AR Medicaid Enrollment: An Overview

1. Federal Health Insurance Marketplace 1 Consumer Entry – Initiate Application 1.3 MAGI - Is Income >138% FPL Consumer Receives Insurance Card 1.5 – Consumer Plan Selection- Referred to Carrier for Payment 1.1 Consumer Sign In & Initiate Application 1.2 Complete MAGI and Provide Results to Consumer 1.4 – Select Premium Tax Credit YES NO C - Carriers A -Federal Data Services Hub verifies key application data Marketplace sends data to AR Medicaid Arkansas Eligibility & Enrollment Framework ACCESS Arkansas AR Medicaid provides notice to consumer and sends data to Marketplace NO Health Care Independence Plan 2 Consumer Entry – Initiate Application 2.3 MAGI - Is Income ≤ 138% FPL 2.4 Medicaid Eligible – Notice Provided to Consumer to go to insureark.org 2.2 Complete MAGI 2.1 Consumer Sign In & Initiate Application YES B - MMIS Arkansas Health Care Independence – insureark.org Traditional Medicaid Traditional Medicaid YES Health Care Independence Plan 3 3.4 Special Healthcare Needs?? Consumer Entry – Entry only after receipt of Medicaid eligibility notice 3.1 - Consumer Sign In 3.2 - Medicaid Eligibility Verification 3.3- Health Care Needs Assessment 3.5 Consumer Plan Selection NO Consumer Receives Medicaid Card