Arkansas Medicaid covers a broad range of medical services, from doctor visits and hospital stays to prescriptions, dental care, mental health treatment, and free rides to appointments. The specifics depend on which program you’re enrolled in. Adults who qualify through income expansion get coverage through private insurance plans paid for by Medicaid, while children, pregnant women, seniors, and people with disabilities each have their own program with slightly different benefits and costs.
Core Medical Services
Every Arkansas Medicaid program covers a baseline set of services required by federal law. These include inpatient and outpatient hospital care, physician visits, lab work and X-rays, home health services, nursing facility care, family planning, and preventive screenings. Nurse midwife services and nurse practitioner visits are also fully covered.
Arkansas has also opted into several services that states can choose whether to offer. These include prescription drugs, physical therapy, occupational therapy, speech therapy, prosthetics, eyeglasses, personal care services, hospice, and case management. Medication-assisted treatment for opioid use disorder is covered as well.
How ARHOME Works for Adults
If you’re an adult who qualifies for Medicaid through income-based expansion, you’re enrolled in a program called ARHOME (Arkansas Health and Opportunity for Me), which replaced the older Arkansas Works program in January 2022. Rather than traditional Medicaid, ARHOME uses Medicaid funding to buy you a private health insurance plan through either Blue Cross Blue Shield or Ambetter.
You’re still a Medicaid beneficiary, but your coverage looks more like employer-sponsored insurance. ARHOME also runs specialized programs called Life360 HOMEs that target specific groups: high-risk pregnant women and newborns, people living in rural communities, and young adults at elevated risk for poor health outcomes. These provide extra support beyond standard medical coverage.
ARHOME Copays
Most ARHOME members pay small copays for certain services. A physician visit, specialist appointment, or rural health clinic visit costs $4.70. The same applies to chiropractor visits, ambulatory surgical centers, and nutritional counseling. Several categories are completely exempt from copays: emergency services, preventive care and immunizations, family planning, inpatient hospitalization, and anything pregnancy-related.
Children’s Coverage Through ARKids First
Children in Arkansas are covered through ARKids First, which has two tiers based on family income. ARKids A has no cost to families at all, with no copays for any service. ARKids B requires small copays for some services. Both programs provide a full package of medical, dental, and vision benefits.
Children on Medicaid also receive coverage through a federal requirement called EPSDT (Early and Periodic Screening, Diagnostic, and Treatment). This is one of the most comprehensive benefits in all of Medicaid. It requires the state to cover any medically necessary service for a child under 21, even if that service isn’t normally covered for adults. This includes developmental screenings, vision and hearing tests, dental checkups, and treatment for any condition discovered during a screening.
Dental Coverage
Arkansas Medicaid covers dental services for both adults and children, but adult coverage comes with a hard cap. Adults are limited to $500 per year in dental benefits. Once you hit that limit, you’re responsible for any additional costs. Unused money does not roll over into the next year, so there’s no benefit to delaying care. Children’s dental coverage through ARKids is more generous, falling under the broader EPSDT requirement.
Prescription Drug Coverage
Prescription medications are covered under Arkansas Medicaid. For adults in fee-for-service Medicaid, copays are based on the cost of the drug: $0.50 for medications under $50, and $3.50 for medications that cost $50 or more. Federal law caps Medicaid copays for preferred drugs at $4. Prescriptions related to pregnancy and family planning carry no copay.
Pregnancy and Newborn Care
Pregnant women can get coverage quickly through a process called Presumptive Eligibility. This provides immediate access to prenatal care while a full Medicaid application is being processed. Covered services during this period include prenatal physician visits, emergency room prenatal visits, prescription drugs related to the pregnancy, and prenatal lab tests. Coverage runs from the date of eligibility determination through the end of the following month.
Once fully enrolled, pregnant women receive comprehensive maternity coverage with no copays for any pregnancy-related service. The Maternal Life360 HOME program through ARHOME provides additional support for high-risk pregnancies.
Behavioral Health and Disability Services
Arkansas runs a specialized system for Medicaid members with complex behavioral health needs or intellectual and developmental disabilities, called PASSE (Provider-led Arkansas Shared Savings Entity). If you qualify, a PASSE organization coordinates all your care and connects you to a wide range of services.
On the medical side, PASSE covers primary care, specialist visits, behavioral health counseling, therapy (physical, occupational, and speech), durable medical equipment, personal care, nursing services, and health counseling. For home and community-based needs, it can include respite care, supported employment, mental health crisis services, supportive housing, environmental modifications to your home, family support partners, and substance abuse detoxification. When facility-based care is necessary, PASSE covers stays in psychiatric facilities, hospitals, and intermediate care facilities for people with intellectual disabilities.
Personal Care Services
If you need hands-on help with daily activities like bathing, dressing, or preparing meals, Arkansas Medicaid may cover in-home personal care services. To qualify, you must meet Medicaid’s “categorically needy” income criteria, need physical assistance with at least one routine or instrumental activity of daily living, and not currently live in a hospital, nursing facility, or other institutional setting. An independent assessment administered by a state contractor determines your level of need.
Non-Emergency Transportation
Getting to medical appointments is one of the most practical benefits Arkansas Medicaid offers. The state contracts with regional transportation brokers who arrange rides for you at no cost. To use the service, you call your regional broker at least 72 hours (three full days) before your appointment. If you don’t know your broker, a statewide help line at 1-888-987-1200 can connect you.
Brokers operate Monday through Friday, 8 a.m. to 5 p.m., and must provide rides for recurring treatments like chemotherapy, radiation, and dialysis. If you have multiple appointments in one day, the broker will arrange transportation to each one. For urgent medical situations, your doctor can call the broker directly and get you a ride without the usual 72-hour notice. If your appointment is outside your region, you’ll need a referral from your doctor sent to the broker.
A few groups cannot use this transportation benefit: nursing home residents, people living in intermediate care facilities for intellectual disabilities, qualified Medicare beneficiaries, and children on ARKids First-B.
What’s Not Covered
Arkansas Medicaid does not cover every possible medical service. Cosmetic procedures, services that aren’t medically necessary, and anything exceeding program limits (like dental work beyond the $500 annual cap for adults) fall outside coverage. Some services that other states cover more generously, like comprehensive adult dental or extensive vision care, are limited in Arkansas. If you’re enrolled in ARHOME through a private plan, your specific benefits may also be shaped by the terms of your Blue Cross Blue Shield or Ambetter plan, though they must meet Medicaid’s minimum requirements.