Basic Considerations

PCK health coverage is available to children from birth through the last day of the month of a child’s 19th birthday.

PCK uses Modified Adjusted Gross Income (MAGI) rules to determine eligibility. Refer to Section 2610 - MAGI Budget Groups / Assistance Units and Section 2245 - Living with a Specified Relative/Tax Filer/Non-Filer Status .

Countable income must be less than or equal to 247% fo the FPL. Refer to Appendix A2, Financial Limits for Family Medical Assistance.

All income received by the applicant must be verified electronically or manually.

PCK recipients must meet the Medical Assistance citizenship/immigration criteria. Citizenship/immigration status must be verified. Refer to Section 2215 - Citizenship/Immigration/Identity .

Referral of the non-custodial parent (NCP) to DCSS does not apply.

Enrollment in PCK begins the first day of the month in which a complete application or renewal, including all applicable verifications and initial premium payment have been received.

PCK does NOT provide prior month coverage. If prior month medical bills are owed, the child may be potentially eligible for Family Medicaid Medically Needy.