Click here for a printable version of this guide

Aged, Blind and Disabled Categories (AABD)

SSI

DHS does not determine eligibility for this category. Individuals who qualify for SSI automatically receive Health Care.

*Full Benefit

Income Limit

• Individual: $994
• Couple: $1491

Income Disregards

• $20 General exclusion applied to unearned income first
• $65.00 + 1/2 of remainder of monthly earned income

Resource Limit

• Individual: $2000
• Couple: $3000

Excluded From Resources

• A home
• 1 vehicle excluded
• A 2nd vehicle can be excluded if it is essential to the means of self-support of the individual or couple
• Some non-home income producing properties
• Life insurance without a cash surrender value
• Burial spaces
• Irrevocable burial arrangements
• Personal effects (ex. antiques)

Counted Toward Resource Limit

• Cash on hand in bank (less income received that month)
• Stocks and bonds
• Real property other than the home
• Personal property (ex. non-excludable car, trailers, boats, etc.)
• Life insurance with a cash surrender face is over $1500
• Revocable burial funds (less $1500 per spouse if $1500 exclusion is not used through application of other burial arrangements)

Other

• Elderly, blind, or disabled. Elderly is defined as age 65 or older
• SSI Recipient
• Retroactive eligibility based on information from SSA

AABD Adult Spend-Down

*Full Benefit

Income Limit

• Individual: $108.33
  • If income exceeds the limit, deduct medical bills
• Couple: $216.66
  • If income exceeds the limit, deduct medical bills

Income Disregards

• Same as SSI

Resource Limit

• Individual: Same as SSI
• Couple: Same as SSI

Excluded From Resources

• Same as SSI

Counted Toward Resource Limit

• Same as SSI

Other

• Must re-enroll for spend-down every 3 months. The Spend-Down will be set up for a fixed period, not to exceed 3 months.

PICKLE (COLA)

*Full Benefit

Income Limit

• Individual: $994
• Couple: 1491

Income Disregards

• Same as SSI
  • *Deduct all COLAs received since the los of SSI

Resource Limit

• Individual: Same as SSI
• Couple: Same as SSI

Excluded From Resources

• Same as SSI

Counted Toward Resource Limit

• Same as SSI

Other

• Current recipient of SSA
• Previously entitled to SSA and SSI concurrently
• Lost SSI for any reason and would be SSI eligible with deduction of all COLAs received since loss of SSI
• Retroactive eligibility based on information from SSA

Disabled Adult Child (DAC)

*Full Benefit

Income Limit

• Individual: $994
• Couple: $1491

Income Disregards

• Same as SSI
  • *Deduct 100% of SSA income that is a child benefit.

Resource Limit

• Individual: $2000
• Couple: $3000

Excluded From Resources

• Same as SSI

Counted Toward Resource Limit

• Same as SSI

Other

• Age 18 or older
• Became disabled or blind before age 22
• Lost SSI due to DAC entitlement or DAC increase
• Retroactive eligibility based on information from SSA

Widows/Widowers and Surviving Divorced Spouses with Disability (OBRA ’90)

*Full Benefit

Income Limit

• Individual: $994
• Couple: $1491

Income Disregards

• Same as SSI
  • *Deduct all SSA income

Resource Limit

• Individual: $2000
• Couple: 3000

Excluded From Resources

• Same as SSI

Counted Toward Resource Limit

• Same as SSI

Other

• Current recipient of SSA Widow/Widower or Disabled Surviving Divorced Spouse benefits
• Not entitled to Medicare
• Lost SSI due to entitlement of SSA
• Retroactive eligibility based on information from SSA

Nursing Facility, Assisted Living, ARChoices & DDS Waiver

*Full Benefit

Income Limit

• Individual: $2,982 (all applicants are treated as individuals for income purposes)
• Couple: $2,982 (all applicants are treated as individuals for income purposes)

Income Disregards

• Income of spouse and children not counted

Resource Limit

• Individual: $2000
• Couple: $3000

Excluded From Resources

• Same as SSI, except when one spouse is institutionalized, the other may be able to keep a portion of the resources up to $162,660 based on a formula

Counted Toward Resource Limit

• Same as SSI

Other

• Functional eligibility
• Categorical eligibility
• Institutional status
• Cost effective
• Level of Care assessment
• ARChoices, Assisted Living Facility, and DDS – No retroctive coverage

Medicare Savings Program

*QMB, SMB, QI-1 and QDWI (Limited Benefit)

ARSeniors (Provides Full Medicaid)

• Individual income limit: $1064.00
• Couple income limit: $1442.67

QMB (Pays Part B premiums, deductibles & copays)

• Individual income limit: $1330.00
• Couple income limit: $1803.33

SMB (Pays Part B premium)

• Individual income limit: $1596.00
• Couple income limit: $2164.00

QI-1 (Pays Part B premium)

• Individual income limit: $1795.50
• Couple income limit: $2434.50

QDWI (Pays Part A premium)

• Individual income limit: $2660.00
• Couple income limit: $3606.67

Income Disregards

• Same as SSI

Resource Limit

• ARSeniors, QMB, SMB, and QI-1
  • Individual: $9,950.00
  • Couple: $14,910.00
• QDWI Resource Limit
  • Individual: $4,000.00
  • Couple: $6,000.00

Excluded From Resources

• Same as SSI

Counted Toward Resource Limit

• Medicare beneficiary
• Age 65 or older, blind or disabled
• ARSeniors is only for individuals aged 65 or older. Retroactive coverage three (3) months prior to application date
• QMB – not eligible for retroactive coverage
• SMB/QI-1 – Retroactive coverage can be up to 3 months, but QI-1 cannot go prior to January 1 in the year of application

PACE

*Full Benefit

Income Limit

• Individual: $2,982 (all applicants are treated as individuals for income purposes
• Couple: $2,982 (all applicants are treatd as individuals for income purposes)

Income Disregards

• Income of Spouse and Children not counted

Resource Limit

• Individual: $2000
• Couple: $3000

Excluded From Resources

• Same as SSI, except when one spouse is institutionalized and the other may be able to keep a portion of the resources up to $162,660 based on a formula.

Counted Toward Resource Limit

• Same as SSI

Other

• 55 years old or older
• Live in PACE area
• Functional eligibility
• Cost of care contribution
• Not eligible for retroactive coverage

Workers with Disabilities

Income Limit

• Individual: No earned limit. Unearned income must be at or under the individual SSI limit. Total income will be used to determine cost-sharing amount.
• Couple: No earned limit. Unearned income must be at or under the individual SSI limit. Total income will be used to determine cost-sharing amount.

Income Disregards

• N/A

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Meet disability criteria
• Eligible for SSI except for earned income
• Working (as defined in policy)
• Retroactive coverage 3 months prior to application date

TEFRA

*Full Benefit

Income Limit

• Individual: $2,982 (Only child’s income is counted)
• Couple: $2,982 (Only child’s income is counted)

Income Disregards

• N/A

Resource Limit

• Individual: $2000 (Only child’s resources are counted)
• Couple: $2000 (Only child’s resources are counted)

Excluded From Resources

• Same as SSI

Counted Toward Resource Limit

• Same as SSI

Other

• Functional eligibility
• Children who would otherwise be institutionalized
• Custodial parents with taxable income at or above 150% of the FPL or over $25,000 in annual income, whichever is more, must pay ap premium based on income
• Retroactive coverage 3 months prior to application date

Autism

*Full Benefit

Income Limit

• Individual: $2000 (Only child’s resources are counted)
• Couple: $2,982 (Only child’s income is counted)

Income Disregards

• N/A

Resource Limit

• Individual: $2000 (Only child’s resources are counted)
• Couple: $2000 (Only child’s resources are counted)

Excluded From Resources

• Same as SSi

Counted Toward Resource Limit

• Same as SSI

Other

• Functional eligibility
• Autism diagnosis
• Disability determination
• Must apply and be approved by 5th birthday.
• Age restricion of 18 months – 8th birthday.
• No retroactive coverage

Families and Individuals Group (MAGI)

ARKids A

*Full Benefit

Income Limit

142% of FPL

• Family Size 1 – Income: $1,888.60
• Family Size 2 – Income: $2,560.73
• Family Size 3 – Income: $3,232.87
• Family Size 4 – Income: $3,905.00
• Family Size 5 – Income: $4,577.13

Add $672.13 for each additional member

Earned Income Deductions

147% of FPL

Additional 5% Income Disregard if child has insurance

• Family Size 1 – Income: $1,955.10
• Family Size 2 – Income: $2,650.90
• Family Size 3 – Income: $3,346.70
• Family Size 4 – Income: $4,042.50
• Family Size 5 – Income: $4,738.30

Add $695.80 for each additional member

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Children under age 19 yrs. old
• Relationship/Living arrangement criteria
• Eligible for additional 5% Income Disregard if needed for eligibility and child has insurance
• Retroactive coverage can begin 3 months prior to application date
• PCP assignment required
• 12-month continuous eligibility

ARKids B

*Limited Benefit

Income Limit

211% of FPL

• Family Size 1 – Income: $2,806.30
• Family Size 2 – Income: $3,805.03
• Family Size 3 – Income: $4,803.77
• Family Size 4 – Income: $5,802.50
• Family Size 5 – Income: $6,801.23

Add $998.73 for each additional member

Earned Income Deductions

216% of FPL

Additional 5% Income Disregard if needed

• Family Size 1 – Income: $2,872.80
• Family Size 2 – Income: $3,895.20
• Family Size 3 – Income: $4,917.60
• Family Size 4 – Income: $5,940.00
• Family Size 5 – Income: $6,942.40

Add $1022.40 for each additional member

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Children under age 29 yrs. old
• Relationship/Living arrangement criteria
• Eligible for additional 5% Income Disregard if needed for eligibility
• Retroactive coverage can begin 3 months prior to application date
• Copays required
• PCP assignment
• 12-month continuous eligibility

Pregnant Women

*Full Benefit

Income Limit

209% of FPL

• Family Size 1 – Income: $2,779.70
• Family Size 2 – Income: $3,768.97
• Family Size 3 – Income: $4,758.23
• Family Size 4 – Income: $5,747.50
• Family Size 5 – Income: $6,736.77

Add $989.27 for each additional member

Earned Income Deductions

214% of FPL

Additional 5% Income Disregard if needed

• Family Size 1 – Income: $2,846.20
• Family Size 2 – Income: $3,859.13
• Family Size 3 – Income: $4,872.07
• Family Size 4 – Income: $5,885.00
• Family Size 5 – Income: $6,897.93

Add $1012.93 for each additional member

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Pregnant
• Number of expected babies are included in the household size
• Retroactive coverage is determined by the current PW eligibility determination and should have alleged medical expenses for the retro period
• Coverage ends at 60th day post-partum

Unborn Child

*Limited Benefit

Income Limit

209% of FPL

• Family Size 1 – Income: $2,779.70
• Family Size 2 – Income: $3,768.97
• Family Size 3 – Income: $4,758.23
• Family Size 4 – Income: $5,747.50
• Family Size 5 – Income: $6,736.77

Add $989.27 for each additional member

Earned Income Deductions

214% of FPL

Additional 5% Income Disregard if needed

• Family Size 1 – Income: $2,846.20
• Family Size 2 – Income: $3,859.13
• Family Size 3 – Income: $4,872.07
• Family Size 4 – Income: $5,885.00
• Family Size 5 – Income: $6,897.93

Add $1012.93 for each additional member

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Pregnant
• Number of expected babies are included in the household size
• Retroactive coverage is determined by the current PW eligibility determination and should have alleged medical expenses for the retro period
• Coverage ends at 60th day post-partum

Presumptive Eligibility Pregnant Woman (PE-PW)

*Limited Benefit

Income Limit

209% of FPL

• Family Size 1 – Income: $2,779.70
• Family Size 2 – Income: $3,768.97
• Family Size 3 – Income: $4,758.23
• Family Size 4 – Income: $5,747.50
• Family Size 5 – Income: $6,736.77

Add $989.27 for each additional member

Earned Income Deductions

214% of FPL

Additional 5% Income Disregard if needed

• Family Size 1 – Income: $2,846.20
• Family Size 2 – Income: $3,859.13
• Family Size 3 – Income: $4,872.07
• Family Size 4 – Income: $5,885.00
• Family Size 5 – Income: $6,897.93

Add $1012.93 for each additional member

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Pregnant
• No other active Health Care coverage
• Self-Attested Information only
• Number of expected babies are included in the household size
• Start date will be date of determination
• End date will be date of final determination of a full category

Parents/Caretaker Relatives

*Full Benefit

Income Limit

209% of FPL

• Family Size 1 – Income: $124.00
• Family Size 2 – Income: $220.00
• Family Size 3 – Income: $276.00
• Family Size 4 – Income: $334.00
• Family Size 5 – Income: $388.00
• Family Size 6 – Income: $448.00
• Family Size 7 – Income: $505.00
• Family Size 8 – Income: $561.00
• Family Size 9> – Income: $618.00

Earned Income Deductions

• No Income Disregards

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Must have a child age 18 in the home
• Deprivation does not have to exist
• Retroactive coverage can begin 3 months prior to application date

ARHOME Program (Adult Expansion Group)

*Full Benefit

Income Limit

133% of FPL

• Family Size 1 – Income: $1,768.90
• Family Size 2 – Income: $2,398.43
• Family Size 3 – Income: $3,027.97
• Family Size 4 – Income: $3,657.50
• Family Size 5 – Income: $4,287.03

Add $629.53 for each additional member

Earned Income Deductions

138% of FPL

Additional 5% Income Disregard if needed

• Family Size 1 – Income: $1,835.40
• Family Size 2 – Income: $2,488.60
• Family Size 3 – Income: $3,141.80
• Family Size 4 – Income: $3,795.00
• Family Size 5 – Income: $4,448.20

Add $653.20 for each additional member

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Must be between ages 19-64
• Cannot be pregnant at time of application
• Not eligible for or enrolled in Medicare
• Cannot be eligible for Parent/Caretaker Relative
• Eligible for additional 5% Income Disregard if needed for eligibility
• Retroactive coverage 30 days prior to application dates

Former Foster Care

*Full Benefit

Income Limit

• No Income Limit

Earned Income Deductions

• No Income Disregards

Resource Limit

• No Resource Limit

Excluded From Resources

• N/A

Counted Toward Resource Limit

• N/A

Other

• Must have aged out of the Arkansas Foster Care Program between the ages of 19 through 21
• If aged out of foster care in another state, must have reached the age of 18 on or after Januar 1, 2023
• Retroactive coverage can begin up to 3 months prior to application
• 12-month continuous eligibility for recipients under 19

Non-MAGI Families

*Full Benefi

Spend Down

• (a) Pregnant Women
• (b) Under-18 (U-18)
• (c) Unemployed Parent
• (d) AFDC related

Income Limit

• Family Size 1 – Income: $108.33
• Family Size 2 – Income: $216.66
• Family Size 3 – Income: $275.00
• Family Size 4 – Income: $333.33

Add $58.33 for each additional member

Deduct outstanding medical bills if income exceeds limit for household size

Earned Income Deductions

• Deduct $90 for work-related expense
• Deduct actual childcare expenses up to $200 a month for a child under age 2 or $175 a month for a child aged 2 or older

Resource Limit

• Family Size 1 – Income: $2000
• Family Size 2 – Income: $3000
• Family Size 3 – Income: $3100
• Family Size 4 – Income: $3200

Add $100 for each additional member

Excluded From Resources

• A home
• Household and personal goods
• Student loans and grants
• Other bonafide loans
• One burial plot per family member

Counted Toward Resource Limit

• Cash on hand or in the bank (less income received that month)
• Stocks and bonds
• Accessible trust funds
• Cash surrender value of life insurance policies
• U.S. Savings Bonds
• Other personal property
• Equity value of more than $1500 is counted for one car. Full equity value is counted for additional cars

Other

• (a) Pregnant Women only
• (b) Under-18: Children under 18 years only
• (c) Deprivation due to unemployment of parent
• (d) Deprivation due to absence, death or disability of parent
• Retroactive coverage can begin up to 3 months prior to application

*This is a summary of eligibility requirements. Other factors will also enter determining your eligibility for a program. Unless otherwise noted, all categories receive “full” Health Care. Benefit packages are defined by the Department of Human Services, Division of Medical Services. This information was current at the time this summary was prepared but changes may have been made subsequently due to federal regulations, state laws, court decisions or other factors. DHS cannot be bound by any information in this reference chart that conflicts with current policy or program requirements. Arkansas’ complete Health Care Policy can be found at: https://humanservices.arkansas.gov/divisions-shared-services/county-operations/division-policies/

Additional information is available at: https://medicaid.mmis.arkansas.gov/

Apply for benefits online at access.arkansas.gov.

For an application form, contact your local county DHS office or call 1-855-372-1084.