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Medicaid

Medicaid Introduction

Medicaid is a program that helps pay for necessary medical services for needy and low-income people. It uses state and federal government funds. The program provides health care coverage to nearly 1 in 5 Americans. Medicaid can pay some of your medical bills but not always all of them. If you are an adult on Medicaid, you will pay for part of your medical care, unless you are either pregnant, a Health Care Independence program enrollee with household income at or below 100% of the federal poverty level, or residing in a nursing home.

The Department of Human Services (DHS) runs the Medicaid program in Arkansas. Medicaid and Medicare are different programs. Medicare is federal health insurance. It pays for medical services for the elderly and disabled. Medicaid will not make payments to you. It will pay doctors, hospitals, and other healthcare providers who are enrolled in the Medicaid program. Your doctor or healthcare provider should bill Medicaid for your medical services.

Applying

To find out if you and your family qualify for Medicaid, fill out an application at access.arkansas.gov, in the Health Insurance Marketplace, or the DHS office in your county. If you cannot go to the DHS office, a relative or a friend can apply for you. You must sign an application form and give certain information about yourself and your family. The county office decides eligibility. When you go to the county office to apply, bring:

  • your birth certificate or other proof of your age
  • paycheck stubs
  • Social Security Card
  • letters or forms from Social Security, SSI, Veteran’s Administration, or other sources that show the amount of income that you get insurance policies, even other health insurance
  • bank books or other papers that show your assets (things that you own)

For more information, visit medicaid.state.ar.us.

Eligibility

That depends on your household income, how much property you own, your age, and your situation. Most people who get Medicaid are in one of these groups:

  • 65 years or older or under 18 years old and on ARKids First
  • blind
  • disabled, including working disabled
  • pregnant
  • a parent or relative who is taking care of a child with an absent, disabled, or unemployed parent
  • living in a nursing home
  • under 21 years old and in foster care
  • in medical need of certain home- and community-based services
  • have breast or cervical cancer
  • a parent or relative who is taking care of a child
  • aged 19 through 64 with household income below 138% of the federal poverty level with the 5% disregard applied

If you are eligible for Medicaid, you do not need to buy a plan in the Health Insurance Marketplace. If you cannot get full Medicaid benefits, there are other programs that might help:

  • ARKids First B
  • Medicaid spend-down
  • women's health (family planning)
  • Medicare Savings Program (QMB, SMB, and QI-1)
  • tuberculosis (TB)

 

Immigrant Status:

To qualify for Medicaid, you must be a citizen or be a ”qualified alien.” Before becoming eligible, a qualified alien must first serve a five-year waiting period, though there are exceptions. A qualified alien includes lawful permanent residents (i.e. green card holders), refugees, and other persons with similar longer-term statuses. Moreover, recent changes now provide that Marshall Islanders and other Pacific Islanders are eligible for
Medicaid. Undocumented immigrants are not eligible for Medicaid, though coverage may be available to cover emergencies, such as the cost of delivery and labor related to pregnancy. In Arkansas, prenatal care may be available regardless of immigration status so long as income criteria are met. If you do not qualify for
Medicaid based on your immigration status, you may still be eligible for other health assistance programs. For example, the federal tax subsidy for plans purchased through the Health Insurance Marketplace.