Overview
The Health Care (Medicaid) program helps you, if you are eligible, to pay some of your medical bills. Eligibility is determined based on income, resources, Arkansas residency, and other requirements. Covered services also vary among Health Care categories. The program offers coverage for individuals of all ages, with some special categories for those who are blind, disabled, pregnant, and those who need long term services in a nursing facility or in community-based settings.
Health Care reimburses health care providers for covered medical services provided to eligible individuals. 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 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 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.
Long Term Services and Supports | More Information
Nursing Facility (Long Term Care) – This program provides coverage for individuals who are residents of nursing homes if the care in the facility is medically necessary and they meet income, resource, and other criteria.
Living Choices (Assisted Living) – This program provides coverage in an assisted living facility for 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, resource, 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 – This program provides coverage for home and community-based services for adults age 21 through 64 with a physical disability OR age 65 and older AND who need help with an activity of daily living, meet nursing facility functional needs criteria, income, resource, and other criteria.
Community and Employment Supports – This program serves individuals of any age who are determined to be developmentally or intellectually disabled, and who would be eligible for coverage if they were in a nursing facility, but choose to remain at home.
PACE – Program of All-Inclusive Care for the Elderly- This program provides a comprehensive health and social services to coordinates primary, preventive, acute, and long term services and support for individuals in need of nursing facility care who are 55 years of age or older. The individual must also meet income, resource, and other criteria.
Workers with Disabilities – This program provides full coverage to disabled individuals age 16 to 65 who are working. Individuals with lower income pay the normal Health Care co-pays. Individuals with higher income pay higher co-pays.
Children and Family
ARHOME – This program is for people ages 19 – 64 who meet income and other requirements. Coverage is provided either through an individual qualified health insurance plan or traditional fee-for-service Medicaid.
ARKids First – This program for is for children and teens. It is divided into two categories. ARKids A provides a full range of health care services to children under age 19 with family income under 142% Federal Poverty Level. ARKids B 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. Arkids B provides a more limited range of services with limited co-pays for some services.
Newborn – This program provides full coverage to children up to age 1 whose mothers were eligible for Health Care provided by the State at the time of their births. Children approved in the Newborn category are guaranteed coverage for the first year of life regardless of income changes that may occur during that first year.
TEFRA – This is a home and community-based program for individuals age 18 or younger with disabilities that 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 are at risk for future institutional placement. Individuals must also meet the income, resource, and other criteria for eligibility.
Autism Waiver – This program is for 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 – This program provides full coverage to adults who have related minor children in the home for whom they exercise care and responsibility and meet income and other requirements.
Full Pregnant Woman – This program provides full coverage for women age 19 and above who are pregnant at the time of application, and meet income and other criteria.
Unborn Pregnant Woman – This program is for non-citizen pregnant women who meet income requirements but do not meet citizenship requirements. Limited coverage includes: prenatal, delivery, postpartum and conditions which may complicate the pregnancy. Coverage continues through the pregnancy and until the end of the month of the 60th day postpartum.
Emergency Health Care Services for Aliens – This program is for 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. Coverage is available for fixed periods of time necessary for acute onset emergency services if the individual meets the financial, categorical, and other criteria.
Related Documents
| Title | Type | Posted Date |
|---|---|---|
| Medicaid Change Report | ||
| Medicare Savings Application | 9/2022 | |
| Medicare Savings Application – Spanish | 9/2022 | |
| Medicaid Quick Reference Guide | 3/2024 |
