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Medicaid 101

Medicaid provides vital health insurance coverage to hundreds of thousands of Arkansans. It allows children to get their annual check-ups, ensures Arkansans with disabilities can get the services and support they need to work and go to school, and helps pregnant women get lifesaving care. Read more about the program below to learn who qualifies, what is covered, and how you can enroll. This information will equip you with the information you need to advocate for Arkansans who rely on Medicaid to stay healthy, get treated for serious illnesses, and manage chronic health conditions.  

What is Medicaid?

The Medicaid program was created in 1965 under Title XIX of the Social Security Act. This program is a joint federal and state level program that provides health care coverage for over 80 million people across the United States. It is jointly funded by the federal government and individual states, and states have discretion on how to administer their Medicaid programs. States also determine eligibility standards, and which services enrollees can access. Additionally, states can opt into Medicaid expansion to provide access to health coverage for more people with low incomes in their states. So far, 41 states including Arkansas have adopted Medicaid expansion.  

Who is eligible for Medicaid in Arkansas? 

Adult coverage:  

The Arkansas Health and Opportunities for Me (ARHOME) Medicaid program for adults covers Arkansas residents aged 19-64 with household incomes of up to 138% of the Federal Poverty Line. Additionally, pregnant people with household incomes up to 214% of the Federal Poverty Line are eligible for Medicaid in Arkansas.  

Child coverage:  

The ARKids First A (Kids Medicaid) program covers Arkansas children aged birth through 18 with household incomes up to 142% of the Federal Poverty Line. Additionally, the ARKids First B (CHIP) program covers Arkansas children aged birth through 18 with household incomes from 142% to 211% of the Federal Poverty Line.  

Other coverages: 

Parent/Caretaker coverage 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.  

Provider-led Arkansas Shared Savings Entity (PASSE) coverage is a program that serves Medicaid clients with complex behavioral health, developmental, or intellectual disabilities. 

Tax Equity and Fiscal Responsibility Act (TEFRA) coverage is a Medicaid program that can help families with children younger than 19 years old who have a disability and receive care in their homes rather than an institution. The TEFRA program can help pay for the cost of those services for eligible children. Individuals must also meet the income, resource, and other criteria for eligibility.  

What services are covered? 

Mandatory Medicaid benefits offered by all states:  

Inpatient/outpatient hospital services, Early and Periodic Screening, Diagnostic, and Treatment (EPDST), nursing facility services, physician services, laboratory and x ray services, transportation to medical care, and certified pediatric and nurse practitioner services.  

Optional services covered by Arkansas Medicaid: 

Chiropractic care, adult dental coverage (limited to Medicaid adults living in long term care facilities, nursing homes, or PACE facilities), hospice care, certified nurse midwife delivery, podiatry, prescription drugs, physical therapy, speech, hearing, and language disorder services, respiratory care services, case management, vision care coverage, and smoking cessation services.  

How do I apply? 

Arkansans can apply for Medicaid online by visiting https://access.arkansas.gov/, by mail or phone, or in person at local DHS county offices statewide. The online application process allows you to submit a single application or for an entire family, renew your case or update your information, upload documents, read notices from DHS, set up text and email alerts, and check the status of an application or renewal.  

Apply in person: Find a County Office – Arkansas Department of Human Services 

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

Apply by phone: 1-800-482-8988 

Conclusion 

Medicaid is an essential health insurance program that provides coverage to hundreds of thousands of Arkansans. For far too many, the cost of health care is out of reach, and Medicaid helps to bridge the gap between cost and care for Arkansas individuals and families. The program plays an important role as a connection to care, a support to local health care providers, and as a creator of jobs in our state. Entire communities are strengthened when Arkansans have access to affordable and accessible health care coverage.