Arkansas Medicaid Card PDF Details

The Arkansas Medicaid Card is the official identification document for residents enrolled in Arkansas Medicaid and the ARKids First program. Your card serves as proof of eligibility and must be presented at every medical appointment. The ARKids First program provides healthcare coverage to eligible children in Arkansas whose families meet income requirements.

Services Covered by Arkansas Medicaid

The Medicaid program in Arkansas covers a broad range of healthcare services for eligible beneficiaries. Covered services include:

How to Use Your Medicaid Card

Always carry your Medicaid or ARKids First card to every healthcare appointment. Present your card at check-in to confirm your coverage. If you have lost your card or need a replacement, contact the Arkansas Department of Human Services (DHS) at 1-800-482-5431. You may also request a new card through your managed care organization.

When visiting a provider, confirm they accept Arkansas Medicaid before scheduling your appointment. Providers must be enrolled in the Medicaid program to bill for covered services. If you receive a bill for a covered service, contact your managed care organization or DHS for assistance.

Choosing a Primary Care Physician (PCP)

All Arkansas Medicaid recipients are required to select a Primary Care Physician (PCP). Your PCP is your main point of contact for routine care, referrals to specialists, and coordination of your overall health. To find a Medicaid-enrolled PCP in your area, contact your managed care organization or visit the Arkansas DHS Medical Services website.

If you need to change your PCP, contact your managed care organization. Changes typically take effect at the start of the following month.

Non-Emergency Medical Transportation (NET)

Arkansas Medicaid covers non-emergency medical transportation for eligible beneficiaries who have no other way to reach their medical appointments. You must request transportation at least 48 hours in advance. Contact your designated transportation coordinator to arrange a ride to and from appointments, including specialist visits and approved outpatient procedures.

Related Medicaid and Healthcare Forms

If you need to apply for coverage or manage other healthcare documents, these related forms are available on FormsPal:

QuestionAnswer
Form NameArkansas Medicaid Card
Form Length72 pages
Fillable?No
Fillable fields0
Avg. time to fill out18 min
Other nameslost arkansas medicaid card, replacement medicaid card, arkids cards, arkids 1st

How to Edit Arkansas Medicaid Card Online for Free

Completing this PDF is straightforward using FormsPal's online editor. Follow these steps to fill out your Medicaid documentation and save the completed form:

Step 1: Select the "Get Form Now" button to open the document in the editing tool.

Step 2: Use the editing tools to add, adjust, highlight, check, cross, insert, or remove fields and text throughout the form.

Fill in the sections for Medicaid and ARKids First card details, Non-Emergency Transportation (NET) guidance, Covered Services, Adult Development Day Treatment, and Ambulance Service (Emergency Only).

Arkansas Medicaid Card form fields to fill out

Complete the Ambulatory Surgical Center, Autism Waiver, Chiropractor, Dental Care, Disability Services, Early Intervention Day Treatment, Tax Equity and Fiscal Responsibility Act (TEFRA), DDS Community and Employment, First Connections Program, Children with Chronic Health Conditions, Title V Children and Youth with Special Needs, Doctor Services, Emergency Room Services, Hearing, and Home Health Services sections with all required information.

Filling out Arkansas Medicaid Card form stage 2

Enter the required information in the Immunizations, Independent Choices, Lab Tests and X-Rays, Long-Term Services and Support, Program of All-Inclusive Care for the Elderly (PACE), Nursing Home Care, ARChoices in Home Care, Medical Equipment, Medical Supplies, and Mental Health and Substance Use sections.

Part 3 of entering details in the Arkansas Medicaid Card form

Record your rights and responsibilities as a Medicaid recipient, then complete the following final sections: Non-Emergency Transportation (NET), Nurse-Midwife Certified, Nursing Home Care, Personal Care, Podiatrist, Pregnancy Termination, Prescription Drugs, Rehab Services, Rehabilitative Hospital, Rural Health Clinic, Targeted Case Management, Physical or Occupational Therapy, Tobacco Cessation Program, Vision Care, and Well-Child Care.

Completing the Immunizations, Lab Tests, and Long-Term Services sections of the Arkansas Medicaid Card form

Review all completed sections one final time, paying special attention to: Non-Emergency Transportation (NET), Nurse-Midwife Certified, Nursing Home Care, Personal Care, Podiatrist, Prescription Drugs, Rehab Services, Rehabilitative Hospital, Rural Health Clinic, Targeted Case Management, Physical or Occupational Therapy, Tobacco Cessation Program, Vision Care, and Well-Child Care.

Reviewing the final sections of the Arkansas Medicaid Card form

Step 3: Once you click "Done," your completed form can be transferred to any of your devices or sent to the email address you specify.

Step 4: Keep at least two or three copies of the completed document for your records.

Tips for Completing Your Medicaid Form

Before starting, gather your Medicaid or ARKids First member ID number and your Primary Care Physician's name and contact information. Having these details ready makes the process faster and reduces errors.

FormsPal also offers the ARKids First Application form for families applying for children's healthcare coverage. If you need to appeal a coverage decision, the Health Insurance Appeal Request Form is also available. Recipients who need specialist referral documentation can use the Medicaid Referral form on FormsPal.

For questions about your coverage or to request a replacement card, contact the Arkansas Department of Human Services (DHS) at 1-800-482-5431.

Watch Arkansas Medicaid Card Video Instruction

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Related Resources

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  • Arkansas ARKids First! | Benefits.gov

    CHIP provides low-cost comprehensive health coverage to children, and sometimes pregnant women, for families that earn too much money to qualify for Medicaid. The Children's Health Insurance Program (CHIP) provides health coverage to nearly eight million children and families with incomes too high to qualify for Medicaid, but can't afford private coverage. In some states, CHIP covers parents and pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program. Please note: these programs may be called by different names in your state. Some benefits covered through CHIP, include: Routine check-ups Immunizations Doctor visits Prescriptions Dental and vision care Inpatient and outpatient hospital care Laboratory and X-ray services Emergency services To be eligible for this benefit program, you must be a resident of Arkansas and meet all of the following: Either 18 years of age and under or a primary care giver with a child(ren) 18 years of age and under, and A U.S. Citizen, National, or a Non-Citizen legally admitted into the U.S, and Uninsured (and ineligible for Medicaid). To be eligible, you must have an annual household income (before taxes) that is below the following amounts: Annual Household Income Limits (before taxes) Household Size* Maximum Income Level (Per Year) 1 $27,177 2 $36,757 3 $46,336 4 $55,915 5 $65,495 6 $75,074 7 $84,654 8 $94,233 *For households with more than eight people, add $9,579 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

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