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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 - 17 - 4.4.2 The Medicaid application and enrollment process is initiated and facilitated for children found through the screening to be potentially eligible for medical assistance under the state Medicaid plan under Title XIX. (Section 2102)(b)(3)(B)) (42 CFR 457.350(a)(2)) Response: FSD uses the same application for, SCHIP 1, and SCHIP 2. The same Eligibility Specialist makes the eligibility determination for MO HealthNet, SCHIP 1, and SCHIP 2. Children are determined ineligible for regular MO HealthNet before being approved for SCHIP 1 or SCHIP 2. 4.4.3 The State is taking steps to assist in the enrollment in SCHIP of children determined ineligible for Medicaid. (Sections 2102(a)(1) and (2) and 2102(c)(2)) (42 CFR 431.636(b)(4)) Response: FSD uses the same application for, SCHIP 1, and SCHIP 2. The same Eligibility Specialist makes the eligibility determination for MO HealthNet, SCHIP 1, and SCHIP 2. Children are determined ineligible for regular MO HealthNet before being approved for SCHIP 1 or SCHIP 2. 4.4.4 The insurance provided under the state child health plan does not substitute for coverage under group health plans. Check the appropriate box. (Section 2102)(b)(3)(C)) (42 CFR 457.805) (42 CFR 457.810(a)-(c)) 4.4.4.1  Coverage provided to children in families at or below 200% FPL: describe the methods of monitoring substitution. Response: There is a six month look back period for health insurance when determining eligibility. Children whose available health insurance coverage was dropped within the last six months without good cause will have a six month waiting period for SCHIP 1 coverage. The six month look back period does not apply to children in families with income below 150% FPL. 4.4.4.2  Coverage provided to children in families over 200% and up to 250% FPL: describe how substitution is monitored and identify specific strategies to limit substitution if levels become unacceptable.