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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 (Medicaid coverage for poverty level children 14 to 19 in families at or below 100% FPL effective July 1, 1998 and for targeted low income children 1 to 19 in families at or below 150% FPL, effective July 1, 1999, and a separate insurance package for children birth to 19 not eligible for Medicaid and with family income under 200% FPL, effective November 1, 1999. Eligibility standards will be consistent statewide.)

4.1.2.

Age:

Birth to 19 years of age

4.1.3.

Income:

To be eligible for the Medicaid expansion, the children must be from families whose incomes are at or below 150% FPL. To be eligible for the insurance product the children must be from families whose incomes are at or below 200% FPL. Income disregards will be applied to ensure the child is enrolled in the appropriate program. If children are determined to be Medicaid eligible, they cannot be enrolled in the insurance program. Income will be cross-referenced with other programs, which require income verification. See Section 4.3 (See Appendix E).

4.1.4.

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

There will not be any resource testing for the insurance program for income eligible Medicaid applicants.

4.1.5.

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

Medicaid residency requirements will be used for the Medicaid expansion and the separate insurance program.