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05.22.17

Am I eligible for Arkansas Medicaid?

Arkansas Medicaid is a type of health insurance and resource program for children, families, the disabled, and the elderly who fall under certain guidelines and restrictions for eligibility. Under Arkansas Medicaid, if you meet certain criteria, you are able to receive medical services, medical visits, prescription medicines, medical supplies (called DME or durable medical equipment), social services, and more.

If you are an Arkansas resident, and meet certain income, resource, age, and disability requirements, Medicaid will reimburse your medical provider for certain covered health care services. Eligibility is determined based on income, resources, Arkansas residency, and other requirements.  Covered services also vary among categories.  

Age and Income Requirements for Arkansas Medicaid

For The Elderly:

People who are 65 years and older and meet income or other resource restrictions can get full Arkansas Medicaid coverage.

If you have Medicare, you may be eligible for Medicaid QMB, or the Medicare Savings Program, which covers the 20% copay that Medicare does not pay for certain health and medical services. QMB coverage depends on personal income and Medicare deductibles, among other restrictions.

If you are 65 years old, could live in a nursing home facility but choose to live in your private home, Arkansas Medicaid ElderChoices will cover certain health related social services.  

If you live in a nursing home, require medical care, and meet certain income guidelines, you may qualify for Arkansas Medicaid Long Term Care.

Individuals who are determined blind or disabled are eligible for full Medicaid coverage based on the Social Security Administration’s criteria of income, resources, and other requirements.

For Those with Disabilities:

If you have a developmental disability, are any age, could live in a nursing facility, but choose to live at home, you qualify for Arkansas Medicaid’s DDS Alternative Community Services.

If you are aged 21 to 65 years old and have a physical disability in which you could live in a nursing facility but choose to live at home, you qualify for Arkansas Medicaid Alternatives for Adults with Physical Disabilities.

If you are physically or mentally disabled and work, you qualify for Arkansas Medicaid Working Disabled. Your Medicaid would cover many of your healthcare costs except for some co-pays. Your level of working income determines your co-pay. The higher your working income, the higher your co-pay.

For Children and Mothers:

Children under the age of 19 with physical, mental, or emotional needs, as diagnosed by a doctor, and whose family meets income requirements are eligible for full Arkansas Medicaid ARKids First. ARKids First has its own set of restrictions that are different from full regular Arkansas Medicaid.

The parent or legal guardian of children under the age of 18 who meet family income requirements are eligible for full Arkansas Medicaid health care coverage.

Pregnant women who meet family income and other requirements are able to receive full Arkansas Medicaid coverage. Pregnant women who have family income up to 200% of the Federal Poverty Level are potentially eligible for health care coverage including prenatal checkups, labor and delivery, and postpartum care through the 60th day after delivery through Arkansas Medicaid.

Eligibility of Arkansas HealthCare Independence Program Individuals:

HCIP individuals between the ages of 19-64 are eligible for Arkansas Medicaid health insurance coverage depending on income. Individuals with no children listed as dependents and who have incomes below 138% of the Federal Poverty Level or parents with family income between 17% and 138% of the Federal Poverty Level are eligible.
HCIP pays up to 100% of your healthcare costs and is an official health insurance plan. The government, through Arkansas Medicaid, pays up to 100% of the costs to the health insurance company. Your coverage is dictated by the health insurance company, not Arkansas Medicaid, with certain legal restrictions.

Su-Lauren Wilson

sulauren