Requirements for eligible individuals

Ark. Code Ann. § 23-61-1005 — under State Insurance Department.

Ark. Code Ann. § 23-61-1005

(a) An eligible individual is responsible for all applicable cost-sharing and premium payment requirements as determined by the Department of Human Services.

(b) An eligible individual may participate in a health improvement initiative, as developed and implemented by either the eligible individual's individual qualified health insurance plan or the department.

(c) (1) (A) An eligible individual who is determined by the department to meet the eligibility criteria for a risk-based provider organization due to serious mental illness or substance use disorder shall be enrolled in a risk-based provider organization under criteria established by the department.(B) An eligible individual who is enrolled in a risk-based provider organization is exempt from the requirements of subsections (a) and (b) of this section.(2) (A) An eligible individual who is determined by the department to be medically frail shall receive healthcare coverage through the fee-for-service Arkansas Medicaid Program.(B) An eligible individual who is enrolled in the fee-for-service Arkansas Medicaid Program is exempt from the requirements of subsection (a) of this section.

(1) (A) An eligible individual who is determined by the department to meet the eligibility criteria for a risk-based provider organization due to serious mental illness or substance use disorder shall be enrolled in a risk-based provider organization under criteria established by the department.(B) An eligible individual who is enrolled in a risk-based provider organization is exempt from the requirements of subsections (a) and (b) of this section.

(A) An eligible individual who is determined by the department to meet the eligibility criteria for a risk-based provider organization due to serious mental illness or substance use disorder shall be enrolled in a risk-based provider organization under criteria established by the department.

(B) An eligible individual who is enrolled in a risk-based provider organization is exempt from the requirements of subsections (a) and (b) of this section.

(2) (A) An eligible individual who is determined by the department to be medically frail shall receive healthcare coverage through the fee-for-service Arkansas Medicaid Program.(B) An eligible individual who is enrolled in the fee-for-service Arkansas Medicaid Program is exempt from the requirements of subsection (a) of this section.

(A) An eligible individual who is determined by the department to be medically frail shall receive healthcare coverage through the fee-for-service Arkansas Medicaid Program.

(B) An eligible individual who is enrolled in the fee-for-service Arkansas Medicaid Program is exempt from the requirements of subsection (a) of this section.

(d) An eligible individual shall receive notice that:(1) The Arkansas Health and Opportunity for Me Program is not a perpetual federal or state right or a guaranteed entitlement;(2) The Arkansas Health and Opportunity for Me Program is subject to cancellation upon appropriate notice;(3) Enrollment in an individual qualified health insurance plan is not a right; and(4) If the individual chooses not to participate or fails to meet participation goals in the economic independence initiative, the individual may lose incentives provided through enrollment in an individual qualified health insurance plan or be unenrolled from the individual qualified health insurance plan after notification by the department.

(1) The Arkansas Health and Opportunity for Me Program is not a perpetual federal or state right or a guaranteed entitlement;

(2) The Arkansas Health and Opportunity for Me Program is subject to cancellation upon appropriate notice;

(3) Enrollment in an individual qualified health insurance plan is not a right; and

(4) If the individual chooses not to participate or fails to meet participation goals in the economic independence initiative, the individual may lose incentives provided through enrollment in an individual qualified health insurance plan or be unenrolled from the individual qualified health insurance plan after notification by the department.