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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 38

a. Birth defect, including genetic, congenital or acquire disorders; b. Developmental disabilities; or c. Chronic and complex illness.

6.2.25.

Premiums for private health care insurance coverage (Section 2110(a)(25))

6.2.26.

Medical transportation (Section 2110(a)(26))

Ambulance transportation is covered including air ambulance under certain emergency situations

6.2.27.

Enabling services (such as transportation, translation, and outreach services (See instructions) (Section 2110(a)(27))

6.2.28.

Any other health care services or items specified by the Secretary and not included under this section (Section 2110(a)(28))