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Missouri Application for the State Children’s Health Insurance Program Effective Date: 05/01/2009 Approval Date:

Prior Approval Date: 09/28/2007 - 14A - FSD determines they are no longer eligible due to no longer meeting eligibility criteria caused by a change in household circumstances or other change. However, the family does not need to re-apply and this is what is meant by “deemed eligible until FSD determines otherwise”. Families are required to report changes, and FSD makes a determination of continued eligibility considering the change. Lastly, SCHIP 1 and SCHIP 2 cases are closed following a notice to the family if the family fails to complete an annual reinvestigation. 4.1.9  Other standards (identify and describe): Response: Other standards (identify and describe): A Social Security Number and documentation of citizenship and alien status for children who are covered by SCHIP 1 and SCHIP 2. A net worth test of $250,000 is also required. Children with special healthcare needs must still be uninsured to qualify and cannot have access to affordable health insurance. Access to affordable insurance available through employment, a group membership, or from a private company causes ineligibility. In addition, children in families with gross income above 150% of the FPL cannot have access to affordable employer sponsored or private health insurance. These children must pay a premium to be eligible (a cost sharing provision). The following is a description of the affordability test for both groups: • Three percent of 150% of the FPL for a family of three, for families with a gross income of more than 150% and up to 185% FPL. • Four percent of 185% of the FPL for a family of three, for families with a gross income of more than 185% and up to 225% FPL. • Five percent of 225% of the FPL for a family of three, for families with a gross income of more than 225% but less than 300% FPL. 4.2 The State assures that it has made the following findings with respect to the eligibility standards in its plan: (Section 2102)(b)(1)(B)) (42 CFR 457.320(b)) 4.2.1  These standards do not discriminate on the basis of diagnosis.