The Arkansas Medicaid Card form is a crucial document designed to facilitate access to healthcare services for eligible individuals and families within the state. It serves as an entry point to a comprehensive guide, explaining enrollees' rights, responsibilities, and the variety of services covered under Arkansas Medicaid and the ARKids First program. To ensure you are fully informed and able to navigate your health coverage effectively, consider taking the time to fill out this form by clicking the button below.
In the state of Arkansas, the Medicaid Card form serves as a crucial gateway for residents to access a variety of healthcare services, including the Arkansas Medicaid and ARKids First programs. This comprehensive document, titled "Arkansas Medicaid Client Handbook," has been revised in 2021 to provide an updated guide on the rights and responsibilities of Medicaid recipients. It covers essential information ranging from how to apply for Medicaid and ARKids First, understanding the purpose and use of the Medicaid or ARKids First card, selecting a Primary Care Physician (PCP), and navigating through emergency situations. Furthermore, it elucidates on the recipient's rights and responsibilities, handling of charges and bills, coordination of benefits with Medicare or other medical insurance, as well as the specifics of Medicaid coverage, such as non-emergency transportation (NET) services and a wide array of covered services. These range from dental care, home health services, mental health and substance use disorder services, to long-term care and support for various groups including adults, children with chronic health conditions, and the elderly. This guide serves as an indispensable resource for understanding how Medicaid and ARKids First integrate into the lives of Arkansas residents, ensuring they are well-informed about accessing necessary healthcare services.
Arkansas Medicaid, ARKids First,
&You
Arkansas Medicaid Client Handbook
A GUIDE TO YOUR RIGHTS AND RESPONSIBILITIES
REVISED 2021
Arkansas Medicaid, ARKids First, & You
Table of Contents
Your Guide to Arkansas Medicaid and ARKids First
. . 1
What is Medicaid. . . . . . . . . . . . . . . . . . 對 . . 2
About Medicaid and ARKids First
3
Applying for Medicaid and ARKids First
. 5
Your Medicaid or ARKids First Card
11
Your Primary Care Physician (PCP)
.
13
What to Do in an Emergency
.17
Your Rights
. 對 . . . .
19
Your Responsibilities.. . . . . . . . . . . . . . . . . 對
23
Charges and Bills . . . . . . . . . . . . . . . . . . 對 . 25
Using Medicaid with Medicare or Medical Insurance. . 27
Medicaid, ARKids First, and Your New Baby. .
. . . . . 29
Getting to the Doctor: Non-Emergency
Transportation (NET)
. . . . . . . . . .
.31
Covered Services. . . . . . . . . . . . . . . . . . 對 . 37
Adult Development Day Treatment (ADDT)
38
Ambulance Service (Emergency Only)
. 38
Ambulatory Surgical Center
39
Autism Waiver. .
. . . . . . . . . . . . . . . . 對
40
Chiropractor. . .
. . . . . . . . . . . . . . . 對
Community Health Centers
Dental Care.. . . . . . . . . . . . . . . . . 對 . . . . . . . 41
Disability Services
. . . . . . . . . . . . . . . . . 對 . . . .
42
Early Intervention Day Treatment (EIDT)
Tax Equity and Fiscal Responsibility Act (TEFRA) Program..
43
DDS Community and Employment Support (CES). . . .
45
First Connections Program.. . . . . . . . . . . . . . . . 45 Children with Chronic Health Conditions (CHC) Program (Title V Children and Youth with Special Health Care Needs).45
Doctors’ Services.. . . . . . . . . . . . . . . . . 對 . . . .
46
Emergency Room Services
47
Hearing
. . . . . .
. . 對 . . . .
. . . .
Home Health Services .
. . . . . . . . . . . . . . .
. . 對 .
Hospice Care . .
. . .
. 對 . .
. 48
Hospital Care. .
Immunizations
. . . . . . . .
對 . . . .
49
Independent Choices
Lab Tests and X-Rays
. 對 . . 49
Long-Term Services and Support. .
. . . . . . . . . . . .
Program of All-Inclusive Care for the Elderly (PACE).
. 50
Nursing Home Care.
. . . . . . .
. . . . . 對 . .
50
Living Choices Assisted Living . .
. . . . . . . . .
ARChoices in Home Care . .
. . . . . . . . . . .
51
Medical Equipment.. . . . . . . . . . . . . . . . . 對 . . . 52
Medical Supplies
. . . 對 .
52
Mental Health and Substance Use Disorder Services. . . .
Non-Emergency Transportation (NET) Service
54
Nurse-Midwife (Certified)
. 對 54
Nursing Home Care.. . . . . . . . . . . . . . . . . 對 . . . 54
Nurse Practitioners
. . . . . . . . . . 對 .
. .
Personal Care
. 對
. 55
Podiatrist
Pregnancy Termination . .
. . . 對
Prescription Drugs. . . .
56
Rehab Services . .
. 56
Rehabilitative Hospital. .
57
Rural Health Clinic. . . .
. . . . . . . . . . . . . . 對 . .
58
Targeted Case Management
. 58
Therapy (Physical, Occupational, or Speech)
Tobacco Cessation Program
. . . . .
59
Vision Care
Well-Child Care
. 60
Women’s Health
. . . . . . . . . . . . . 對 . . .
61
Access Arkansas. . . . . . . . . . . . . . . . . . 對 . .62
Important Phone Numbers
.63
How to use this handbook:
〈Read through this entire handbook as soon as you can to learn about Medicaid and ARKids First.
〈Keep it as a reference to look up things you need to know.
〈Mark the parts that you do not understand and make a note of your questions.
〈When you get answers to your questions, write them in your handbook for future reference.
This handbook cannot tell you everything.
〈Laws and rules can change, so some things might have changed since this handbook was printed.
〈This handbook is not a legal document. That means it is just a guide, not a contract.
〈The Department of Human Services (DHS) is not responsible for information in this handbook that is no longer correct.
〈Call Medicaid at 1-800-482-8988 if you have questions.
DHS is here to help you!
Call or visit your county office when you have questions or concerns.
You can find the closest county office to you at https://
humanservices.arkansas.gov.
1
What is Medicaid?
Medicaid is a program that helps you by paying for covered medical care you need. The term “Medicaid” in this handbook refers to many types of health care coverage like:
〈Traditional Medicaid – coverage for people with household incomes less than 100 percent of the Federal Poverty Level
〈Arkansas Works – health care coverage for people with household incomes that are more than 100 percent and up to 138 percent of the Federal Poverty Level
〈Dental care coverage for eligible children and adults
〈Pregnancy & Newborn Medicaid - coverage for women who are pregnant or who have recently given birth as well as their newborns;
〈ARKids First - coverage for children up to age 19
〈First Connections - coverage to support infants and toddlers with developmental delays
〈TEFRA - a category of Medicaid that provides care to children with a disability in their homes rather than in institutions
〈Community Employment Support Waiver – coverage for people who have a developmental disability and need special care
〈Autism Waiver - treatment for clients from ages 18 months through 7 years with a diagnosis of autism spectrum disorder
〈Long-term Care - coverage for people who need long-term disability services, in-home personal assistance, assisted living, or nursing home services
〈Many other categories of Medicaid
You don’t have to remember all of these program names. After you apply, you will get a letter to let you know if you or your child is eligible for one or more of these programs. Learn more about these programs under Covered Services starting on page 37.
2
Medicaid
〈Medicaid is a program that helps you by paying for covered medical care you need. Read page 5 to find out who can get Medicaid.
〈Medicaid uses state and federal money to pay these bills. In Arkansas, DHS runs the Medicaid program.
〈Medicaid is not the same thing as Medicare. Medicare pays for covered medical services for people age 65 and older and for some people who have a disability.
ARKids First
〈ARKids First is health care insurance for children.
〈ARKids First has two programs: ARKids A and ARKids B.
〈ARKids A is Medicaid for children.
〈ARKids B is for children whose parents make too much money to get regular Medicaid, but do not have health insurance for their children.
〈When you fill out the ARKids First application, you can apply for both programs. DHS will decide whether you qualify for either program.
Do Medicaid and ARKids First pay you or your doctor?
〈Medicaid and ARKids First will not make payments to you.
〈Medicaid and ARKids First pay doctors, hospitals, and other health care providers who are enrolled in the Medicaid program.
〈Your doctor or other health care providers should bill Medicaid or ARKids First for your medical services; however, billing Medicaid or ARKids First is not mandatory. Please see page 4 for more information about how Medicaid pays for services.
Some important points about Medicaid and ARKids First:
〈Medicaid and ARKids First can help pay some of your medical bills but not all medical bills are covered.
〈Doctors do not have to bill Medicaid or ARKids First, even if they are Medicaid or ARKids First providers.
〈Before you get a service or treatment for you or your child, ask if it will be billed to Medicaid or ARKids First.
〈If Medicaid will not be billed for a service, the doctor must tell you.
〈If you still want the treatment, you may have to pay for it yourself
or you can find another doctor who will bill Medicaid or ARKids First.
〈Most people must choose a primary care physician, also called a PCP.
〈Your PCP is the doctor who is in charge of your health care.
〈You will be given a card to show your doctor or health care provider for the coverage you get.
〈Take care of your card, and keep it with you at all times. Your card makes it easier to get the care you need.
〈If you have ARKids B, or if you’re an adult on Medicaid, you will have to pay for part of your medical care.
〈Do not let others use your card. If you do, you are breaking the law. This means you could lose your Medicaid eligibility and even serve time in jail.
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