Medicaid Costs and Coverage in Arkansas

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Arkansas Medicaid coverage and costs are closely associated with the qualifications of the beneficiary. How much is Medicaid for approved applicants is dependent on the factors like age and household income. Determining what services are covered by Medicaid and what does Medicaid not cover will also influence the overall cost to participants. Applicants should know the ins-and-outs of Medicaid coverage in order to avoid any unnecessary surprises down the road. For instance, there is a common misconception with knowing how much does Medicaid cost, as many applicants assume that Medicaid is entirely free. While most Medicaid coverage is free, there still may be need to pay a premium, copayment or deductible in many cases. Becoming familiar with the general Medicaid cost estimates for services offered to each family member can help a new applicant prepare for medical expenses. To learn more about the types of Medicaid insurance coverage and the costs associated with enrolling in Arkansas Medicaid, continue reviewing the sections below.

What services are covered by Medicaid in Arkansas?

Learning what services are covered by Medicaid in Arkansas is important for every new applicant and potential applicant. Each state has its own types of Medicaid coverages and costs, which is influenced by laws and adopted policies such as the Affordable Care Act (ACA) expansion. Arkansas has a variety of Medicaid covered services in addition to the federally mandatory ones. Medicaid services covered in Arkansas that are mandatory include but are not limited to:

  • Inpatient and outpatient hospital services
  • X-ray and laboratory services
  • Emergency and non-emergency transportation to and from medical providers
  • Family planning services and supplies
  • Rural health clinic services

Some services covered by Medicaid are restricted by age such as nursing facility services for enrollees older than 20 years of age as well as periodic screenings for those younger than 21 years of age. The types of Medicaid insurance can also vary depending on eligibility level and how an applicant’s income requirements influence their level of coverage for Medicaid. After applying for Medicaid, approved petitioners will receive comprehensive information about the health care treatments and procedures available to them.

In order to learn more about mandatory Medicaid costs and coverages, download our comprehensive guide.

What services are not covered by Medicaid in Arkansas?

In addition to the services covered by Arkansas Medicaid, applicants should also be well-versed in the types of services not covered. Services not covered by Medicaid, otherwise known as optional services, are not mandatory and may have associated fees or copayments attached. Along with the notification of approval and available services, beneficiaries may receive a list of fees associated with common optional services. Optional coverage for Medicaid may also be included in an applicant’s mandatory services list if he or she qualifies. A few of the services for Medicaid that are optional in Arkansas include:

  • Hospice services
  • Orthotic appliances and chiropractic services
  • Prescription drugs
  • Prosthetic devices and medical supplies
  • Dental and vision care

Like covered services, some Medicaid optional services are contingent on the enrollee’s age. For example, Medicaid considers occupational, physical and speech therapy optional services for beneficiaries younger than 21 years of age. The types of Medicaid insurance coverage available will also depend on the medical needs of the enrolled patient. Medicaid will cover health care services that are medically necessary. A Medicaid doctor can request approval for coverage on a service typically not cover.

How much does Medicaid cost in Arkansas?

Arkansas Medicaid coverage is provided to applicants who meet all the necessary criteria for eligibility including the Medicaid income requirements. Medicaid cost estimates in AR are nominal since the program aims to help low-income families and those most in need. Medicaid coverage is able to be provided at a low cost due to the funding allotted to the program. However, exact costs for Medicaid coverage cannot be provided since fees fluctuate and vary greatly depending on many moving parts.

While Medicaid estimated costs can be extremely low, there still may be copayments attached to different services provided. In many cases, a provider or practitioner can deny Medicaid coverage if the copayment is not able to be paid. Copayments can vary depending on the type of eligibility an applicant has and the level of enrollment. This is why it is crucial for applicants to keep their information as updated in the system as possible, in case they qualify for lower copayments as time goes on.

More often, Medicaid coverage costs are waived entirely. Depending on the type of coverage for Medicaid an applicant is approved for, he or she may not need to have any copayments, deductibles or premiums for services rendered. Medicaid cost estimates can be provided once an applicant is approved into the program. It is important for applicants to go over all the costs for Medicaid once they are approved. Understanding if there are any premiums, fees or copayments attached to services can help prepare an applicant if something should arise.

For details on Medicaid qualifications for no-cost coverage, download our comprehensive guide.