Are you worried about your health coverage? The Private Option program for Medicaid expansion has been replaced with Arkansas Works. However, most people who had health insurance through the Private Option in 2016 will not see much change to their coverage in 2017 under Arkansas Works.
The Affordable Care Act provided money for states to expand the number of people covered under their state Medicaid health programs. Arkansas chose to expand Medicaid by using Medicaid funds to buy private health insurance for eligible residents (those with incomes up to 138% of the federal poverty level – about $16,394 for an individual). They called this program the Private Option.
When the Private Option ended on Dec. 31, 2016, it was replaced with Arkansas Works. While similar to the Private Option in many ways, Arkansas Works includes several new features. Here’s a short summary of them.
- Encourages you to get insurance from your employer, if available. If you’re age 21 and older and working, you will need to enroll in your employer’s health insurance, if it’s available and your employer agrees to participate. Arkansas Works will pay the health insurance premiums and co-payments to your employer on your behalf.
- Makes it easier to take advantage of training and work opportunities. If you don’t have a job, you will be referred to the Department of Workforce Services for job training and job-search programs. For the immediate future, you won’t lose your health coverage if you do not find a job. This could possibly change in the future.
- May require you to pay a monthly premium. If your income is at least 100 percent of the federal poverty level (FPL), you will pay a monthly premium of $13 in 2017. In the future, the premium will be equal to 2 percent of your income, or about $19 to $27 a month. You will not lose coverage if you fail to pay the premiums. However, you will owe a debt to the state. No premium will be charged if your income is below 100 percent of the FPL, or $11,770 for 1 person (or $24,250 for a family of four).
- Covers health expenses only from the date you enroll. These is no more coverage for up to 90-days before you became eligible.
- Continues to use Medicaid funds to purchase qualified health plans (QHP) from the private insurance market. This means you have the same private health insurance policy as other workers.
Who’s eligible for Arkansas Medicaid
- Children from birth to age 18 with incomes up to 211 percent of the federal poverty level (FPL), or $24,835 per year.
- Pregnant women with incomes up to 209 percent of the FPL, or about $24,600.
- Adults with incomes up to 138 percent of the FPL ($16,243)
- Certain disabled Arkansans
Arkansas Works will continue the incentive benefit to those who enroll and make their premium payments (if they’re required, according to your income) on time and who work to achieve health behavior standards.
It’s still available
To apply for Arkansas Works, get an application at any Department of Human Services (DHS) office; or call toll free 1-800-482-8988. You may also enroll online at Healthcare.gov.
There is no deadline to apply for Arkansas Works. You can apply at any time, as soon as you think you’re eligible, based on your income.
For more information
You can reach the Arkansas Works Information Service Center at 1-888-987-1200 (option 3). Specially trained counselors can answer your questions or refer you to other resources for help.
People on Arkansas Works may be eligible for free Non-Emergency Transportation (NET) to get to and from your doctor or other medical appointments. There is a limit to the number of trips in a year and they must be scheduled in advance. This service is available only if you have no other way to get to the appointment. Contact NET at 1-888-987-1200 (option 1).
If you are having problems with Medicaid, Arkansas Works or have a complaint, call 1-888-987-1200 (option 2).
Work with what you have now
No one knows for certain if the Affordable Care Act, which provides funds for expansion of Medicaid (called Arkansas Works in Arkansas), will end, be changed, or will continue to provide many of the same benefits it does now. While that uncertainty can create a lot of worry, all you can do is work with what’s in place today. Many experts think it could be a year, or longer before major changes are made at the consumer level. You have a window to opportunity during 2017 to improve your health. Don’t miss it.
If you’re not part of Arkansas Works, apply now to see if you’re eligible. If you’re eligible, try to get your health needs taken care of now, while coverage is in place. Work with your doctor to develop a plan, going forward, for what you can do to stay as healthy as possible.
There are many lifestyle changes that you can make to improve your health that don’t cost a thing or require you to visit a doctor. They include:
- Quit smoking. There are free services to help you quit and free apps for your cell phone. Call toll free 1-800-QUIT-NOW to speak with trained counselors who can help and guide you to free resources.
- Lose a few pounds if you’re overweight. Make a commitment to keep it off. You’re worth it!
- Eat healthier foods and eat less junk food, fast food and foods full of sugar, fat and salt. Most fruits and vegetables are even healthier if eaten raw – no cooking required. Choosing foods that are full of nutrition – instead of empty calories, sugar and salt – can help maintain a healthy weight.
- Ask your doctor what shots you need and when. Have you been putting off getting a procedure or surgery your doctor recommended? Now’s the time to get it taken care of while you have coverage.
- Ask your doctor what health screenings you need and get caught up with them. These may include blood pressure, cholesterol and diabetes screening, mammograms for women, and other tests. Use the results as a guide to areas of your health to focus on if coverage is lost in the future.
- Increase the amount of exercise you get. Walking is free and one of the easiest and most important things you can do to stay healthy. Walking can help you lose weight and keep it off. It can also strengthen your bones to avoid breaks, improve your circulation, boost your mood and improve your immunity to diseases. Walking is great for improving your sleep, glucose levels, memory and brain function. It also lessens pain and reduces your risk of tripping and falling by improving balance.