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MEDICAL SERVICES POLICY MANUAL,SECTION A
A 100GeneralProgram Information
5. Emergency services; 6. Services that are considered preventative or provider-preventable diseases; 7. Health Maintenance Organization (HMO) enrollees; 8. Services provided to individuals receiving hospice care; 9. PASSE enrollees; 10. AmericanIndian/ Alaska Natives; and 11. Individuals that are at or below twenty (20) percent of the FPL.
A-115 CostSharing for Workers withDisabilities MS Manual 01/01/23 Recipients of Medicaid for Workers with Disabilities (WD) with gross income up to one hundred and fifty percent (150%) of the FPL for their family size will be subject to paying Health Care co- pays. Recipients with income greater than one hundred and fifty percent (150%) of the FPL will be assessed for co-payments up to twenty percent (20%) of Health Care maximum allowable, up to ten dollars ($10) per visit. NOTE: Transitional Medicaid will follow the same cost share guidelines as Workers with Disabilities.
A-116 Premiums for the Adult Expansion Group MSManual 08/29/22 A program participant who has income of at least 100% of the federal poverty levelwill pay a premium of no more than 2% of their income to a health insurance carrier. Individuals who are medically frail and receiving traditional Medicaid will not be required to pay a premium.
A-120 Dual Eligibles-Medicare/Medicaid MSManual 07/01/20 Medicare is a Federal Insurance Program which pays part of hospital and medical costs for persons 65 years of age and over, certain disabled persons and others determined eligible by the Social Security Administration. Medicare Insurance in Arkansas is processed by Arkansas Blue Cross and Blue Shield. Medicare consists of 4 types of coverage, Part A - Hospital Insurance, Part B - Medical Insurance, Part C - Medicare Advantage Plans and Part D - Prescription Drug Coverage.