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The Arkansas Medicaid Card form provides essential information for individuals enrolled in Arkansas Medicaid and ARKids First programs. It outlines the rights and responsibilities of beneficiaries, ensuring they understand how to access necessary healthcare services. The guide walks users through the application process, describes what to expect from their Medicaid or ARKids First card, and details the role of a Primary Care Physician (PCP). Understanding what to do in emergencies and knowing one’s rights and responsibilities are crucial for effective utilization of these services. It also covers various services, including hospital care, dental services, and mental health support, as well as important aspects regarding non-emergency transportation. Overall, this form serves as a comprehensive resource, empowering recipients to navigate their healthcare options with confidence.

Arkansas Medicaid Card Example

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

Arkansas Medicaid, ARKids First, & You

Ambulatory Surgical Center

39

Autism Waiver. .

. . . . . . . . . . . . . . . . 對

40

Chiropractor. . .

. . . . . . . . . . . . . . . 對

40

Community Health Centers

40

Dental Care.. . . . . . . . . . . . . . . . . 對 . . . . . . . 41

Disability Services

. . . . . . . . . . . . . . . . . 對 . . . .

42

Early Intervention Day Treatment (EIDT)

42

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

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. . 對 . . . .

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47

Home Health Services .

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47

Hospice Care . .

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. 48

Hospital Care. .

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. 48

Immunizations

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對 . . . .

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49

Independent Choices

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49

Lab Tests and X-Rays

. 對 . . 49

Long-Term Services and Support. .

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49

Program of All-Inclusive Care for the Elderly (PACE).

. . .

. 50

Nursing Home Care.

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. . . .

. . . . . 對 . .

 

 

50

Living Choices Assisted Living . .

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. 50

ARChoices in Home Care . .

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. . . .

51

Medical Equipment.. . . . . . . . . . . . . . . . . 對 . . . 52

Medical Supplies

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. . . 對 .

. . .

 

 

52

Mental Health and Substance Use Disorder Services. . . .

52

Arkansas Medicaid, ARKids First, & You

Non-Emergency Transportation (NET) Service

 

54

Nurse-Midwife (Certified)

. 對 54

Nursing Home Care.. . . . . . . . . . . . . . . . . 對 . . . 54

Nurse Practitioners

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. . . . . . . . . . 對 .

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54

Personal Care

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.

.

. .

. 對

 

. 55

Podiatrist

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.

. 對

 

. 55

Pregnancy Termination . .

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.

.

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.

.

.

. . . 對

 

. 55

Prescription Drugs. . . .

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56

Rehab Services . .

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. 對 . . . .

 

. 56

Rehabilitative Hospital. .

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.

.

. . . 對

.

57

Rural Health Clinic. . . .

. . . . . . . . . . . . . . 對 . .

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58

Targeted Case Management

 

. 58

Therapy (Physical, Occupational, or Speech)

 

58

Tobacco Cessation Program

. . . . .

.

 

 

 

 

 

59

Vision Care

. 對

 

 

 

 

 

 

 

 

59

Well-Child Care

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.

.

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.

. 對 . . . .

 

. 60

Women’s Health

. . . . . . . . . . . . . 對 . . .

.

61

Access Arkansas. . . . . . . . . . . . . . . . . . 對 . .62

Important Phone Numbers

 

.63

Your Guide to Arkansas Medicaid and ARKids First

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.

Arkansas Medicaid, ARKids First, & You

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.

Arkansas Medicaid, ARKids First, & You

2

About Medicaid and ARKids First

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.

Arkansas Medicaid, ARKids First, & You

3

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.

4

Arkansas Medicaid, ARKids First, & You

Form Characteristics

Fact Name Fact Description
Programs Covered The Arkansas Medicaid Card covers both Arkansas Medicaid and ARKids First programs for eligible clients.
Client Handbook The Arkansas Medicaid, ARKids First, & You handbook provides essential information about rights and responsibilities, as updated in 2021.
Primary Care Physician Clients must choose a Primary Care Physician (PCP) upon enrollment to manage their healthcare needs effectively.
Governing Laws Arkansas Medicaid operates under Title XIX of the Social Security Act and adheres to state regulations outlined in the Arkansas Code Annotated.

Guidelines on Utilizing Arkansas Medicaid Card

After obtaining the Arkansas Medicaid Card form, you will need to provide specific personal information necessary for your application. This process is important as it will help establish your eligibility for Medicaid benefits in Arkansas.

  1. Personal Information: Fill in your full name, including middle initial.
  2. Date of Birth: Enter your date of birth in the appropriate format.
  3. Social Security Number: Provide your Social Security number. If you do not have one, indicate this clearly.
  4. Address: Write your current residential address, including city, state, and ZIP code.
  5. Contact Information: Enter your phone number and email address, if available.
  6. Household Information: Include details about other household members, such as their names and relationships to you.
  7. Income Information: List your current income sources and their amounts. You may need to provide documentation later.
  8. Health Coverage: Indicate whether you have other health insurance coverage, including the policy number and name of the insurance company.
  9. Signature: Sign and date the form to verify that the information is accurate and complete.

After completing the form, it is advisable to review all entries for accuracy. Once confirmed, submit it according to the guidelines provided on the form or by your local Medicaid office. This will initiate the process of reviewing your application for Medicaid eligibility.

What You Should Know About This Form

What is the Arkansas Medicaid Card?

The Arkansas Medicaid Card is an essential document for individuals enrolled in the Arkansas Medicaid program. It provides access to medical services covered under this program. Each recipient receives a unique card that includes important information such as the recipient's name, identification number, and details regarding benefits. This card must be presented when visiting healthcare providers or pharmacies to ensure that services are billed to Arkansas Medicaid properly.

How do I apply for a Medicaid card in Arkansas?

Applying for a Medicaid card in Arkansas involves a few straightforward steps. First, individuals need to determine their eligibility based on income and other criteria. Once eligibility is established, an application can be submitted through the Access Arkansas website or in person at a local Department of Human Services office. It is important to provide accurate information and supporting documents during the application process to avoid delays. After processing, if approved, the recipient will receive their Arkansas Medicaid Card by mail.

What should I do if I lose my Arkansas Medicaid card?

If your Arkansas Medicaid card is lost or stolen, it's crucial to act quickly. You can request a replacement card by contacting the Arkansas Department of Human Services. This can typically be done over the phone or through their online services. Once you report the loss, a new card will be issued, ensuring that your access to healthcare services remains uninterrupted.

What services are covered by the Arkansas Medicaid program?

The Arkansas Medicaid program covers a broad range of services designed to meet the healthcare needs of its recipients. This includes routine doctor visits, hospital care, preventive services, mental health services, prescription medications, and more specialized treatments. Each recipient is encouraged to review their benefits and consult with their primary care physician to understand what services are available under their specific coverage. It is essential to keep abreast of any changes to covered services to ensure comprehensive care.

Common mistakes

Completing the Arkansas Medicaid Card form can be a straightforward process, but many individuals make common mistakes that can delay their applications or lead to confusion. One frequent error is failing to provide accurate personal information. Applicants often overlook the importance of double-checking their names, addresses, and Social Security numbers. Even a small typo can result in significant issues down the line.

Another mistake involves not submitting required documentation. Many applicants assume that their submission is complete without verifying that they have included all necessary documents. Missing items can lead to delays or denials. Ensuring all documents are included is crucial for a smooth application process.

Some individuals also make the error of ignoring deadlines. Medicaid applications must be submitted within specific timeframes. When applicants fail to adhere to these deadlines, they may lose their eligibility or have to restart the entire process, causing unnecessary frustration and delays.

A lack of understanding regarding eligibility requirements can lead to mistakes as well. Many applicants misinterpret the income guidelines or the specific criteria for their situation. It is essential to carefully review eligibility before applying to avoid disappointment.

Additionally, applicants sometimes rush through the form. This can result in incomplete or inaccurate answers. Taking the time to read each question thoroughly helps ensure that all necessary information is provided correctly. Rushing increases the likelihood of making mistakes.

Another common pitfall is not keeping copies of submitted forms and documents. Having a record of what was sent can be invaluable. If questions arise or if a follow-up is needed, having copies can prevent further complications.

Applicants should also be aware of the importance of being truthful and transparent when filling out the form. Providing false information, even unintentionally, can lead not only to denial of eligibility but also potential future legal repercussions.

Moreover, many individuals forget to update their information if circumstances change. When personal situations evolve, such as changes in income or household size, it is crucial to report these changes promptly to maintain coverage.

Finally, individuals frequently overlook the opportunity for assistance. Many resources are available to help applicants complete their forms accurately. Reaching out to local organizations or Medicaid representatives can provide valuable guidance and support, ensuring a more efficient process.

Documents used along the form

The Arkansas Medicaid Card form is an essential document for individuals seeking healthcare coverage in Arkansas. Along with this form, there are several other important documents that individuals may need to familiarize themselves with to ensure they understand their rights and responsibilities under the program. Below are some of these related forms and documents.

  • Medicaid Application Form: This document is required to apply for Medicaid benefits. It gathers necessary information about the applicant’s income, household, and medical needs.
  • Client Handbook: The Arkansas Medicaid Client Handbook provides detailed information about Medicaid services, the application process, and the rights and responsibilities of clients.
  • Primary Care Physician (PCP) Selection Form: Individuals must fill out this form to designate a primary care physician who will oversee their healthcare and refer them to specialists as needed.
  • Non-Emergency Transportation Request Form: This form is used to request transportation services for medical appointments that are not emergencies, ensuring clients can access necessary care.

Understanding these forms can help streamline the process of obtaining Medicaid benefits and accessing medical services. Each document plays a distinct role in ensuring individuals receive the support they need.

Similar forms

  • Medicaid Application Form: This form serves as the initial step for individuals seeking to enroll in the Medicaid program. Just like the Arkansas Medicaid Card form, it collects personal and financial information to determine eligibility for benefits.
  • Food Stamps Application: Similar in purpose, this document is used to apply for food assistance benefits. It requires detailed information about household income and expenses, much like the Arkansas Medicaid Card form does for healthcare benefits.
  • Children’s Health Insurance Program (CHIP) Application: This form helps families apply for health coverage for children. Analogous to the Arkansas Medicaid Card form, it checks income levels and family size to establish eligibility for the program.
  • Arkansas Works Application: This document is for those seeking coverage through the Arkansas Works health program. Both forms aim to provide access to necessary health services, leading applicants through similar processes of information submission and eligibility checks.

Dos and Don'ts

When filling out the Arkansas Medicaid Card form, it is crucial to pay careful attention to detail in order to avoid delays in processing or potential issues with your coverage. Below is a list of things you should and shouldn't do during this important process:

  • Do read the entire form thoroughly before starting. Understanding each section will help you provide accurate information.
  • Do write clearly and legibly. This ensures that your information can be easily read and understood by the reviewers.
  • Do double-check the personal information you enter, including names, dates of birth, and addresses, to confirm they match official documents.
  • Do provide all required documentation. This might include proof of income, residence, or identity. Incomplete applications may be rejected.
  • Do keep a copy of your completed form and any supporting documents for your records. This is essential if any issues arise later.
  • Don't leave any sections blank unless instructed to do so. Incomplete forms can lead to delays in processing your application.
  • Don't hesitate to ask for help if you encounter any confusion while filling out the form. Resources are available to assist you in the process.

By adhering to these guidelines, you can streamline the process of obtaining your Medicaid card and set yourself up for success in accessing necessary medical services.

Misconceptions

Misconception 1: The Arkansas Medicaid card is only for low-income individuals.

Many believe that only low-income individuals qualify for Arkansas Medicaid. However, Medicaid also covers children, pregnant women, and individuals with disabilities, regardless of their income level.

Misconception 2: Having an Arkansas Medicaid card limits your healthcare choices.

You can see a wide range of healthcare providers with your Arkansas Medicaid card. It is important to note that certain services may require referrals or prior authorization.

Misconception 3: If you have private insurance, you cannot use Medicaid services.

This is not true. Arkansas residents can utilize Medicaid benefits in conjunction with private insurance. It often helps cover services that private insurance may not fully pay for.

Misconception 4: The application process for the Arkansas Medicaid card is overly complicated.

While it may seem daunting, the application process has been simplified. Resources are available to assist applicants in completing the process accurately and efficiently.

Misconception 5: Once you receive an Arkansas Medicaid card, you never have to reapply.

This is a common misunderstanding. Eligibility for Arkansas Medicaid can change based on specific factors, so recipients must periodically confirm their continued eligibility and provide any necessary updates.

Key takeaways

Filling out and using the Arkansas Medicaid Card form requires careful attention to detail. Here are key takeaways to ensure a smooth application process and effective use of the card.

  • Understand Medicaid: Medicaid provides health coverage for eligible individuals. Familiarize yourself with what services are covered.
  • Eligibility: Check if you qualify for Arkansas Medicaid or ARKids First by reviewing the eligibility criteria.
  • Accurate Information: Fill out the form truthfully and precisely. Incorrect information can delay processing or result in denial.
  • Main Documents: Prepare to submit necessary documentation, such as proof of income or residency, when applying.
  • Card Usage: Once you receive your Medicaid card, always present it when accessing medical services to ensure coverage.
  • Emergency Situations: Understand what to do in emergencies and verify that your card covers emergency services effectively.
  • Know Your Rights: You are entitled to certain rights as a Medicaid recipient. Review them to stay informed.
  • Your Responsibilities: Be aware of your responsibilities, such as reporting changes in income or living situations.
  • Non-Emergency Transportation: If needed, learn about available transportation services for non-emergency medical appointments.
  • Keep Records: Maintain copies of your application and any correspondence related to your Medicaid coverage for future reference.

These points highlight critical steps in managing the Arkansas Medicaid Card effectively. By being informed, recipients can maximize their benefits and navigate the healthcare system with confidence.