DHS

Contact Us

What does ARKids Pay?

ARKids A and B both cover a range of services to keep your kids health. The charts below have information about services, coverage limits, authorizations, and co-payments.

ARKids A coverage does not have any out of pocket costs.

Coverage for children in ARKids B will have an annual limit equal to five percent (5%) of the family’s annual gross income (the amount before taxes).

For example, if a family of four has an annual gross income of $40,000 then their out-of-pocket expense can’t be more than $2,000 ($40,000 x .05 = $2,000).

If you need more information, you can always call the ARKids hotline at 1-888-474-8275.

Apply now: https://access.arkansas.gov/

ARKids A
(copayment not required)

Program Coverage Limits Prior Authorization
Ambulance (emergency only) Medical necessity None
Ambulatory Surgical Center Medical necessity PCP referral
Chiropractor Medical necessity PCP referral
Dental Care (Orthodontia included) Medical necessity PA required for some procedures
Durable Medical Equipment Medical necessity PA required for some equipment
Emergency Room Services Medical necessity None
EPSDT Screens All per protocol PCP or ADH administered
Family Planning Family Planning services only None
Federally Qualified Health Center Medical necessity See Physician Service
Hearing Services Medical necessity PCP referral
Home Health Medical necessity PCP Rx required
Hospice Medical necessity Physician certification
Immunizations All per protocol PCP or ADH administered
Inpatient Hospital Medical necessity PA for stays of more than 4 days
Inpatient Psychiatric and Psychiatric Residential Treatment Facility Services Medical necessity PA required
Laboratory and X-Ray Medical necessity PCP referral
Medical Supplies Medical necessity PCP Rx required
Nurse Midwife Medical necessity None
Outpatient Mental and
Behavioral Health
Medical necessity PCP Rx required
Physician Services Medical necessity PCP referral to specialists. Patient must use PCP for access to all services,including the professional component of services rendered in inpatient settings.
Psychology Services Medical necessity Physician Rx required
Podiatry Medical necessity PCP referral
Prescription Drugs Medical necessity Prescription (must use generic and rebate mfg. when available)
Rural Health Clinic Medical necessity See Physician Services
Therapy Services —
Speech, Occupational, and Physical
Medical necessity PCP referral and prescription required
Transportation For Medicaid-covered
services only
None
Vision Care 1 eye exam and
1 pair of eyeglasses per 12 months
None

Apply now: https://access.arkansas.gov/

Jump to Top

ARKids B
(copayment required)

Program Coverage Limits Prior Authorization Copayment*
Ambulance (emergency only) Medical necessity None $10 per trip
Ambulatory Surgical Center Medical necessity PCP referral $10 per visit
Chiropractor Medical necessity PCP referral $10 per visit
Dental Care (Orthodontia included) Medical necessity Some restorative services $10 per visit
Durable Medical Equipment $500 per year PCP prescription plus referral 20% per DME item
Emergency Room Services Medical necessity None $10 per visit
Family Planning Family Planning
services only
None None
Federally Qualified Health Center Medical necessity None $10 per visit
Home Health Medical necessity PCP referral (limited to 10 visits per State Fiscal Year) $10 per visit
Immunizations All per protocol PCP or ADH administered None
Inpatient Hospital Medical necessity Prior approval for stays of more than 4 days 10% of first inpatient day
Inpatient Psychiatric and Psychiatric Residential Treatment Facility Services Medical necessity Prior approval required 10% of first inpatient day
Laboratory and X-Ray Medical necessity PCP referral $10 per visit
Medical Supplies Medical necessity PCP prescriptions(limited to $125 per month, with extension based on medical necessity) None
Nurse Midwife Medical necessity None $10 per visit
Outpatient Mental and Behavioral Health Medical necessity PCP referral $10 per visit
Physician Services Medical necessity PCP referral to specialists. Patient must use PCP for access to all services,including the professional component of services rendered in inpatient settings. $10 per visit
Podiatry Medical necessity PCP referral $10 per visit
Prescription Drugs Medical necessity Prescription $5 per prescription(must use generic and rebate mfg. when available)
Preventive Health Screening All per protocol PCP or ADH administered None
Rural Health Clinic Medical necessity None $10 per visit
Therapy Services, Speech, Occupational, and Physical Medical necessity PCP referral $10 per visit
Vision Care 1 eye exam and 1 pair of eyeglasses per 12 months Routine exams and diagnostic $10 per visit

Apply now: https://access.arkansas.gov/

Jump to Top

 

Arkansas Department
of Human Services
(501) 682-1001

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

Google Map | Contact Us