FAQs for Clients
What is Title XIX?
Title XIX, popularly known as Medicaid, is a joint federal and state program that provides necessary medical services to eligible persons who are not able to pay for such services to help these families and individuals become or remain independent and able to care for themselves.
Each state has some sort of Medicaid program to meet the federal mandates and requirements as laid out in Title XIX. Section 7 of Act 280 of 1939 and Act 416 of 1977 authorized the State of Arkansas to establish and maintain a medical care program for the indigent and vested responsibility for regulating and administering the program in the Arkansas Department of Human Services. The Arkansas Medicaid program was implemented January 1, 1970.
Individuals are certified as eligible for Medicaid services through the state’s county Human Services Offices or District Social Security Offices. The Social Security Administration automatically sends SSI client information to DHS.
What are Medicaid and ARKids First?
Medicaid is a program that helps pay for medically necessary medical services for low-income Arkansans. It uses state and federal money to pay for those services. DHS runs the Medicaid program in Arkansas. Medicaid and Medicare are different programs. Medicare is federal health insurance for people aged 65 and older, and for some people who have a disability.
ARKids First is health insurance for children. ARKids First has two programs: ARKids First-A and ARKids First-B.
- ARKids First-A is Medicaid for children.
- ARKids First-B is for people who make too much money to get regular Medicaid, but do not have health insurance for their children.
When you fill out the ARKids First application, you can apply for both programs. DHS will decide whether you qualify for either program.
What If You Have Supplemental Security Income (SSI)?
SSI is for some people who are age 65 and older. It is also for some adults and children who are blind or have a disability.
If you can get SSI, you will get Medicaid. But if you lose your SSI benefits, you might also lose your Medicaid benefits.
Call the Social Security Administration at 1-800-772-1213 or visit your local Social Security office for more information.
Who Can Get Full Medicaid Benefits?
It depends on how much money you make, how much property you own, your age, and your situation. Most people who can get Medicaid are in one of these groups:
- Age 65 and older
- Under age 19
- The parent or the relative who is caretaker of a child with an absent, disabled, or unemployed parent
- Living in a nursing home
- Under age 21 and in foster care
- In medical need of certain home- and community-based services
- Disabled, including working disabled
What if I can’t get full Medicaid benefits?
There are programs that can help.
- ARKids First-B (Child Health Insurance Program Title XXI funded)
ARKids First-B is for children under age 19 who do not have medical insurance through a parent’s employer, or who cannot use their medical insurance. For example, if a noncustodial parent living outside of Arkansas has health insurance on their child who lives in Arkansas but Arkansas doctors do not accept that insurance, the child may be able to get ARKids First-B. On ARKids First-B, you will make a small payment called a co-payment for prescription drugs and some medical care, but not for preventive care like well-child check-ups. You can apply for ARKids First-A (Medicaid) and ARKids First-B (Child Health Insurance Program Title XXI funded) at the same time. DHS will look at your application and decide whether you qualify for either program.
- Medicaid Spend-Down
If you are hurt or sick and need a lot of care, you might be able to get temporary help from Medicaid even if you make too much money to get regular Medicaid. This is called “Medicaid Spend-Down.” To qualify for Medicaid Spend-Down, you must be spending a large part of your money on medical care. You have to re-enroll in Medicaid Spend-Down every three months. Contact the DHS office in your county for details.
- Medicare Savings Programs (Qualified Medicaid Beneficiary, Specified Low Income Medicare Beneficiary, and Qualifying Individuals-1 Group)
You must be on Medicare to qualify for any Medicare Savings Program. You must make less than a certain amount. Different programs have different rules. For more information about Medicare Savings Programs, contact the DHS office in your county.