Is A Woman Who Has Access To A Family Members Employer
Possibly. If the employer-sponsored insurance is unaffordable or not MEC, the woman is eligible for APTCs. Affordability is determined by the IRS standards for the percentage of income a person is expected to spend on insurance. This calculation applies to the cost of the employees insurance, not the cost of the family plan. That means that if the premiums for the employees insurance are affordable, no member of the family is eligible for an APTC. If the individuals premium is unaffordable, the family will be eligible for APTCs in an amount determined by their income and the premium cost.
What Is Pregnancy Medicaid
Medicaid is a government-sponsored health insurance program for low-income families who have no medical insurance or inadequate insurance. All states offer Medicaid or a program similar to Medicaid to help pregnant women receive adequate prenatal and postpartum care. Medicaid also offers health insurance to seniors, children, and people with disabilities.
Lawsuit Over Arkansas Medicaid Work Requirement Was Slated For Scotus But Hearing Was Canceled And Work Requirement Waiver Was Then Rescinded By Hhs
The Trump administration appealed the case, as expected, and a panel of three judges on the U.S. Court of Appeals for DC heard oral arguments in the appeal in October 2019. During the arguments, all three judges expressed concerns about the coverage losses that stem from Medicaid work requirements, which was the crux of Boasbergs ruling earlier in the year that suspended the work requirement. And in February 2020, the three-judge panel unanimously ruled that it was arbitrary and capricious for HHS to approve the Arkansas Works waiver, and upheld Boasbergs ruling to overturn the states Medicaid work requirement. So the work requirement has remained suspended.
In July 2020, however, the Trump administration asked the Supreme Court to intervene and allow Arkansas to reinstate its work requirement once the COVID-19 situation is under control enough to allow the unemployment rate to return to normal levels. The Supreme Court justices agreed to hear the case, and oral arguments in the lawsuit, Arkansas v. Gresham, were scheduled for March 29, 2021 at the Supreme Court.
But the Biden administration does not support Medicaid work requirements, and asked the Supreme Court to cancel the hearing. That request was granted, and Arkansas v. Gresham was not heard by the Supreme Court.
Soon thereafter, in March 2021, HHS officially withdrew approval for the Medicaid work requirement in Arkansas.
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Where To Apply For Medicaid In Arkansas In Person
If you need help filling out your Medicaid application form you can apply for Arkansas Medicaid in person. Many people who do not know how to apply for Medicaid choose this option to enlist the help of office employees. You can pick up, complete, and submit an application at the Department of Human Services office in the county where you live.
Furthermore, applicants can obtain more information about Medicaid regulations and program details. If you cannot make it in person, you can have a family member or friend apply for you. When you visit the Department of Human Services office, you should be ready with the information you need to apply for Medicaid.
As with the other methods of applying for Medicaid, applicants need all current insurance forms, pay stubs, verifiable identification and other necessary documents. If you do not have all of this information available, the state can still process your Medicaid application, but it may take longer to get the health insurance for which you are entitled.
After submitting an application, applicants waiting to hear about the case status may wait for a status update via mail or phone call. There will be further instructions available, based on each applicants unique case.
Learn About Medicaid In Arkansas
What is Medicaid in Arkansas? AR Medicaid provides a way for low-income applicants to get the health care they need. The benefits of Medicaid cover a wide range of medical procedures and services. The program provides such things as doctor visits and prescriptions at little or no cost. A majority of the funding for Medicaid, totaling six billion in 2016, is contrived from both federal and state governments. Additionally, the federal government creates the guidelines, including minimum eligibility requirements such as age and income, which Arkansas officials uphold. Eligibility information about Medicaid is particularly important for specialty groups like the disabled, elderly and pregnant women. However, the resources for Medicaid coverage are limited and a process is in place for officials to determine who is eligible for Medicaid coverage.
To qualify for Medicaid in Arkansas, residents must first fill out an application form and turn it into state agents. The form to get Medicaid requires a lot of details such as full legal name to more specific data like financial records. Income is an essential factor to qualify for benefits. Arkansas Medicaid officials will verify the information provided on the application form and alert applicants by mail when a decision is made. Further information about Medicaid supplied in the notification will include the cost and coverage provided by the program.
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How To Apply For Medicaid
Enter your zip code to get started.
Arkansas Medicaid program helps needy individuals pay for basic and necessary medical services living in Arkansas and meeting the program eligibility guidelines. The program uses state and federal government funding to provide for the cost of free Medicaid benefits in Arkansas.
It is important to understand that Medicaid and Medicare are two different programs in Arkansas. Medicare only covers individuals who are either aged 65 and above or have a disability. On the other hand, Medicaid covers various additional eligibility categories as well in addition to these two categories covered by Medicare.
In order to receive Medicaid benefits in Arkansas, applicants need to meet financial as well as non-financial eligibility. Financial eligibility is based on Modified Adjusted Gross Income guidelines but some candidates are exempt from MAGI rules.
Certain individuals may also enjoy full exemption from income eligibility for Medicaid. Individuals enrolled in certain other programs such as cancer treatment and prevention program and SSI will automatically qualify for Medicaid in Arkansas.
You can enroll in the Medicaid program in Arkansas by completing an online application. You can also download an application. If you prefer applying in person, you can visit a DHS office in your state.
For further information about the program, you can visit Arkansas Department of Human Services website.
How To Apply For Medicaid In Arkansas
The Arkansas Medicaid application process is an opportunity for residents who cannot afford health insurance to obtain medical coverage. Learning how to apply for Medicaid in AR is beneficial for families who meet the eligibility requirements to receive Medicaid benefits. It is important for prospective applicants to understand what will be on the AR Medicaid application form and where to apply for Medicaid insurance in the state. If you are wondering, Can you apply for Medicaid online? or Where do you sign up for Medicaid in Arkansas? continue reading the outlined information below.
Where do you sign up for Medicaid in Arkansas?
While many states allow applicants to apply for Medicaid online, the state of Arkansas does not have a way to sign up for Medicaid via web. However, you may print the Medicaid form from the internet and fax it to 870-534-3421 or mail the form to:
DHS Jefferson County
P.O. Box 5670
Pine Bluff, AR 71611
If you are enrolled in the program, workers at the county office will provide you with more information on what health care services Medicaid covers and which medical providers are available to you. They will also ask you to pick a primary care physician.
Find out more about the requirements to receive benefits from Medicaid in our free guide.
Information Required on the Medicaid Application Form in Alabama
- Your name, birth date and Social Security Number
- Your before-tax income
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District Of Columbia Medicaid
Eligibility overview: Washington, D.C., has one of the most generous Medicaid programs in the U.S., covering adults with household incomes up to 210% of the FPL as part of its expansion program. It also has programs for pregnant, parent/caretaker, elderly, disabled and child residents.Income requirements: The expansion covers adults without dependents who make up to $2,082 a month when applying on their own. Elderly, blind or disabled D.C. residents are eligible if they make up to 100% of the FPL, or $1,063 per month for one individual, and have resources below $4,000 for one person. D.C. also covers pregnant women with incomes up to 319% of the FPL, or $3445 monthly, and parents/caretakers with incomes up to 216% of the FPL.
How to apply for Washington, D.C. Medicaid: You can apply online at DC Health Link or by visiting your closest Income Maintenance Administration Service Center.
Other notable programs: Long-term care and nursing home care services Spend Down, a Medicaid program for people who exceed income limits, but have high medical bills Emergency Medicaid for people who canât qualify for standard Medicaid due to citizenship/immigration status.
If You Dont Have Health Coverage
- Health coverage makes it easier to get the medical check-ups and screening tests to help keep both you and your baby healthy during pregnancy.
- If you qualify for a Special Enrollment Period due to a life event like moving or losing other coverage, you may be able to enroll in a Marketplace health plan right now. Being pregnant doesnt make you eligible, but the birth of a child does.
- Create an account now to apply for Marketplace coverage through the Open Enrollment Period or a Special Enrollment Period. If you select the option to get help paying for coverage on your application, youll be asked if youre pregnant. Reporting your pregnancy may help you and your family members get the most affordable coverage.
- If you dont qualify for a Special Enrollment Period right now, youll be eligible to apply within 60 days of your childs birth. You can also enroll in 2021 coverage during the next Open Enrollment Period this fall.
- If eligible for Medicaid or CHIP, your coverage can begin at any time.
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Help For Adults And Seniors To Stay Safely In Their Homes
DHS has several programs that are designed to help adults with physical disabilities and seniors stay in their homes and communities rather than go to s skilled nursing facility. To apply for the programs below, please reach out to your local county office. If you would like to talk to a counselor about your options, call the Choices in Living Resource Center at 1-866-801-3435 or email .
ARChoices in Home Care provides attendant care, home-delivered meals, personal emergency response systems, adult day services, and respite care. Independent Choices is like ARChoices in Home Care, but the client is responsible for hiring, training, and supervising his or her in-home workers from Medicaid funds the client or his/her representative control.
Living Choices Assisted Living is a Medicaid program that pays for apartment-style housing for people who need extra care and supervision. Its for people who are at risk of being placed in a nursing home or who are in a nursing home and want more independence.
Program of All-Inclusive Care for the Elderly is for people age 55 and older who have been determined by the state, based on specific criteria, to need nursing home care. PACE allows them to live as independently as they can.
Arkansas Medicaid Expansion Enrollment Has Declined Significantly Since 2016
By September 30, 2016, total enrollment in expanded Medicaid in Arkansas had reached 324,000 . And by December 2016, there were 331,000 people enrolled in the states expanded Medicaid. The states total Medicaid enrollment grew by 70 percent from the end of 2013 to December 2016, reaching 948,181.
But as of January 1, 2017, enrolled in expanded Medicaid dropped to 310,951, following the states efforts to remove people from Medicaid who were no longer eligible from the program. 21,280 non-eligible people were removed from the states expanded Medicaid rolls at the start of 2017. Enrollment had climbed to over 320,000 by March 31, 2017, but it had declined to 285,000 by January 2018, in line with the decline in the states overall Medicaid enrollment from 2017 to 2018.
As of January 2019, enrollment in Arkansas Works stood at 234,400 people , although it had grown to . Thats more than 27% lower than it had been in 2016. Although that would be a positive change if the individuals in question had transitioned to employer-sponsored plans or other private health insurance options, Judge Boasbergs ruling makes it clear that there are certainly a number of people who have lost Medicaid coverage and simply become uninsured.
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Effective Date Of Coverage
Once an individual is determined eligible for Medicaid, coverage is effective either on the date of application or the first day of the month of application. Benefits also may be covered retroactively for up to three months prior to the month of application, if the individual would have been eligible during that period had he or she applied. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility.
Work Requirement Took Effect In June 2018 And 18000 People Had Lost Coverage By The End Of 2018
Arkansas received federal approval in March 2018 to make some modifications to the states Medicaid expansion program, including the implementation of a work requirement and the unconditional elimination of Medicaids three-month retroactive eligibility, replacing it with a 30-day retroactive eligibility provision instead. The waiver amendment was submitted in June 2017, and Arkansas had hoped to implement the changes by January 2018. But the waiver approval noted that the work requirement could be implemented no earlier than June 1, 2018.
The state wasted no time, however, and implemented it as of June 5, 2018. The work requirement was delayed until 2019 for people under the age of 30, but applied as of June 5 to people between the ages of 30 and 49 who werent otherwise exempt. They had to work or participate in other community engagement activities at least 80 hours per month in order to maintain access to Medicaid coverage. After three months of non-compliance, Medicaid eligibility would terminate.
So people began losing coverage as of the end of August for failure to comply with the work requirement including failure to comply with the onerous reporting requirements, detailed below. By the end of 2018, more than 18,000 people had lost their Medicaid coverage in Arkansas under the new work requirement. A beneficiary who lost coverage due to non-compliance with the work requirement was locked out of Arkansas Works until the end of the year.
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Similar Program New Name
After 2016, Medicaid expansion in Arkansas was called Arkansas Works instead of the Private Option. But it was widely noted that the fundamental mechanics of the new program were very similar to the Arkansas Health Care Independence Program, which was the name of the Arkansas waiver program from 2014 through 2016. Arkansas still uses Medicaid funds to purchase private coverage for eligible enrollees in the exchange, which was the basic premise of the Private Option in the first place.
But lawmakers who were opposed to the Private Option were able to end it and replace it with Arkansas Works in many cases, fulfilling campaign promises but without the ramifications that would ensue if the state were to kick 300,000+ people off their health insurance .
What Is Arkansas’ Medicaid Expansion ‘private Option’
Arkansas is among the states expanding Medicaid, but it is using a non-standard approach or waiver. Arkansas Medicaid expansion waiver allows the state to use Medicaid expansion funds to subsidize premiums for beneficiaries who purchase private health insurance through the health insurance marketplace.
Arkansas received federal approval in late 2014 to amend its Private Option waiver. The approved changes establish health savings accounts for beneficiaries, allow cost-sharing for Private Option Beneficiaries at 50% of FPL, and limit some transportation services.
The growth in Arkansas Medicaid enrollment has played a significant role in the reduction in the uninsured rate in the state. According to U.S. Census data, 16% of Arkansas residents were uninsured in 2013, and that had dropped to 7.9% by 2016 a decrease of more than 50%.
However, the future of Arkansas Private Option/Arkansas Works is not certain. The state legislature must reauthorize the program annually with a 75% majority in both the House and Senate. In 2014, it took five attempts to pass reauthorization. S.B.196 reauthorized Medicaid expansion in March 2017. In 2019, the Arkansas House Medicaid expansion funding just two days after the states Medicaid work requirement had been overturned by a federal judge. But the following week the measure was approved was signed into law in early April, reauthorizing Medicaid expansion funding in Arkansas until the end of June 2020.
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Who Is Eligible For Medicaid
The general guidelines for eligibility for Medicaid are set by the Federal government however, each state sets up their own specific requirements for eligibility and these can differ from state to state.
All States are required to include certain individuals or groups of people in their Medicaid plan.
The state eligibility groups are:
- Categorically needy
- Medically needy
- Special groups
In the categorically needy group, this will cover pregnant women whose income level is at or below 133% of the Federal Poverty level.
In the medically needy group, this will cover a pregnant woman who makes too much money to qualify in the categorically needy group. This means that women, who may have been denied Medicaid before, may be able to qualify now.
