Applying for HIPP Benefits

There are three ways to apply for Arkansas HIPP benefits! You can:

• Fill out and submit an online application.
• Print a HIPP application and mail in or fax your completed application.
• Call our toll-free line 1-855-692-7447 (Monday - Friday, 8 am - 5 pm CT) to start your application over the telephone.

Submit your completed application and documents by:

Toll-free Fax: 1-855-777-1001, or
Mail: HMS
Attn: AR HIPP
1818 N. Taylor St. #360
Little Rock, AR 72207

Please note, this is a mailing address only, not a physical location.

To process your application, you will need to send in the following information before you can officially be determined ARHIPP eligible:

1. Policyholder's Social Security number
2. A copy of the front and back of your insurance card
3. Medical Policy number and group number
4. Pharmacy group, BIN and PCN numbers
5. Summary of benefits for your policy plan or desired policy plan
6. Your health insurance rate sheet
7. Employer & employee share of premium cost
8. A recent paystub or other verification to show proof of your premium payment
9. Medicaid client(s) name & Medicaid identification number(s)