Arkids application form printable 2026

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  1. Click ‘Get Form’ to open the ARKids application form in the editor.
  2. Begin by filling out the 'Applicant Information' section. Enter your Social Security Number, last name, first name, middle initial, birth date, race, sex, county, email address, and both street and mailing addresses. Ensure all fields are completed accurately.
  3. In the 'Household' section, list all children under age 19 living in your household who you want considered for ARKids. Provide their Social Security numbers and attach copies of birth certificates if necessary.
  4. Proceed to the 'Income' section. Indicate whether anyone listed has income from various sources and provide details about gross pay and frequency of payment.
  5. Complete sections on child care expenses, unpaid medical bills, health insurance status, chronic illness or disability information, and primary care physician selection as applicable.
  6. Finally, review the declaration statement carefully before signing. Ensure that all information is accurate and complete before submitting your application.

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When you go to the county office to apply, bring: your birth certificate or other proof of your age. paycheck stubs. Social Security Card. letters or forms from Social Security, SSI, Veterans Administration, or other sources that show the amount of income that you get insurance policies, even other health insurance.
Required Documents: Proof of identity (drivers license, state ID) Proof of citizenship or legal alien status (if applicable) Proof of income for all household members (pay stubs, tax returns) Proof of Arkansas residency (utility bill, lease agreement) Verification of disability (if applicable)
ARKids First Income Eligibility Effective April 01, 2024 Family SizeARKids A MonthlyARKids B Monthly 1 $1,782.10 $2,648.05 2 $2,418.73 $3,594.03 3 $3,055.37 $4,540.02 4 $3,692.00 $5,486.002 more rows
Apply online at . If your computer has Adobe Acrobat Reader you can fill out the application online. If not, the print the application.
Typically, a Medicaid application takes 3 to 6 months to process, unless a disability determination needs to be made. The process time can also increase if the required documentation is not provided promptly. The Department of Human Services is responsible for administering the Medicaid program in Arkansas.

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People also ask

What documents and information do you need for your Medicaid application? Your name and date of birth. Your Social Security number. Your monthly payment amounts for rent, mortgage, or utilities. Proof of citizenship or immigration status. Proof of income, like paystubs or W-2s.

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