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Application for the State of Indiana Children’s Health Insurance Program Amendment #7

Effective Date:

12

Approval Date: 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:

0-18 (less than 19 years of age)

4.1.3.

Income:

Children with incomes from 150-300% of the FPL are eligible for CHIP. For income amounts above 200 % FPL up to 300% FPL, no standard Medicaid income deductions will be applied. Families with higher incomes will be subject to higher premiums. (A more detailed discussion on cost sharing can be found in Section 8).

4.1.4.

Resources (including any standards relating to spend downs and disposition of resources):

4.1.5.

Residency (so long as residency requirement is not based on length of time in state):

Must be residents of Indiana

4.1.6.

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

4.1.7.

Access to or coverage under other health coverage:

Children cannot have other creditable health care coverage. A three- month waiting period from the date the child was last covered will be imposed.

Exceptions to the waiting period will be provided if the coverage was lost involuntarily (such as through the loss of employment, divorce etc.) or if the child was previously covered by Medicaid.

4.1.8.

Duration of eligibility:

All children have 12 months as the duration of eligibility. Families are asked to notify DFR if their income increases or if health insurance coverage is obtained during the eligibility period.

Children age 3 through 18 remain eligible only as long as they meet income and other program requirements.