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Medical Services – Appendix D, Benefits Available Under Medicaid and ARKids First 01/01/19 Appendix D Page 3 of 4 Outpatient Hospital Services – Most outpatient hospital care is covered, however there may be some charges the recipient may have to pay. There is a limit on the number of visits for adults aged 21 or older. ARKids B coverage requires a co-payment. Personal Care Services - Personal care services will be paid if they are prescribed by a physician and provided according to a plan of care in the recipient’s home. Physician Services - Medicaid will pay for a limited number of physician services for recipients aged 21 or older each year. Podiatrist Services – A podiatrist specializes in problems of the feet. Recipients age 21 or older have a limit number of visits Medicaid will pay for. ARKids B requires a copayment. Prescription Drugs – Medicaid and ARKids cover most prescription drugs. Some prescriptions will require prior approval. ARKids B recipients may have to pay a copay. Private Duty Nursing Services (PDN) - Nursing services may be covered for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing staff of a hospital or skilled nursing facility. Prosthetics - A range of prosthetic services is available to Medicaid recipients based on the age of the recipient. Psychology Services – A broad range of psychology services for recipients under age 21 is provided through the Child Health Services (EPDST) Program. Rehabilitative Services for Persons with Mental Illness (RSPMI) – Medicaid will pay for some rehabilitative services for mental illness. Rehabilitative Services for Persons with Physical Disabilities (RSPD) – Medicaid pays for rehabilitation services for children under age 21 with physical disabilities, if services are recommended by a doctor or other licensed medical worker. The child must have had a severe brain injury or a spinal cord disorder or injury. Rural Health Clinic Services – Medicaid will pay for a limited number of visits to a rural health clinic for individuals aged 21 or older. Targeted Case Management – Targeted case managers help patients find and get the medical services needed as prescribed by a doctor. The patient may be able to get this service if younger than 21 and referred as a result of a well-child check-up; has ARKids A or regular Medicaid; has a developmental disability; is aged 60 or older; or is pregnant. TEFRA Services – Medicaid pays for services in the home for certain children (aged 18 or younger) with disabilities if they would qualify for Medicaid as residents of a hospital, skilled nursing facility, or ICF/IID (Intermediate Care Facilities/Individuals with Intellectual Disabilities).