Arkansas Application for Presumptive Eligibility for Medicaid

State:
Multi-State
Control #:
US-0538BG
Format:
PDF
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Description

Use this form to find out quickly if you qualify for presumptive eligibility for Medicaid. Presumptive eligibility offers you and your family immediate access to health care while you apply for regular Medicaid or other health coverage.
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How to fill out Application For Presumptive Eligibility For Medicaid?

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FAQ

Presumptive eligibility begins on the date that a Qualified Provider determines that the net family income of a pregnant woman does not exceed the appropriate level of the Federal Poverty Income Guidelines.

Presumptive Eligibility for Pregnant Women is immediate and temporary coverage for low-income women who are pregnant and might be eligible for Medi-Cal. Coverage is available for up to 60 days while you apply for ongoing Medi-Cal.

Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Who is eligible for Arkansas Medicaid Program? Household Size*Maximum Income Level (Per Year)1$19,3922$26,2283$33,0644$39,9004 more rows

Medicaid for SSI Recipients in Arkansas SSI recipients in Arkansas automatically qualify for Medicaid. You will automatically be enrolled in Medicaid after you are approved for benefits.

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Arkansas Application for Presumptive Eligibility for Medicaid