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Model Application Template for the State Children’s Health Insurance Program

ARKANSAS Effective Date: July 1, 2003

Approval Date: 16 Section 4. Eligibility Standards and Methodology. (Section 2102(b))

Check here if the state elects to use funds provided under Title XXI only to provide expanded eligibility under the state’s Medicaid plan, and continue on to Section 5.

4.1. The following standards may be used to determine eligibility of targeted low- income children for child health assistance under the plan. Please note whether any of the following standards are used and check all that apply. If applicable, describe the criteria that will be used to apply the standard. (Section 2102)(b)(1)(A)) (42CFR 457.305(a) and 457.320(a))

4.1.1.

Geographic area served by the Plan: Statewide 4.1.2.

Age: Conception to birth (Separate Child HealthProgram) 4.1.3.

Income: At or below 200% FPL. 4.1.4.

Resources (including any standards relating to spend downs and disposition of resources): The resource test for the separate child health program is the same as applied to the comparable group in the Medicaid State Plan. 4.1.5.

Residency (so long as residency requirement is not based on length of time in state): Enrollees must be current Arkansas residents with the intent to remain in the State. 4.1.6.

Disability Status (so long as any standard relating to disability status does not restrict eligibility): Not applicable. 4.1.7.

Access to or coverage under other health coverage: SCHIP enrollees cannot be eligible for Medicaid. SCHIP enrollees cannot have access to a state health benefits program; enrollees in the separate child health program (unborn child) may not have health insurance that covers pregnancy related services. 4.1.8.

Duration of eligibility: The duration of eligibility is conception to birth. 4.1.9.

Other standards (identify and describe): There is no SSN requirement for the separate child health program to cover unborn children.

4.2. The state assures that it has made the following findings with respect to the eligibility standards in its plan: (Section 2102)(b)(1)(B)) (42CFR 457.320(b))

4.2.1.

These standards do not discriminate on the basis of diagnosis. 4.2.2.

Within a defined group of covered targeted low-income children, these standards do not cover children of higher income families without covering children with a lower family income. 4.2.3.

These standards do not deny eligibility based on a child having a pre-existing medical condition.