How to Get ARKids First as a Grandparent Without a Custody Order

Your grandchild is living with you and needs health insurance. You've heard about ARKids First but assumed you'd need custody papers to apply. You don't.

Arkansas Department of Human Services explicitly allows non-parent caretaker relatives to apply for child-only Medicaid coverage — and the eligibility determination looks at the child's income, not yours.

What ARKids First Covers

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

• ARKids A — full Medicaid coverage for children in families with income under 142% of the federal poverty level
• ARKids B — CHIP coverage for children in families with income at least 142% but under 211% of the federal poverty level

Both tiers cover doctor visits, hospital stays, prescriptions, dental care, vision, mental health services, and immunizations.

The "Child-Only" Application

Here's what matters for grandparents: you can apply for the child's ARKids coverage as a caretaker relative without a custody order. DHS determines eligibility using family-income limits and family size. It counts parents and caregivers toward family size, so report the household accurately and ask DHS how income is counted for the child's specific application.

That means:

• ARKids eligibility uses family-income limits tied to family size
• DHS counts parents and caregivers toward family size; do not assume the caregiver's income is excluded
• You do not need a legal custody order
• You do not need to cooperate with the Office of Child Support Enforcement (OCSE) — that requirement applies only if you're also seeking public benefits for yourself

This is a critical distinction. Many caregivers avoid applying because they think their own household income or lack of legal custody will disqualify the child. Neither is true for child-only coverage.

How to Apply

Online: Go to access.arkansas.gov and create an account. Select that you're applying for a child in your care. The portal will walk you through the application.

In person: Visit your county DHS office. Bring identification for yourself and the child, plus any documentation you have about the child's living situation.

By mail: Download form DCO-0152 from the DHS website, complete it, and mail it to your county office.

You'll need the child's Social Security number (or the application can proceed while one is being obtained), the child's date of birth, and information about any income the child receives.

What Approval Gets You

Once the child is approved, you'll receive an ARKids First card. This card covers medical visits, but it's separate from your authority to consent to the care itself. Having insurance means the doctor's visit gets paid for — but the medical consent to authorize the treatment comes from Arkansas Code §20-9-602, which gives grandparents, adult siblings, and in loco parentis caregivers their own statutory authority.

Both pieces are needed: the insurance card to pay and the legal consent authority to approve.

Common Sticking Points

The caseworker asks about a parent's income. Answer questions about the child's household accurately and ask DHS how its household rules apply when a parent lives elsewhere.

The caseworker asks for custody papers. DHS policy does not require legal custody for child-only health coverage applications. If the worker insists, ask to speak with the county office manager and reference the DHS Medicaid Beneficiary Handbook's caretaker relative provisions.

You're worried about triggering a DCFS investigation. Applying for ARKids First is a benefits application, not a child welfare report. DHS's medical services division and the Division of Children and Family Services are separate operations with separate purposes.

The Bigger Picture

Getting the child insured is one piece of a larger paperwork puzzle — school enrollment, medical consent authority, and the document folder you'll need to carry to appointments. The School and Medical Consent Guide for Arkansas ties all of these together, including the ARKids First application walkthrough, so you handle insurance, school, and medical consent in one organized pass.

See more Arkansas guides →