Health Care Redetermination Notices
If you have received a Health Care Notice terminating your Medicaid/HCIP benefits, or if you have applied for Medicaid/HCIP and have not received a decision in 45 days, please contact our office for possible legal representation.
Toll Free: 1-800-9 LAW AID (1-800-952-9243)
Craighead County Residents call: (870) 972-9224
Pulaski County Residents call: (501) 376-3423
Washington County Residents call: (479) 442-0600
Have you received a Health Care Redetermination Notice?
Arkansas is currently in the process of verifying continued eligibility for those individuals receiving Medicaid/HCIP benefits. Almost 50,000 people across the State of Arkansas have received a Health Care Redetermination Notice from the Department of Human Services (DHS). This Notice advises individuals to submit proof of income within 10 days from the Date of Notice listed at the top of the letter. An individual should submit copies of the requested information along with a copy of the Health Care Redetermination Notice in one of the following ways:
• Mail your documents to the address which appears on your DHS Notice. Make sure that your Social Security Number and Date of Birth are on the documents. If not already printed on your documents, write this information on your documents. Make a note for yourself of the date and address where you mailed the documents.
• Take your documents to a DHS County Office near you, or ANY DHS County Office. Get proof of submission from DHS if possible. Make sure that your Social Security Number and Date of Birth are on the documents. If not already printed on your documents, write this information on your documents.
What do I need to provide proof of income to DHS?
DHS will accept the following documents as proof of income:
• Check stub (for previous month)
• Letter from Employer (verifying income)
• Verification of Earnings Form – DCO97 (completed by employer)
• Benefit Award Letter (such as Social Security or Unemployment Benefits)
What if I am self-employed? What do I need to provide proof of income to DHS?
• Tax Return, including Schedule C
• If you have not filed, provide the extension and last year’s return
What if I am unemployed? What do I need to provide proof of income to DHS?
• Letter explaining that you have no income. This letter must include your signature.
What if I cannot meet the 10 day deadline to provide proof of income?
• Call ANY DHS County Office and speak with a DHS representative to request an extension. This will prevent your case from being closed for failing to respond. Make note of the individual you spoke with concerning the extension of time and the new date for providing proof of income.
What will happen if I do not provide proof of income?
If you fail to provide the required documents by the deadline or do not receive an extension of time to provide proof of income, you will lose your health insurance coverage. However, if you can provide proof of income within 90 days from the date of termination, you could potentially be reinstated, if determined eligible.
What if I have received a Health Care Notice terminating my benefits?
If the renewal information is not received on time, Medicaid recipients will receive a Health Care Notice terminating (ending) their benefits.
Federal regulations demand that anyone whose coverage is terminated for failure to submit verification information is allowed 90 days to submit the necessary information and be re-enrolled if eligible, without having to re-apply.
If individuals had their coverage terminated and believe they are still eligible, they should submit the information requested by DHS on the original Health Care Redetermination Notice as explained above.
If you miss the 90-day deadline, you can re-apply for Medicaid/HCIP.
Beneficiaries who re-enroll during the 90-day window will initially be put into traditional Medicaid. At this point, it is unclear how long it will take for an individual to be placed back into their private plan. It is expected that an individual will be placed back into their plan in 1-2 months, however, this is a manual process and at this time, there is no automated, streamlined process in place.
What Is The Health Care Independence Program?
The Health Care Independence Program provides health care coverage to Arkansans who are U.S. citizens and certain legally‐residing immigrants ages 19‐64 with household incomes below 138% of the Federal Poverty Level for their family size. This program provides private insurance coverage to eligible adults with no monthly premium costs. Arkansas uses federal Medicaid dollars to pay the monthly premiums for the person. If you are eligible, you may have a small co‐pay for doctor visits, prescriptions and certain other medical services. You can apply on line at www.access.arkansas.gov.
How much is 138% of the Federal Poverty Level?
It depends on your family size but for example, it is about $16,242 annually for an individual (family size of 1) and $21,983 for a family size of 2.
Is The Health Care Independence Program the same as the Private Option?
Yes. It is sometimes called the Private Option because health care coverage is provided through a private insurance plan.
I’ve heard that some people in the Health Care Independence Program are getting Medicaid instead of a private insurance plan. Why?
Most people eligible for the program will receive a private insurance plan at no cost to them. About 10% of those eligible, though, will be better served by Medicaid because those individuals have chronic conditions, extensive medical needs, or trouble handling daily activities, like taking medications or caring for themselves. Medicaid provides additional services to help people better manage those issues.
What services do I get under the Health Care Independence Program and when can I access them?
The program allows you to pick an insurance plan that has the services that best meet your health care needs. All plans must cover outpatient services, emergency services, hospital stays, prescription drugs, preventive and wellness services, maternity and newborn care, mental health and substance abuse disorder services, and laboratory services. To read more about these Essential Health benefits, go to www.arhealthconnector.org.
I have children under the age of 18 living with me. Are they eligible for the Health Care Independence program?
No, you must be at least 19 for the Health Care Independence Program. However, children under the age of 19 may be eligible for the ARKids First program. Since you have children under age 18 living with you, they must also be covered in order for you to be eligible for coverage. If they do not have health care coverage, you should apply for ARKids for them at https://access.arkansas.gov/Voter.aspx.
What happens if I’m not eligible for the Health Care Independence Program?
If the reason you are not eligible is because you have too much income, the information you have already provided to DHS will be electronically sent to the Health Insurance Marketplace. They will use the information to determine your eligibility for other financial assistance to help you pay the monthly premiums for other coverage. This assistance is in the form of tax credits and cost‐sharing reductions that will help you purchase a Qualified Health Plan available through the Health Insurance Marketplace. To read more about this, go to www.healthcare.gov.