Homepage Blank Arkansas Medicaid Card Form
Outline

The Arkansas Medicaid Card form serves as a critical resource for individuals enrolled in the Arkansas Medicaid and ARKids First programs. This form provides essential information regarding the rights and responsibilities of clients, ensuring that they understand their coverage and the services available to them. Key sections include details on how to apply for Medicaid, information about primary care physicians, and guidance on what to do in emergencies. Additionally, the form outlines the various covered services, from routine medical care to specialized treatments, and includes important information about non-emergency transportation options. Understanding this form is vital for beneficiaries to navigate their healthcare needs effectively and to make the most of the benefits provided under Arkansas Medicaid and ARKids First.

Sample - Arkansas Medicaid Card Form

Arkansas Medicaid, ARKids First,
Arkansas Medicaid Client Handbook
A GUIDE TO YOUR RIGHTS AND RESPONSIBILITIES
REVISED 2021
&You
Table of Contents
Your Guide to Arkansas Medicaid and ARKids First. . . . . . .1
What is Medicaid
.......................................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
............................................19
Your Responsibilities
...................................23
Charges and Bills
......................................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
......................................37
Adult Development Day Treatment (ADDT) .................38
Ambulance Service (Emergency Only) ......................38
Arkansas Medicaid, ARKids First, & You
Ambulatory Surgical Center ................................. 39
Autism Waiver ..............................................40
Chiropractor ................................................40
Community Health Centers .................................40
Dental Care .................................................41
Disability Services ........................................... 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 ............................................46
Emergency Room Services ..................................47
Hearing ..................................................... 47
Home Health Services ......................................47
Hospice Care ...............................................48
Hospital Care ...............................................48
Immunizations ..............................................49
Independent Choices .......................................49
Lab Tests and X-Rays ........................................49
Long-Term Services and Support ............................49
Program of All-Inclusive Care for the Elderly (PACE) ........50
Nursing Home Care ....................................... 50
Living Choices Assisted Living ............................50
ARChoices in Home Care .................................51
Medical Equipment .........................................52
Medical Supplies ............................................52
Mental Health and Substance Use Disorder Services .........52
Arkansas Medicaid, ARKids First, & You
Non-Emergency Transportation (NET) Service ...............54
Nurse-Midwife (Certified) ...................................54
Nursing Home Care .........................................54
Nurse Practitioners ..........................................54
Personal Care ...............................................55
Podiatrist ...................................................55
Pregnancy Termination .....................................55
Prescription Drugs ..........................................56
Rehab Services .............................................56
Rehabilitative Hospital ......................................57
Rural Health Clinic ..........................................58
Targeted Case Management ................................58
Therapy (Physical, Occupational, or Speech) .................58
Tobacco Cessation Program ................................. 59
Vision Care ..................................................59
Well-Child Care .............................................60
Womens Health ............................................61
Access Arkansas .......................................62
Important Phone Numbers
............................63
Arkansas Medicaid, ARKids First, & You
1
Arkansas Medicaid, ARKids First, & You
DHS is here to help you!
Call or visit your county office when you have questions or concerns.
Your Guide to Arkansas Medicaid
and ARKids First
You can find the closest county office to you at https://
humanservices.arkansas.gov
.
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.
2
Arkansas Medicaid, ARKids First, & You
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.
3
Arkansas Medicaid, ARKids First, & You
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.
4
Arkansas Medicaid, ARKids First, & You
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 youre 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.

Form Information

Fact Name Details
Program Overview The Arkansas Medicaid Card is part of the Arkansas Medicaid and ARKids First programs, which provide healthcare coverage to eligible individuals and families.
Client Handbook The "Arkansas Medicaid, ARKids First, & You" handbook serves as a guide to rights and responsibilities, outlining important information for clients.
Application Process Individuals must apply for Medicaid and ARKids First to receive a Medicaid Card. The application process is detailed in the handbook.
Primary Care Physician Each Medicaid client is assigned a Primary Care Physician (PCP) to coordinate their healthcare services.
Emergency Services The handbook includes guidance on what to do in an emergency, ensuring clients know how to access urgent care.
Governing Laws The Arkansas Medicaid program is governed by state laws, including the Arkansas Code Annotated Title 20, Chapter 77.

Detailed Guide for Filling Out Arkansas Medicaid Card

Completing the Arkansas Medicaid Card form is a straightforward process. Following the steps outlined below will help ensure that all necessary information is accurately provided. This will facilitate the processing of your application and help you receive your Medicaid card promptly.

  1. Begin by gathering all necessary personal information, including your full name, date of birth, and Social Security number.
  2. Provide your current address, including city, state, and zip code.
  3. List your contact information, including a phone number and email address, if applicable.
  4. Indicate your household size by including the number of people living in your home.
  5. Fill in details about your income, including sources and amounts, to determine eligibility.
  6. Include information about any other health insurance coverage you may have.
  7. Sign and date the form to certify that all information provided is accurate and complete.
  8. Submit the completed form as directed, either online or by mailing it to the appropriate address.

Obtain Answers on Arkansas Medicaid Card

  1. What is the Arkansas Medicaid Card?

    The Arkansas Medicaid Card is an essential document for individuals enrolled in the Arkansas Medicaid program. This card serves as proof of eligibility for Medicaid services, allowing beneficiaries to access a wide range of medical care and support services. It is crucial for members to present their Medicaid Card when visiting healthcare providers to ensure that they receive covered services without incurring out-of-pocket expenses.

  2. How do I apply for an Arkansas Medicaid Card?

    Applying for an Arkansas Medicaid Card involves several steps. First, individuals must determine their eligibility based on income, household size, and other factors. Applications can be submitted online through the Access Arkansas portal, by mail, or in person at local Department of Human Services (DHS) offices. After submitting the application, it may take several weeks to receive a decision. If approved, the Medicaid Card will be mailed to the individual’s address.

  3. What should I do if I lose my Arkansas Medicaid Card?

    If you lose your Arkansas Medicaid Card, it is important to act quickly. You can request a replacement card by contacting the Arkansas Medicaid office or visiting the Access Arkansas website. Be prepared to provide personal information to verify your identity. Once your request is processed, a new card will be issued and sent to you, ensuring that you can continue to access necessary healthcare services without interruption.

  4. What information is included on the Arkansas Medicaid Card?

    The Arkansas Medicaid Card contains several important pieces of information. This includes the member's name, Medicaid identification number, and the effective date of coverage. Additionally, the card may display the name of the primary care physician (PCP) assigned to the member, as well as contact information for customer service. It is essential to keep this information up to date to avoid any issues when seeking medical care.

Common mistakes

Filling out the Arkansas Medicaid Card form can be a daunting task, and many applicants make mistakes that can delay their approval or even lead to denial of benefits. Here are some common pitfalls to avoid:

One significant error is incomplete information. When applicants skip sections or fail to provide necessary details, it creates gaps that can result in processing delays. Every piece of information is crucial; thus, ensuring that all fields are filled out completely is essential.

Another frequent mistake is inaccurate personal details. This includes misspellings of names, incorrect Social Security numbers, or wrong addresses. Such inaccuracies can lead to confusion and may require additional verification steps, prolonging the application process.

Many individuals also neglect to review eligibility requirements before applying. Each program under Medicaid has specific criteria. Failing to meet these can result in immediate denial. Taking the time to understand the requirements can save applicants from unnecessary frustration.

Additionally, some applicants forget to provide supporting documentation. Proof of income, residency, and other documents are often required. Missing these documents can lead to delays or denials, as the application cannot be fully processed without them.

Another common oversight is not signing the form. It may seem trivial, but an unsigned application is often considered invalid. Before submitting, double-checking for a signature can prevent unnecessary setbacks.

In some cases, applicants fail to update their information if circumstances change. Changes in income, household size, or health status can affect eligibility. Keeping the Medicaid office informed of any changes ensures that the application remains accurate and valid.

Moreover, some people do not keep copies of their submissions. This can be problematic if there are questions or issues later on. Having a record of what was submitted can be invaluable for reference during follow-ups.

Lastly, not following up after submitting the application is a common mistake. Many applicants assume that their submission will be processed without any issues. However, checking in can help identify any problems early on and facilitate quicker resolutions.

By being aware of these common mistakes, applicants can approach the Arkansas Medicaid Card form with greater confidence and increase their chances of a smooth application process.

Documents used along the form

The Arkansas Medicaid Card form is essential for accessing healthcare services under the Medicaid program. However, several other forms and documents accompany it, each serving a specific purpose. Understanding these documents can help ensure you receive the benefits you need efficiently.

  • Medicaid Application Form: This form is used to apply for Medicaid benefits. It collects personal information, income details, and other relevant data to determine eligibility.
  • ARKids First Application: Similar to the Medicaid application, this form is specifically for children. It helps families apply for health insurance coverage under the ARKids First program.
  • Client Handbook: This handbook provides detailed information about rights, responsibilities, and services covered under Arkansas Medicaid and ARKids First. It serves as a guide for clients.
  • Primary Care Physician (PCP) Selection Form: This document allows Medicaid recipients to choose their primary care physician. It is essential for coordinating healthcare services.
  • Emergency Services Notification: This form is used to report emergency services received. It helps ensure that emergency care is covered under the Medicaid plan.
  • Non-Emergency Transportation (NET) Request Form: This form is necessary for arranging transportation to medical appointments when emergency services are not required.
  • Medicaid Renewal Form: This document must be completed periodically to maintain Medicaid eligibility. It updates personal and financial information.
  • Prescription Drug Form: This form is used to request coverage for prescription medications. It helps ensure that necessary drugs are included under the Medicaid plan.
  • Provider Directory: This document lists all healthcare providers that accept Medicaid. It is a useful resource for finding doctors and specialists.
  • Appeal Form: If a Medicaid claim is denied, this form allows clients to appeal the decision. It outlines the process for challenging denials and seeking a review.

Being aware of these documents can streamline your experience with Arkansas Medicaid. Each form plays a vital role in ensuring you receive the benefits and services you deserve. Keep them handy for quick reference as you navigate your healthcare options.

Similar forms

The Arkansas Medicaid Card form shares similarities with several other important documents related to healthcare and assistance programs. Here are four documents that are comparable:

  • Medicare Card: Like the Arkansas Medicaid Card, the Medicare Card serves as proof of eligibility for healthcare services. It also outlines what services are covered and provides information on how to access those services.
  • Children’s Health Insurance Program (CHIP) Card: This card is similar in that it provides coverage for children's healthcare needs. Both cards ensure that families have access to necessary medical services for their children.
  • Insurance Identification Card: An insurance ID card functions similarly by confirming a person's enrollment in a health insurance plan. It typically includes details about coverage and how to utilize services, much like the Medicaid Card.
  • Veterans Health Administration Card: This card is issued to veterans and grants access to healthcare services. It shares similarities with the Arkansas Medicaid Card in that it identifies the holder's eligibility for specific health services and benefits.

Dos and Don'ts

When filling out the Arkansas Medicaid Card form, it is essential to be thorough and accurate. Here are five things to do and five things to avoid:

  • Do read the instructions carefully before starting the form.
  • Do provide accurate personal information, including your name, address, and Social Security number.
  • Do double-check all entries for spelling and numerical accuracy.
  • Do submit the form before the deadline to avoid delays in processing.
  • Do keep a copy of the completed form for your records.
  • Don't leave any required fields blank; incomplete forms can lead to rejection.
  • Don't use abbreviations or nicknames; use your legal name as it appears on official documents.
  • Don't forget to sign and date the form; an unsigned form is invalid.
  • Don't submit the form without reviewing all the information provided.
  • Don't ignore any additional documentation that may be required; check the guidelines.

Misconceptions

Understanding the Arkansas Medicaid Card form can be crucial for those seeking assistance. However, several misconceptions often arise. Here are nine common misunderstandings, along with clarifications to help you navigate this important resource.

  • Misconception 1: The Arkansas Medicaid Card is only for low-income individuals.
  • This is not entirely true. While Medicaid primarily assists low-income individuals, it also serves various populations, including children, pregnant women, and individuals with disabilities, regardless of their income level.

  • Misconception 2: You cannot apply for Medicaid if you already have insurance.
  • This is incorrect. Many individuals can qualify for Medicaid even if they have other insurance. Medicaid may cover additional services that your primary insurance does not.

  • Misconception 3: Once enrolled, you will never need to reapply for Medicaid.
  • Enrollment is not permanent. You must renew your application periodically to maintain eligibility, as circumstances may change.

  • Misconception 4: The Medicaid Card is only useful for hospital visits.
  • This is misleading. The Arkansas Medicaid Card covers a wide range of services, including preventive care, mental health services, and prescription drugs, not just hospital visits.

  • Misconception 5: You must have a Social Security number to apply for Medicaid.
  • While a Social Security number is typically required, there are exceptions for certain groups, such as undocumented immigrants and some refugees.

  • Misconception 6: Medicaid only covers emergency services.
  • This is a common myth. Medicaid provides comprehensive coverage, including routine check-ups, preventive care, and long-term services.

  • Misconception 7: You cannot choose your healthcare provider with Medicaid.
  • In fact, you can select a Primary Care Physician (PCP) from the network of providers. Your choice can impact the quality of care you receive.

  • Misconception 8: All services are covered under Medicaid.
  • This is not accurate. While many services are covered, there are limitations and exclusions. It’s essential to review the specific services covered by your plan.

  • Misconception 9: The application process for Medicaid is overly complicated.
  • Although the process may seem daunting, resources are available to assist you. Many organizations provide guidance and support to help you complete your application smoothly.

By addressing these misconceptions, individuals can better understand their rights and responsibilities under the Arkansas Medicaid program. Accessing the right information can empower you to make informed decisions about your healthcare.

Key takeaways

Here are key takeaways for filling out and using the Arkansas Medicaid Card form:

  • Eligibility: Ensure you meet the eligibility requirements for Arkansas Medicaid or ARKids First before applying.
  • Accurate Information: Provide accurate and complete information on the form to avoid delays in processing.
  • Documentation: Gather all necessary documentation, such as proof of income and identification, to support your application.
  • Primary Care Physician: Select a Primary Care Physician (PCP) when filling out the form, as this will be your main healthcare provider.
  • Emergency Services: Understand what constitutes an emergency and how to access emergency services under your Medicaid plan.
  • Rights and Responsibilities: Familiarize yourself with your rights and responsibilities as a Medicaid recipient to ensure you receive appropriate care.
  • Renewal Process: Be aware of the renewal process for your Medicaid card to maintain your coverage without interruption.