Medicaid reimburses health care providers for covered
medical services provided to eligible needy
individuals in certain categories. Eligibility is
determined based on income, resources, Arkansas residency,
and other requirements. Covered services also vary
among categories. Categories are summarized below
under these two headings:
1. Aged, Blind and Disabled Categories
Individuals aged 65 and older who meet income,
resource and other requirements are eligible for full
Medicaid coverage.
Individuals who are determined blind or disabled
based on Social Security Administration criteria who meet
income, resource and other requirements are eligible for
full Medicaid coverage.
Medicare Savings Program provides limited
coverage to supplement Medicare recipients. Coverage
varies based on income, ranging from payment of the
Medicare premiums, deductibles and co-insurance for
low-income individuals to paying only a portion of the
Medicare Part B premium for individuals with higher
incomes.
Long Term Care - Individuals who are
residents of nursing homes may qualify for Medicaid if the
care in the facility is medically necessary and they meet
income, resource and other criteria.
ElderChoices
covers individuals age 65 and older
who would be eligible if they were in a nursing facility,
but choose to remain at home.
Alternatives for Adults with Physical Disabilities
covers individuals who are physically disabled and between
the ages of 21 and 65 who would be eligible for Medicaid
if they were in a nursing facility, but choose to remain
at home.
DDS Alternative Community Services covers
individuals of any age who are determined to be
developmentally disabled. Who would be eligible for
Medicaid if they were in a nursing facility, but choose to
remain at home.
Working Disabled provides full coverage to
disabled individuals who are working. Individuals
with lower income pay the normal Medicaid co-pays.
Individuals with higher income pay higher co-pays.
2. Children and Family Categories
Needy children under age 19 who meet income,
resource and other requirements are eligible for full
Medicaid coverage under the ARKids First program.
A parent or other caretaker relative or children
under age 18 with an absent, disabled or unemployed
parent who meet income, resource and other requirements
are eligible for full Medicaid coverage.
Needy pregnant women who meet income, resource
and other requirements are eligible for full
Medicaid coverage.
Pregnant women with income up to 200% of Federal
Poverty Level may be eligible for limited coverage if they
meet certain income, resource and other criteria,
including prenatal, delivery, postpartum and conditions
which may complicate the pregnancy. Coverage
continues through the pregnancy and until the end of the
month that the 60th day postpartum falls.
Family planning provides limited coverage that
includes family planning services only to women of
childbearing age and who also meet income, resources and
other criteria.
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