Your Comprehensive

ARMedicaid

Guide

Published on
January 9, 2024
Last updated
January 9, 2024
Written by
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Katie Wilkinson
Reviewed by
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Quick Overview of ARMedicaid

Arkansas Medicaid plays a vital role in supporting the healthcare needs of its residents. Designed to assist over a million individuals each year, the program requires applicants to meet specific criteria related to income, age, and other requirements. Successful enrollment involves providing proof of income, completing accurate forms, and submitting applications to the appropriate office or worker.

Benefits you get with ARMedicaid

Arkansas Medicaid offers a comprehensive range of benefits, supporting various health needs for eligible individuals. Here's an overview of some key services:

  1. Adult Development Day Treatment (ADDT): Services at licensed clinics for adults with developmental disabilities, including instruction in communication, self-care, and job-preparation skills, plus nursing and therapy services.
  2. Emergency Ambulance Service: Covered only in critical health situations, including transfers between hospitals and from home to hospital.
  3. Ambulatory Surgical Centers: For surgeries not requiring an overnight hospital stay, a referral is usually needed from the primary care provider (PCP).
  4. Autism Waiver: Intensive early intervention for children with autism spectrum disorder, including individual assessments, therapeutic aids, and consultative clinical services.
  5. Chiropractic Care: For back pain and other spinal issues, with a limit on the number of visits for adults over 21.
  6. Community Health Centers: Federally Qualified Health Centers (FQHCs) are available as a PCP choice or with a referral from a PCP.
  7. Dental Care: For children under 21 and adults with limitations, including orthodontic care for children and basic dental services for adults.
  8. Disability Services: Various services are available; find more details under the Long-Term Services and Support or Rehab sections of the Arkansas Medicaid Client Handbook.
  9. Early Intervention Day Treatment (EIDT): For children with developmental disabilities or delays, including occupational, physical, and speech therapy and nursing services.
  10. TEFRA Program: Home care for children with disabilities, with eligibility criteria and potential premium payments based on family income.
  11. DDS Community and Employment Support (CES) Waiver: In-home or group home care for people with developmental disabilities.
  12. First Connections Program: Support for children under three with developmental delays, offering family and caregiver support for child development.
  13. Children with Chronic Health Conditions (CHC) Program: Care coordination services for families of children with special health care needs.
  14. Doctor Services: Limited visits per year for adults over 21, with a co-payment for ARKids B enrollees.
  15. Emergency Room Services: Only in medical emergencies, without needing a referral from a PCP.
  16. Hearing Services: For individuals under 21, including hearing tests and aids.
  17. Home Health Services: For medically necessary in-home care by a healthcare worker or nurse, with pre-approval in some cases.
  18. Hospice Care: For terminally ill patients, primarily in the patient's home.
  19. Hospital Care: Inpatient and outpatient services, with co-payment requirements for specific age groups and ARKids B enrollees.
  20. Immunizations: For prevention of diseases, available through PCPs or the Arkansas Department of Health.
  21. Independent Choices: An in-home assistance program where clients control Medicaid funds to hire and supervise their own care worker.
  22. Lab Tests and X-Rays: Covered with a referral from a PCP, with annual limits on the dollar amount for adults over 21.
  23. Long-Term Services and Support: Including nursing home care, PACE program, and Living Choices Assisted Living.
  24. ARChoices in Home Care: Services for adults with physical disabilities and seniors, including attendant care, meal delivery, and emergency response systems.
  25. Medical Equipment: Durable medical equipment for home use, with certain restrictions and approval requirements.
  26. Medical Supplies: Items for health needs, usually disposable, with a monthly limit on what Medicaid will pay.
  27. Mental Health and Substance Use Disorder Services: Including outpatient behavioral health and inpatient psychiatric services for children under 21.
  28. Non-Emergency Transportation (NET): Rides to doctor appointments and other Medicaid-covered services for ARKids A enrollees.
  29. Nurse-Midwife Services: For pregnancy and childbirth-related care.
  30. Nurse Practitioners: Specialized nurses who can treat illnesses and injuries and provide checkups.
  31. Personal Care: Assistance with daily tasks for eligible individuals under specific aid categories.
  32. Podiatrist Services: Foot care specialists, with visit limits for adults over 21 and co-payment requirements for ARKids B enrollees.
  33. Pregnancy Termination: Covered only if medically necessary and approved by Medicaid.
  34. Prescription Drugs: Most are covered with a Preferred Drug List, and some require Medicaid approval.
  35. Rehab Services: For certain illnesses or injuries, including rehabilitative services for persons with physical disabilities and hospital-based rehab.
  36. Rural Health Clinic Services: These are available in areas with limited doctors and a visit limit for adults over 21.
  37. Targeted Case Management: Helps patients access needed medical services with eligibility criteria.
  38. Therapy Services: Physical, occupational, and speech-language therapy for individuals under 21.
  39. Tobacco Cessation Program: Counseling and products to help quit tobacco use.
  40. Vision Care: Limited eye exams and eyeglasses, with co-payments for adults over 21 and ARKids B enrollees.
  41. Well-Child Care: Includes regular checkups and shots for disease prevention.
  42. Women's Health Services: Including pelvic exams, pap tests, and mammograms, with co-payment for ARKids B enrollees and adults over 21.

Beneficiaries can contact Medicaid directly for more detailed information or updates on services.

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ARMedicaid eligiblity rules

To be eligible for Arkansas Medicaid, you must be a resident of Arkansas, a U.S. national, citizen, permanent resident, or legal alien in need of health care/insurance assistance, whose financial situation is characterized as low-income or very low-income. You must also be one of the following:

  • Pregnant
  • Be responsible for a child 17 years of age or younger
  • Have a disability or a family member in your household with a disability.

In addition, most Medicaid and all CHIP eligibility are based on modified adjusted gross income (MAGI). Income eligibility levels are tied to the federal poverty level (FPL):

  • A child aged 18 or younger with income at or below 142% of the federal poverty level (FPL)
  • A parent or caretaker of a child age 18 or younger with income at or below 15% of the FPL
  • An adult aged 19 through 64 who is not receiving Medicare, does not have dependent children and has income at or below 100% of the FPL
  • A pregnant person with income at or below 133% of the FPL.

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How to apply for ARMedicaid

To apply for traditional Medicaid:

Go to the DHS office in the county where you live. If you cannot go, a friend or family member may apply for you. Sometimes, applications may be taken over the phone, and you can mail documents to your local DHS office. 

Call 1-800-482-8988 or your local county DHS office for more information. 

When you go to the county office, you will need to take information about yourself and the family members who live with you, including: 

  • Something to prove your age (birth certificate, driver’s license, or a birth record from hospital)
  • Paycheck stubs for anyone in your household who has a job
  • Social Security card
  • Letters or forms that show the amount of your income
  • Insurance policies
  • Bank statements showing how much money and/or property you own

You will fill out an application form. The form will ask questions about your family, how much money you make, and any other money or property you have.

You may apply online at access.arkansas.gov for Medicare Savings, ARHOME, Pregnant Women, Former Foster Care, and ARKids First. 

How to renew ARMedicaid

Beneficiaries will receive a letter from the Department of Human Services (DHS) indicating they need to renew. The letter will contain all the information regarding how and when to return the packet. DHS may have already collected enough information to renew some beneficiaries without requiring them to provide additional information.

Renewal packets should be returned by the due date listed on the packet, about 60 days from the date on the letter. A reminder letter giving additional time will be sent if the packet is not returned by the due date. If the packet is not received by the date on the reminder, the case will close.

Beneficiaries who wish to check if they need to renew their eligibility for Medicaid can do so online at access.arkansas.gov. They can create an account if they still need to get one and complete the renewal information online when it's time. Additionally, they can submit their questions through the Access Anywhere form at ar.gov/accessanywhere. Alternatively, they can call 1-855-372-1084 or any local DHS county office to ask someone to check their Medicaid status and see if they need to renew their coverage.

Additional programs through ARMedicaid

These programs are available to help family caregivers get paid for caring for loved ones on ARMedicaid.

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