Arkansas Medicaid Plans: ARKids, ARHOME, PASSE, and Eligibility

Arkansas Medicaid is not one program but a set of at least eight, each built for a specific group of people. Which of the Arkansas Medicaid plans you qualify for depends on your age, your household income compared to the Federal Poverty Level, and whether you have a disability or another special circumstance like pregnancy or caregiving. The plans differ in income thresholds, whether assets count, what services are covered, and even which insurance company delivers the care.¹

ARKids First for Children Under 19

ARKids First covers Arkansas children under 19 and splits into two tiers based on family income.¹

ARKids A serves children in families with income below 142% of the Federal Poverty Level. There are no premiums and no copays, and benefits include well-child checkups, immunizations, dental visits, eye exams, and general medical care.²

ARKids B picks up otherwise uninsured children in families earning at or above 142% but below 211% of the FPL. Benefits are similar to ARKids A but slightly more limited, and small copays apply to some services.¹

For a family of four in 2026, 142% of the FPL is roughly $46,860 per year and 211% is about $69,630.³ Neither ARKids tier counts assets, so savings, vehicles, and similar property do not disqualify a child.⁴

ARHOME for Working-Age Adults

Arkansas Health and Opportunity for Me, or ARHOME, is the state’s Medicaid expansion for adults ages 19 to 64. The effective income limit is 138% of the FPL, which is 133% plus a built-in 5% income disregard.⁴ For a single adult in 2026, that comes out to roughly $22,025 a year.³

ARHOME delivers coverage differently from traditional Medicaid. The program uses Medicaid dollars to buy private health insurance for enrollees through one of two carriers, Blue Cross Blue Shield or Ambetter.⁵ You remain a Medicaid beneficiary, but your insurance card comes from one of those companies and you use their provider network. No asset test applies.⁴

Coverage During and After Pregnancy

Pregnant women can qualify for Arkansas Medicaid at income up to 214% of the FPL, and expected babies count toward household size when eligibility is calculated.⁶ Benefits cover prenatal care, delivery, and postpartum services.

Coverage currently ends on the 60th day after delivery.⁶ Federal law gave states the option to extend postpartum coverage to a full 12 months, and most states have taken that option. As of early 2026, Arkansas had not. If you are approaching day 60, check whether you qualify for ARHOME or another category before your pregnancy coverage ends.

Presumptive Eligibility

Presumptive eligibility lets a pregnant woman start prenatal care immediately, without waiting on a full application. A qualified provider makes a preliminary eligibility determination and temporary coverage begins the same day, running through the end of the month after the full determination is issued. If the full application is later denied, you owe nothing for care received during the presumptive period; Arkansas Medicaid covers those costs.⁷

Unborn Child Coverage for Non-Citizens

Arkansas offers a separate Unborn Child category for pregnant women who meet income requirements but not the citizenship or immigration status requirements for regular Medicaid. Benefits are limited to prenatal care, delivery, postpartum care, and treatment of conditions that complicate the pregnancy. Coverage ends on the 60th day postpartum.²

Aged, Blind, and Disabled Coverage

If you are 65 or older, blind, or have a qualifying disability, different rules apply. These categories generally use the income methods of the Supplemental Security Income program instead of the MAGI standard used for children and working-age adults, and they impose an asset test.⁸

For the full-benefit Aged, Blind, and Disabled adult category, countable assets cannot exceed $2,000 for an individual or $3,000 for a couple.⁴ Your home, one vehicle, and certain other property are typically excluded. A spend-down option exists for people whose income exceeds the standard limit but who have significant medical expenses.

Long-Term Care and Waiver Programs

Arkansas provides Long-Term Services and Supports for people who need nursing facility care, assisted living, or home- and community-based services through programs like ARChoices and the Developmental Disabilities Services waiver. The same $2,000/$3,000 asset limits apply.⁴

When one spouse enters a nursing facility, the spouse living at home is allowed to keep a protected share of the couple’s combined assets, called the Community Spouse Resource Allowance. In 2026, the non-applicant spouse can retain up to $162,660. The rule exists so the healthy spouse is not financially wiped out by long-term care costs.

TEFRA for Children With Disabilities

The TEFRA option, named for the Tax Equity and Fiscal Responsibility Act, lets children with disabilities qualify for Medicaid based on the child’s own income and resources rather than the parents’ finances. The condition is that the child must need a level of care that would otherwise require placement in a nursing facility or similar institution; TEFRA lets that care happen at home.⁹

Families with annual income above 150% of the FPL pay a monthly premium on a sliding scale, ranging from $20 at the lowest tier up to $458 at the highest, with total out-of-pocket costs capped at 5% of gross annual income.¹⁰ Families below 150% of the FPL pay no premium.

PASSE for Behavioral Health and Developmental Disability Needs

The Provider-led Arkansas Shared Savings Entity program, PASSE, is the state’s managed care system for Medicaid beneficiaries with behavioral health conditions, developmental disabilities, or intellectual disabilities. A PASSE coordinates and manages your care instead of traditional fee-for-service Medicaid.¹¹

Four organizations operate as PASSEs in Arkansas: Arkansas Total Care, CareSource, Empower Healthcare Solutions, and Summit Community Care.¹² You are enrolled in a PASSE if you receive Developmental Disabilities waiver services, sit on its waiting list while getting state plan services, live in a private DD Intermediate Care Facility, or have a behavioral health diagnosis requiring more than basic counseling and medication management.¹¹

AR HIPP for People With Employer Insurance

The Arkansas Health Insurance Premium Payment program works the opposite way from most Medicaid plans. Instead of replacing employer-sponsored coverage, AR HIPP reimburses you for keeping your employer or COBRA plan, and you keep your Medicaid benefits on top of it.¹³

The dual coverage eliminates most out-of-pocket costs because Medicaid pays what the private plan does not. At least one person on the employer policy must be Medicaid-eligible. You submit your insurance card, a summary of benefits, the employer’s rate sheet, and a pay stub showing premium deductions, and the program renews annually with your plan year.¹³ AR HIPP is easy to miss but can be the best fit for families where one member has high healthcare costs and someone in the household already has group insurance through work.

Parent or Caretaker Relative Category

Adults who care for related minor children in the home may qualify under the Parent or Caretaker Relative category.² The income threshold is very low compared to other categories. Most parents in that income range also qualify for ARHOME with its 138% FPL threshold, which is the more common pathway to coverage for working-age adults.

How Income and Assets Are Counted

Arkansas uses two different methods to evaluate financial eligibility, depending on the program.

For children, pregnant women, parents, and adults under 65 without disabilities, the state uses the Modified Adjusted Gross Income standard. MAGI measures household taxable income against the Federal Poverty Level, adjusted for household size. No asset test applies, so savings, home equity, and vehicles do not count against you.⁸

For people whose eligibility is based on age (65+), blindness, or disability, Arkansas uses SSI-based income methods and does count assets. Countable resources are capped at $2,000 for a single person and $3,000 for a couple.⁴ Common exclusions include a primary residence and one vehicle.

Whatever the program, you must be an Arkansas resident and either a U.S. citizen or a qualified non-citizen.¹⁴ Medicaid is a payer of last resort: if you have other insurance, it pays first and Medicaid picks up the remainder.¹⁵

How to Apply

The fastest way to apply is online at Access.Arkansas.gov, where a single application covers your whole family and you can upload documents and track your case.¹⁶ You can also mail a paper application, apply by phone, or visit a county DHS office.

Have your Social Security number or immigration document number, proof of identity, proof of Arkansas residency such as a utility bill or lease, and income documentation like pay stubs, W-2s, or tax returns.¹⁷ If anyone in the household has existing health insurance, include that policy information.

Submit even if you are missing a document. Your application date affects when benefits begin, and waiting on one piece of paper can cost you coverage days. DHS follows up on anything that is missing.

What Happens After You Apply

DHS has 45 days to decide on most applications. If your application involves a disability determination not already established by the Social Security Administration, a DHS Medical Review Team reviews the medical records and the timeline stretches to 90 days.¹⁸

You can check status through your Access Arkansas account or by calling DHS. Once approved, how your coverage is delivered depends on the program: ARHOME enrollees are placed with Blue Cross Blue Shield or Ambetter,⁵ and beneficiaries with qualifying behavioral health or developmental disability conditions are enrolled in one of the four PASSE organizations.¹¹

If your application is denied or your benefits are reduced, DHS sends a written notice with the reason. You have 30 days to file an appeal for an administrative hearing. If you already receive benefits and appeal within 35 days of the notice, your benefits continue unchanged until the appeal is resolved.¹⁹ Miss those deadlines and you lose the right to challenge the decision.

Keeping Coverage Through Renewal

Arkansas Medicaid eligibility is reviewed every year. One to two months before your renewal date, you will receive a letter. In some cases DHS can verify your information from available data and renew automatically. When it cannot, you must complete and return a renewal form. Federal rules require DHS to give you at least 30 days.²⁰ You can respond through Access Arkansas, by phone, by mail, or in person.

Miss the deadline and your coverage ends, forcing you to start over. This is where people lose coverage unnecessarily, not because they are ineligible but because a renewal letter got buried. Keep your mailing address current with DHS and watch for that notice. If you lose Medicaid and no longer qualify, you can shop for subsidized coverage through Healthcare.gov during a special enrollment period.

Estate Recovery for Long-Term Care Beneficiaries

Federal law requires every state Medicaid program, Arkansas included, to seek repayment from the estates of beneficiaries who were 55 or older when they received certain services, particularly nursing facility care, home- and community-based waiver services, and related hospital and prescription drug costs.²¹ DHS can file a claim against your estate after death to recover what Medicaid paid.

Arkansas law identifies undue hardship situations in which DHS will not pursue recovery, including where estate property is a family member’s sole source of income, where the home is of modest value (50% or less of the average county home price), or where recovery would push an heir onto public benefits. Applicants are notified about estate recovery on the application itself.²²

Estate recovery mostly affects people who received long-term care and owned a home or other property at death. If you are under 55 or receiving only ARHOME or ARKids benefits, it does not apply to you. For families weighing long-term care Medicaid for an aging parent, understanding the rule early can shape financial planning.

1
Arkansas Department of Human Services. DHS 101 Programs
2
Arkansas Department of Human Services. Health Care Programs
3
U.S. Department of Health and Human Services. 2026 Poverty Guidelines
4
Arkansas Department of Human Services. Quick Reference Chart – Health Care Eligibility
5
Arkansas Department of Human Services. ARHOME
6
Arkansas Department of Human Services. Health Care Eligibility – Quick Reference
7
Arkansas Department of Human Services. Presumptive Eligibility for Pregnant Women (PE-PW)
8
Medicaid.gov. Eligibility Policy
9
Cornell Law Institute. 016.20.02 Arkansas Code R 022 – Medical Services Policy MS 27000 – 27075 TEFRA Waiver Home Care for Children
10
Arkansas Department of Human Services. TEFRA Premiums – How Much Will I Pay
11
Arkansas Department of Human Services. PASSE
12
Arkansas Governor’s Council on Developmental Disabilities. PASSE – Arkansas Managed Care
13
Arkansas Department of Human Services. Arkansas Health Insurance Premium Payment Program (AR HIPP)
14
Arkansas Department of Human Services. Medicaid Eligibility
15
Centers for Medicare and Medicaid Services. Third Party Liability (TPL) – Deficit Reduction Act Important Facts for State Policymakers
16
Arkansas Department of Human Services. Apply For Services
17
Arkansas Department of Human Services. Single Adult Health Coverage Application DCO-151
18
Arkansas Department of Human Services. How to Apply for TEFRA Coverage
19
Arkansas Department of Human Services. Medicaid Administrative Reconsiderations and Appeals
20
eCFR. 42 CFR Part 435 Subpart J – Redeterminations of Medicaid Eligibility
21
Medicaid.gov. Estate Recovery
22
Justia Law. Arkansas Code Title 20-76-436 – Recovery of Benefits From Recipients Estates