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Missouri Application for the State Children’s Health Insurance Program Effective Date: 07/01/2009 Approval Date:

Prior Approval Date: 09/28/2007 - 14 - 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)) (42 CFR 457.305(a) and 457.320(a)) 4.1.1  Geographic area served by the Plan: Response: SCHIP 1 and SCHIP 2 are available statewide. 4.1.2  Age: Response: MO HealthNet's SCHIP 1 is available to children age birth through age 18. MO HealthNet's SCHIP 2 is available to children age one through age 18. 4.1.3  Income: Response: The State's upper gross income limit is 300% of FPL. The standard income disregard equal to 100% of the FPL is made from the gross income figure of 300% of FPL. The net income figure will be compared to 200% FPL to determine if the child(ren) is (are) eligible. To be eligible, this net figure must not exceed 200% FPL for children. All wages paid by the U. S. Census Bureau for temporary employment related to Decennial Census activities are excluded in years in which there is a federal census. 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): Response: Eligible children must be a Missouri resident 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: Response: Eligible children must be uninsured and not have access to affordable insurance. 4.1.8  Duration of eligibility: Response: Children are deemed eligible until FSD determines otherwise. FSD makes eligibility determinations on all applications within 30 days. Re-determinations, which are known in Missouri as reinvestigations, are conducted annually whether a change is reported or not. Once determined eligible, children are deemed to remain eligible until