Page 3

3 percent of the FPL must pay a $25 monthly premium.

• There is a $10 co-payment per emergency room visit. This fee is waived if the visit results in immediate inpatient hospitalization or if a prudent layperson would interpret the need for the visit to the ER to be an emergency.

State Action to Avoid Crowd-Out

• The State monitors crowd-out by asking about private insurance coverage on the application and renewal forms, and the Third Party Liability Unit verifies this information. Delaware monitors this data and looks for trends on substitution of coverage over time.

Coordination Between CHIP and Medicaid

• The State is using a single application form for CHIP and Medicaid. Medicaid staff determine eligibility using abbreviated mail-in applications and outstationed eligibility workers at various sites. Eligibility and redetermination of eligibility is consistent with the State’s Medicaid program. A common computer eligibility system is also used.

• Individuals are enrolled in MCOs using the same health benefits manager and the same process of enrollment as is used by Delaware’s Medicaid Section 1115 waiver.

Outreach Activities

• The State is using the following methods of finding, notifying and assisting eligible children to enroll in DHCP:

o Simplified application process using single application for Medicaid and CHIP and continue to outstation staff to complete Medicaid and DHCP applications;

o Partnerships with community based organizations that can help provide outreach to children and their communities and service areas; and,

o Cost effective media such as mailings, newspapers, buses, and public service announcements on radio and TV.

Financial Information

Total FY 2009 CHIP Allotment -- $15,096,397 FY 2009 Enhanced Federal Matching Rate – 65.00%

Date last updated: July 23, 2009