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Get Arkids First Application (pdf) - Center For Arkansas Legal Services - Arlegalservices
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How to use or fill out the ARKids First Application (PDF) - Center For Arkansas Legal Services - Arlegalservices online
Filling out the ARKids First Application is an important step towards securing health coverage for your children. This guide provides clear, step-by-step instructions to help users complete the application accurately and efficiently.
Follow the steps to successfully fill out the application form.
- Click the ‘Get Form’ button to access the ARKids First Application form. This will allow you to open the file and begin filling it out.
- In the first section of the application, indicate whether you wish to apply for either ARKids A or B by checking the appropriate box. Selecting 'Either' allows your children to be placed in the package with the most coverage based on their eligibility.
- Complete the applicant information section. You must provide the name, birth date, race, sex, and contact details of the parent, guardian, or related person living with the children applying for ARKids. Note that the social security number is optional but beneficial for processing.
- List all children under age 19 living in your household. For each child, provide their name, birth date, race, sex, and indicate whether they are a U.S. citizen by marking Yes or No. If applicable, attach copies of their birth certificates.
- Detail the household composition by listing all parents of the children mentioned. Fill in their names, birth dates, race, sex, and citizenship status.
- You will need to provide information on any income received by individuals listed on page 1. Specify sources of income, how often income is received, and who receives it. Attach additional sheets if necessary.
- Indicate whether anyone pays for childcare for the children listed, and if so, provide the amount and frequency of payment.
- Answer questions regarding unpaid medical expenses, health insurance status, and any chronic illnesses or disabilities of the children applying. Provide details as prompted.
- Choose primary care physicians for each of the children applying. Each child can have one primary care physician only, so indicate your preferences.
- Review the authorization and signature section. Ensure you understand the terms and provide your signature along with the date. If someone assisted in completing the form, they must sign and provide their contact information as well.
- Once you have filled out the application thoroughly, you can save your changes, download, print, or share the form. Make sure to return the completed application along with all required documents to your local DHS county office.
Complete your ARKids First Application today to ensure your children receive the health coverage they deserve.
In Arkansas, Medicaid is often referred to simply as 'Medicaid.' It encompasses various programs designed to assist low-income families and individuals, including ARKids First for children's health coverage. For information on applying or understanding specific benefits, refer to the ARKids First Application (PDF) - Center For Arkansas Legal Services - Arlegalservices for the latest updates.
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