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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 14 Effective Month: September 2023

Optional Coverage of the Children’s Health Insurance Program (CHIP) The Division of Medicaid certifies eligibility for the Children’s Health Insurance Program (CHIP). Uninsured children under age 19 whose household income is at or below 200% of the federal poverty level converted to a MAGI-equivalent standard are covered by CHIP, which is a separate health plan. Covered children include: • Infants to age one (1) whose household income is between the MAGI equivalent standards of 185% - 200% of the federal poverty level; • Children age one (1) to age six (6) whose household income is between the MAGI-equivalent income standards of 133% - 200% of the federal poverty level; and, • Children age six (6) to age nineteen (19) whose household income is above 133% of the federal poverty level but below the MAGI-equivalent income standard of 200%.

Optional Presumptive Eligibility for Pregnant Women Determined by Qualified Providers • Qualified providers are allowed to determine presumptive eligibility for individuals eligible for Medicaid in the pregnancy coverage group (COE 88), referred to as Presumptive Eligibility or Pregnant Women or PEP. PEP allows qualified, registered providers to immediately enroll pregnant patients in Medicaid who are determined eligible for Medicaid by authorized provider staff. PEP provides temporary Medicaid eligibility but also allows access to continuing Medicaid coverage provided the PEP decision includes filing a full Medicaid application. • The Medicaid coverage group eligible for PEP decision is limited to pregnant women. The Division of Medicaid is responsible for PEP Medicaid in conjunction with qualified providers that certify PEP eligibility.