartum falls.

Unborn Pregnant Woman- Non-citizen pregnant women who do not meet the alienage requirements for Healthcare and whose household income is at or below the applicable federal poverty limit for the appropriate household size may be eligible for limited coverage including: prenatal, delivery, postpartum and conditions which may complicate the pregnancy.  Coverage continues through the pregnancy and until the end of the month that the 60th day postpartum falls.
 
AR Works- Individuals ages 19 - 64 who meet income and other requirements are eligible for healthcare services either through a QHP or traditional Healthcare.

Emergency Healthcare Services for Aliens- Individuals who are considered Nonqualified aliens living in the U.S. or Qualified aliens living in the U.S. for less than five (5) years.  Healthcare benefits are available to pay for the cost of emergency services if they meet the financial, categorical, and other criteria.

 

Related Documents

Title Type Posted Date
TEFRA Autism Application PDF 09/18/2020
Quick Reference Medicaid Chart 2020 PDF 03/31/2020
Income Trust Form PDF 11/30/2018
Income Trust Fact Sheet PDF 11/30/2018
Medicare Savings Application PDF 11/30/2018
Medicare Savings Application - Spanish PDF 11/30/2018
Long Term Care Application (Spanish) PDF 06/13/2018
Long Term Care Application for Assistance PDF 06/13/2018
Medicaid Application Form | English PDF 02/05/2018
Your Guide To Medicaid Estate Recovery In Arkansas PDF 01/30/2018
Medicaid Application Form | Spanish PDF 01/29/2018
Medicaid Change Report​ PDF
Arkansas Department of Human Services
Arkansas Department of Human Services

Arkansas Department
of Human Services
(501) 682-1001

TTY: 1-800-285-1131 or dial 711 for Arkansas Relay Service

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