ARKids First is Arkansas's name for the federal Children's Health Insurance Program (CHIP), administered by the Arkansas Department of Human Services (DHS). ARKids First covers more than 130,000 Arkansas children in 2026 and is designed for families who earn too much for full Medicaid but cannot afford private insurance. Coverage includes doctor visits, hospitalizations, prescription drugs, dental, vision, and mental health services, at little or no cost to the family.
ARKids First has two tiers. ARKids First-A is identical to Medicaid and costs nothing. ARKids First-B is the true CHIP tier, with small copays but no premiums or deductibles. Arkansas updates its income limits each April 1, so the thresholds on this page reflect the limits effective April 1, 2026. All income limits are based on the 2026 HHS Federal Poverty Guidelines. To compare income limits for adults in Arkansas, see the separate page on ARHOME eligibility. For a nationwide overview, see CHIP eligibility by state.
Quick Answer: Who Qualifies for ARKids First in Arkansas (2026)
Yes. ARKids First covers Arkansas children under 19 whose family income is at or below 211% FPL in 2026. For a family of four, the ARKids First-B CHIP limit is $69,630 per year ($5,803 per month). Children below 142% FPL qualify for ARKids First-A (free Medicaid tier). Children from 142% to 211% FPL qualify for ARKids First-B (CHIP tier, small copays, no premiums). No asset test applies.
- Child must be under age 19 (newborns automatically covered if mother had ARKids or Medicaid at delivery)
- Family income at or below 211% FPL for the household size (see income table above)
- Child must be an Arkansas resident
- Child must be a U.S. citizen or qualified immigrant (Arkansas covers qualified immigrant children with state funds during the federal 5-year waiting period)
- No asset test for either ARKids First-A or ARKids First-B
- 12 months of continuous eligibility once enrolled, regardless of income changes during the year
ARKids First-A vs. ARKids First-B: Arkansas's Two CHIP Tiers Compared
Arkansas divides its children's coverage into two distinct tiers under the ARKids First umbrella. Both tiers cover the same comprehensive set of health services, but they differ on income eligibility and cost sharing. Arkansas DHS automatically places children in the correct tier based on household income when the family applies.
ARKids First-A vs. ARKids First-B comparison 2026, Arkansas| Feature | ARKids First-A (Medicaid) | ARKids First-B (CHIP) |
|---|
| Income range | 0 to 142% FPL | 142% to 211% FPL |
| Annual income limit (family of 4, 2026) | Up to $46,860/year | Up to $69,630/year |
| Premium | $0 (no premium) | $0 (no premium) |
| Office visit copay | $0 | $10 per visit |
| Prescription copay | $0 | Up to $5 per prescription |
| Annual cost-sharing cap | No cap needed (no cost sharing) | 5% of gross family income per year |
| Continuous eligibility | 12 months | 12 months |
| Asset test | None | None |
Cost-sharing amounts for ARKids First-B are effective April 1, 2026. The 5% annual cap on cost-sharing is required by federal CHIP rules and applies to the family's total out-of-pocket for all ARKids First-B services in a 12-month period.
Source: Arkansas DHS ARKids First program guide; federal CHIP cost-sharing rules 42 CFR 457.520
What ARKids First Covers in Arkansas
ARKids First provides comprehensive health coverage for Arkansas children in both the A and B tiers. The benefit package is defined under federal CHIP rules and must be at least as generous as the standard Blue Cross Blue Shield preferred provider organization (PPO) plan or the Arkansas State Employee Health Plan, whichever is more generous. Services covered under ARKids First in 2026 include:
- Well-child visits and preventive care (EPSDT for Medicaid tier: all medically necessary services for children under 21)
- Inpatient hospital care and outpatient services
- Prescription drugs (formulary-based; ARKids First-B copay up to $5 per prescription)
- Dental services including preventive, restorative, and orthodontic care when medically necessary
- Vision services including eye exams and eyeglasses
- Mental health and substance use disorder treatment
- Emergency room care (considered emergency whether or not the situation turned out to be an emergency)
- Immunizations per the CDC Advisory Committee on Immunization Practices (ACIP) schedule
Is Arkansas a CHIP Expansion State? Program Background
Arkansas runs a separate CHIP program (rather than fully integrating CHIP dollars into Medicaid), which means the ARKids First-B tier uses federal CHIP matching funds at a higher federal match rate than Medicaid. Arkansas has participated in CHIP since 1997, when Congress created the program through Title XXI of the Social Security Act. The state covers children up to 211% FPL, which is above the federal minimum floor of 200% FPL and reflects Arkansas's commitment to covering working-class children in middle-income households who lack affordable employer-sponsored coverage.
Arkansas's Medicaid program for adults is ARHOME, which uses an expansion waiver. For children, ARKids First is the primary program. The Medicaid-CHIP boundary in Arkansas sits at 142% FPL for children, meaning children at exactly 142% FPL may fall into either tier depending on their exact income. Arkansas DHS determines the correct tier automatically at application. The Families First Continuous Enrollment Act ended the continuous enrollment protection for all federal programs at the end of 2023; however, federal CHIP law independently requires 12 months of continuous eligibility for all children enrolled in CHIP, so Arkansas must still guarantee a full year of coverage for ARKids First-B enrollees.
How to Appeal an ARKids First Denial in Arkansas
Arkansas families have the right to appeal any denial, termination, or reduction of ARKids First benefits. The appeal must be submitted in writing within 30 days of the date on the denial notice. Arkansas DHS sends all ARKids First denials in writing explaining the specific reason; you have the right to a fair hearing before an impartial DHS hearing officer.
Arkansas also offers expedited appeals when benefits are being terminated while your child is actively receiving treatment. To keep existing coverage in place during an appeal, your written request must reach DHS within 10 calendar days of the termination notice date. Mail or fax appeals to: Arkansas DHS Office of Appeals and Hearings, P.O. Box 1437, Slot S101, Little Rock, AR 72203. You can also request an appeal through the Access Arkansas portal at access.arkansas.gov.
- Submit your appeal in writing within 30 days of the denial date
- Request continuation of benefits within 10 days if coverage is being terminated during active treatment
- Include your child's name, DHS case number, and a clear statement of why you believe the decision was wrong
- Contact Legal Aid of Arkansas (arlawhelp.org) for free legal assistance if you need help preparing your appeal
What If Your Child Does Not Qualify for ARKids First in Arkansas?
Arkansas families whose children do not qualify for ARKids First (because income exceeds 211% FPL or because the child is 19 or older) have several options for health coverage. Arkansas is a Medicaid expansion state through the ARHOME waiver, so adults in the household may qualify for low-cost Medicaid coverage separately. Children who age out of ARKids First at 19 can transition to ARHOME if their income qualifies, or can enroll in an ACA marketplace plan through healthcare.gov.
For children with income between 211% FPL and 400% FPL, the ACA marketplace may offer plans with premium tax credits, though the enhanced premium tax credits from the American Rescue Plan Act expired on January 1, 2026, so marketplace plan costs may be higher in 2026 than in prior years. Families should compare marketplace plan costs against any available employer-sponsored coverage. Dental and vision for children are required to be offered as standalone plans on the ACA marketplace even if the family does not enroll in a comprehensive health plan.
Frequently Asked Questions
What is the income limit for ARKids First in Arkansas for a family of 4 in 2026?
For a family of four, the ARKids First income limit in 2026 is $69,630 per year ($5,803 per month) for the CHIP tier (ARKids First-B at 211% FPL). Families of four earning up to $46,860 per year ($3,905 per month) qualify for the free Medicaid tier (ARKids First-A at 142% FPL). Income limits are based on 2026 HHS Poverty Guidelines and were updated April 1, 2026.
What is the difference between ARKids First-A and ARKids First-B?
ARKids First-A is the Medicaid tier for children in households at or below 142% FPL. It has zero premiums, zero copays, and zero deductibles. ARKids First-B is the CHIP tier for households between 142% and 211% FPL. It also has no premiums or deductibles, but charges $10 per office visit and up to $5 per prescription. The annual family cost-sharing cap for ARKids First-B is 5% of gross family income. Both tiers provide identical benefit packages.
How do I apply for ARKids First in Arkansas?
Apply online at access.arkansas.gov, by phone at 1-888-ARKids-1 (1-888-275-4371), in person at any county Arkansas DHS office, or by mailing a paper application. The online portal is available 24 hours a day. You can apply for ARKids First, ARHOME Medicaid, and SNAP in a single combined application. Processing takes up to 45 days. Coverage typically starts the first day of the month your application is received.
What documents do I need to apply for ARKids First?
You will need each child's birth certificate or other proof of age and identity, Social Security numbers for all household members, proof of Arkansas residency (utility bill, lease, or bank statement), and recent proof of income (pay stubs from the last 30 days, most recent tax return, or employer letter). If any child is not a U.S. citizen, you will also need immigration status documents such as a green card or visa.
Does ARKids First have an asset test in Arkansas?
No. ARKids First has no asset test for either the A or B tier. A family can own a home, vehicles, savings accounts, or retirement accounts and still qualify based on income alone. This is different from some non-MAGI Medicaid categories for adults, which may have asset limits.
Can my child keep ARKids First if my income goes above the limit during the year?
Yes, for the full coverage year. Federal CHIP rules require 12 months of continuous eligibility, meaning once your child is enrolled in ARKids First-B (or ARKids First-A), coverage continues for a full 12 months regardless of income changes. At renewal, DHS will reassess income to determine the tier or whether the child still qualifies.
What if my child was denied ARKids First?
You can appeal any ARKids First denial in writing within 30 days of the denial date. Send your written appeal to Arkansas DHS Office of Appeals and Hearings, P.O. Box 1437, Slot S101, Little Rock, AR 72203. If benefits are being terminated while your child is receiving treatment, request continuation within 10 days to keep coverage active during the appeal. Legal Aid of Arkansas (arlawhelp.org) provides free legal assistance for appeals.
Does ARKids First cover newborns in Arkansas?
Yes. Newborns are automatically enrolled in ARKids First (or Medicaid) for 12 months if the mother was enrolled in Medicaid or ARKids First at the time of delivery. The family does not need to submit a separate application for the newborn. Coverage begins at birth. After the automatic 12-month period, the family must renew and the child will be evaluated for ongoing eligibility.
