Medicaid is a government health insurance program that helps certain people get health care services at a lower cost. In Arkansas, Medicaid is also called the Health Care Program. The state has different Medicaid programs for different groups of people.

What does Arkansas Medicaid cover?

Arkansas Medicaid pays for routine and acute health care services. This includes:

• Visits to health care providers (including physicians and nurse practitioners)
• Inpatient and outpatient hospital services
• Early and periodic screening, diagnostic, and treatment services
• Preventive care (e.g., vaccinations)
• Lab tests and X-rays
• Dialysis services
• Mental health services
• Substance use treatment
• Rural health clinic services
• Medical transportation
• Long-term care (e.g., nursing facility care, home health services)

Most states also cover optional services such as:

• Physical, respiratory, and occupational therapy
• Home- and community-based care
• Case management
• Prescription drugs
• Dental and vision care

Since the program serves those with limited income and resources, people with Arkansas Medicaid benefits pay few to no out-of-pocket costs. To get coverage once you are enrolled, you must go to health care providers that take part in the Medicaid program.

In Arkansas, Medicaid is administered by the Arkansas Department of Human Services (DHS) - Division of Medical Services. Check with your local DHS County Office to learn more about the coverages provided.

How do I know if I qualify for Medicaid in Arkansas?

In general, to be eligible for Medicaid, you must:

• Be an Arkansas resident
• Be a U.S. citizen or a qualified non-citizen
• Meet the income and/or asset limit for your coverage group

What are the different Medicaid programs in Arkansas?

You may be able to get health coverage if you fall into one of the following categories.

Aged, Blind, and Disabled (ABD) Medicaid

In Arkansas, Medicaid for low-income adults who are older (age 65+), blind, or living with a disability is called Aged, Blind, and Disabled.

SSI-Related Medicaid

If you receive or qualify for Supplemental Security Income (SSI) benefits in Arkansas, you are automatically eligible for full Medicaid coverage. This means you must:

• Be over age 65 or living with a disability
• Have income under the SSI limits (federal benefits rate), calculated in the same way
• Have assets under the SSI limits ($2,000/individual, $3,000/eligible couple)

ARSeniors

If you meet the requirements below, you qualify for full Medicaid benefits under ARSeniors:

• You are age 65 or older (there is no disability option).
• You have income at or below 80% of the Federal Poverty Level (FPL).
• You have assets under $9,430 for an individual and $14,130 for an eligible couple.

ARChoices in Homecare

This Arkansas Medicaid program provides home and community-based services for adults (age 21 to 64) with physical disabilities and older adults (age 65+). These services help with daily tasks you may find difficult, such as bathing, dressing, moving around your home, and cooking.

ABD Adult Spend Down

The Medicaid Spend-Down Program lets you get Medicaid benefits even if your income is higher than program guidelines. It works by letting you spend down your income so that you meet Medicaid income limits. The spend-down amount is the amount of income that is over the Medicaid limit. This amount is different for each person.

To get Medicaid benefits, you must submit current paid or unpaid medical bills equal to or greater than your monthly spend-down amount. Once your medical bills reach this amount, you will get Medicaid coverage for the rest of the calendar month. While using Medicaid to pay for your medical expenses, you should use a health care provider who accepts Medicaid.

Examples of health care-related expenses you can use to spend down your income include:

• Medications
• Paid medical bills
• Unpaid medical bills (if they were outstanding 3 months prior to the date of your Medicaid application)
• Nursing home care
• Health-related home renovations, such as wheelchair ramps or chair lifts
• Transportation to medical appointments

If you need help with your health care coverage and costs, you should apply for Medicaid even if you think you are over the income limit or your assets are too high. This is because:

• Not all types of income are counted toward the income limit.
• You may qualify for a different form of health care assistance. For example, if you have Medicare, you may qualify for a Medicare Savings Program (MSP).
• If you are over the income limit, but you have very high medical costs, you may be able to qualify for the Spend-Down Program.

Arkansas Health and Opportunity for Me program (ARHOME)

ARHOME is a Medicaid expansion program for adults age 19 to 64 with income at or below 138% FPL. It uses Medicaid funding to buy low-cost health insurance for people who cannot get coverage through regular Medicaid or private insurance.

If you qualify for ARHOME, you are still covered by Medicaid, but your coverage is provided by private health insurance carriers.  

How do Medicare and Medicaid work together?

If you have both Medicare and Medicaid (called being “dual eligible”), these two programs work together to benefit you. Medicare pays first, and Medicaid pays last.

Medicaid will pay most of the hospital bills that Medicare Part A (Hospital Insurance) does not pay. You may be billed for a small amount, called coinsurance. You might also have to pay part of the deductible for inpatient hospital care. In addition, if you have Medicare Part B (Medical Insurance), the state will pay your Part B monthly premium. Medicaid also pays most of the charges Medicare Part B will not cover (you may be billed for a small amount).

In addition, if you are dual-eligible for Medicare and ABD Medicaid:

• You will automatically be signed up for the Low-Income Subsidy (LIS)/Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with low income pay for their medicines.
• You may be able to get your coverage through a Medicare Advantage Special Needs Plan (SNP) instead of having original Medicare with separate Medicaid coverage. This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from original Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.

Note: SNPs are not available in every community. To find out if there is an SNP in your area, visit the Medicare website or call 1-800-633-4227 or 1-877-486-2048 (TTY).

How do I prepare to apply for Medicaid in Arkansas?

When you apply for Medicaid, you’ll be asked for important information to help determine if you qualify for benefits. Before you start, gather some basic information to make your application process easier:

• A document that shows your age, such as your birth certificate or driver’s license
• Your Social Security card
• Pay stubs for anyone in your household who has earned income
• Documentation that shows any other form of income, such as letters from Veterans Affairs (VA) or the Social Security Administration (SSA)
• Information about your financial assets, such as bank account or investment account statements

How do I apply for Medicaid in Arkansas?

If you get SSI, you should also get Medicaid without having to apply separately. If you do need to apply, there are a few different ways to do so. Read below to learn more about which option might be right for you.

The quickest and easiest way to apply for Medicaid in Arkansas is online through the Access Arkansas website. All your personal information is kept 100% confidential and protected by special security technology. 

Apply through Access Arkansas

In some situations, you may be able to apply for Medicaid over the phone or have someone else apply for you. Call 1-800-482-8988 or contact the DHS office in your county to learn more.  

How can I get help with my Arkansas Medicaid application?

• Contact the DHS office in your county directly or call 1-800-482-8988.
• Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.
• NCOA also has a HelpLine you can call to get free support. To get started today, call 1-800-794-6559.