Medicaid

Updated February 2017   Fact Sheet PDF


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 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.

 

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 nursing home.

 

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 have been lawful permanent resident for at least five years. Lawfully present immigrants (Marshall Islanders) are generally ineligible. There are exceptions, such as for pregnant women. 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.

 

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.

 

This fact sheet is a collaboration of the Center for Arkansas Legal Services and Legal Aid of Arkansas, Inc. These nonprofit organizations provide free legal assistance to eligible Arkansans who meet income, asset, and other guidelines. Legal assistance may also include advice and counsel, brief services, or full representation depending on the situation. For more information about civil legal aid in Arkansas, please visit arlegalservices.org. For information specific to Legal Aid of Arkansas, Inc., visit arlegalaid.org. Apply for services online or by calling 1-800-9-LAW-AID (1-800-952-9243).
The information and statements of law in this fact sheet should not be considered legal advice. This fact sheet is provided as a broad guide to help you understand how certain legal matters are handled in general. Courts may interpret the law differently. Before you take action, talk to an attorney and follow his or her advice. Always do what the court tells you to do.
Content provided by: Center for Arkansas Legal Services

 

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