Arkansas Medicaid and Insurance for a Child Living with a Relative Caregiver

The child in your care needs to see a doctor and you realize there is no insurance card anywhere in the bag that came with them. The parent had coverage through Medicaid, but you have no idea if it is still active or how to use it. You are a relative — not the parent, not a legal guardian — and you assume that means you cannot do anything about insurance.

You can. Arkansas DHS allows caretaker relatives to apply for child-only health insurance without a custody order, and the child's eligibility is based on the child's income — not yours.

ARKids First: The Program You Need

ARKids First is Arkansas's children's health insurance program, covering kids from birth through age 18. It has two tiers:

• ARKids A — full-benefit coverage for eligible children at or below 142% of the federal poverty level. There is no charge for ARKids A.
• ARKids B — limited-benefit coverage for eligible children above the ARKids A limit and through 211% of the federal poverty level. Some services have copays.

For a child living with a relative caregiver, the key rule is this: when you apply for child-only coverage, DHS evaluates the child's individual income and financial resources — not your household income. A child with little or no income may qualify for ARKids A, but DHS determines eligibility and the applicable program tier.

How to Apply

Online: Go to access.arkansas.gov and create an account. Select the option to apply for health coverage. When the application asks about the household, you will specify that you are a caretaker relative applying for child-only benefits.

In person: Visit your local DHS county office. Bring:

• The child's Social Security number (if you have it)
• The child's birth certificate or proof of age
• Your photo ID
• Any proof of the child's income (in most cases, there is none)
• Proof that the child lives with you (a utility bill, lease, or school enrollment document)

By phone: Call the Access Arkansas Helpline at 1-855-372-1084 for application assistance.

You do not need a court order, a Power of Attorney, or the parent's signature to submit a child-only application.

The Child Support Cooperation Rule — and the Exception

When a parent applies for Medicaid, DHS requires cooperation with the Office of Child Support Enforcement (OCSE) as a condition of eligibility. This is the rule that makes many caregivers nervous — they worry that applying for the child's insurance will trigger a child support case against the absent parent.

The exception for caretaker relatives: when you apply for child-only benefits (not benefits for yourself), DHS does not require you to cooperate with OCSE. The child support cooperation requirement applies only when the caretaker relative is also seeking public benefits for themselves.

This is important for caregivers who want to maintain a working relationship with the absent parent and do not want a child support enforcement action complicating that dynamic.

What If the Child Already Has Coverage?

If the child was already enrolled in ARKids First or Medicaid through the parent's case, that coverage may still be active. You can check by:

• Calling the ARKids First hotline at 1-888-474-8275
• Logging into access.arkansas.gov (you will need the child's Social Security number)
• Visiting a DHS county office with the child's identifying information

If coverage is active, you can use the existing insurance card at any provider that accepts Arkansas Medicaid. You do not need to be named on the policy to present the card — the coverage belongs to the child.

If coverage has lapsed (which happens when the parent misses a redetermination), you can restart it by submitting a new child-only application as the caretaker relative.

Coverage Gaps to Watch For

ARKids First covers medical, dental, vision, mental health, and prescription drugs. But there are a few situations where coverage does not solve the underlying authority problem:

• Medical consent is separate from insurance. Having an ARKids card lets the provider bill for services, but the provider still needs consent from someone authorized under § 20-9-602 before treating the child. Insurance pays the bill; consent authorizes the treatment.
• Specialist referrals may require additional consent documentation. Some specialists and hospitals have stricter consent policies than a general pediatrician. Having both insurance coverage and documented consent authority (POA or in loco parentis standing) can help reduce delays, though a provider may still request additional records.
• Dental and orthodontic coverage under ARKids has specific network restrictions. Check the DHS provider directory to find participating dentists near you.

Private Insurance: A Harder Path

If you want to add the child to your employer-sponsored health insurance, a Power of Attorney does not automatically entitle you to enroll the child. Plan requirements differ, so ask your employer's HR department what documentation it accepts; some plans have exceptions for "children placed with you by a court or authorized agency."

Contact your employer's HR department and ask specifically: "What documentation do I need to add a grandchild (or relative's child) to my plan?" The answer varies by insurer.

For the complete insurance enrollment process alongside medical consent authority and school enrollment, the School and Medical Consent Guide for Arkansas walks through each step with the exact forms and statutory references you need.

See more Arkansas guides →