400.18.04 CHILDREN AGE 6 TO AGE 19 – COE-074 (QUASI-CHIP GROUP)

COE-074 covers children age 6 to age 19 whose household income exceeds 107% FPL but does not exceed 133% FPL. There is no MAGI-equivalent income limit for COE-074 since federal law specifies 133% FPL as the statutory limit for Medicaid coverage for children age 6 to age 19. This coverage group is referred to as the quasi-CHIP group because prior to implementation of the ACA, the limit for CHIP eligibility included uninsured children age 6 to age 19 in households with income between 100% FPL and 133% FPL. After the ACA was implemented, children in MAGI households with income between 100% FPL and 133% FPL transitioned from CHIP to Medicaid. When a child active in COE-074 reaches age 19, eligibility as a MAGI-related child ends. Continued coverage is possible only if the child is a parent/caretaker of a child under age 18 or if the child is disabled and can qualify for Medicaid under ABD Medicaid coverage. The approval notice issued at renewal prior to the child’s 19th birthday informs the parent/caretaker of the child’s Medicaid termination at age 19.