HJAR Jan/Feb 2023

44 JAN / FEB 2023 I  HEALTHCARE JOURNAL OF ARKANSAS MEDICAID COLUMN MEDICAID LAST YEAR, most Medicaid clients did not have to pay copays for healthcare services. However, starting Jan. 1, 2023, some Medicaid clients will be asked to begin paying copays for some services. These clients include some individuals in the ARHOME, Workers with Disabilities, and Transitional MedicaidAdult programs. Limits, or caps, are set for out- of-pocket costs. Further, certain vulnerable groups do not have to pay copays or other out-of-pocket costs. (The changes apply only to adult Medicaid clients; ARKids B clients will continue paying the same copays they currently pay.) Providers will play a key role in helping Medicaid clients understand the changes and what they mean. PREMIUMS The first change involves monthly premi- ums for insurance coverage. SomeARHOME clients have been paying $13 monthly premi- ums for their coverage in a qualified health plan. As of Jan. 1, 2023, there are no premiums for ARHOME clients. If clients were paying premiums, they will not need to pay them going forward. COPAYS The second change involves copays. Also, as of Jan. 1, 2023, some Medicaid clients now must pay copays for some services. Copays will generally be $4.70 for a doctor visit and $9.40 for a specialist visit. Generic Most healthcare coverage options — including Medicaid — may include out- of-pocket costs for enrollees. Out-of- pocket costs include things like copayments (or copays for short) and monthly premiums. Medicaid Cost-Sharing for 2023: What Providers and Clients Need to Know