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

Effective Date:

Approval Date: 13 private-public partnership. The Texas Medicaid program, through the Health Insurance Premium Payment (HIPP) Program, pays health insurance premiums for Medicaid eligible children. HIPP works with other state agencies, private employers, and private health coverage providers to ensure that Medicaid eligible children are able to take advantage of health coverage to which they have access. Given the broader scope of Medicaid benefits relative to the typical defined benefits package, children are able to take advantage of both public and private resources in receiving the services they need.

The Texas Title V program for children with special health care needs (CSHCN), has a similar program that pays private health coverage premiums, when doing so is cost effective for CSHCN and when the family is unable to afford the premiums. This program serves children with family incomes up to 200% of the federal poverty level.

2.3. Describe the procedures the state uses to accomplish coordination of SCHIP with other public and private health insurance programs, sources of health benefits coverage for children, and relevant child health programs, such as title V, that provide health care services for low-income children to increase the number of children with creditable health coverage. (Previously 4.4.5.) (Section 2102)(a)(3) and 2102(c)(2) and 2102(b)(3)(E)) (42CFR 457.80(c))

Linkages established with other public/private health insurance partnerships provide opportunities for collaboration and mutually supportive operations.

Coordination with Medicaid is achieved through coordinated outreach efforts and a joint children’s application. Outreach efforts are coordinated with organizations such as insure-a-kid as well as contracts with 34 local, community-based organizations (CBOs). The CBOs were selected based on their local expertise and experience with low-income populations. SCHIP enrollment information is routinely shared with Texas’ Title V agency in order to coordinate program benefits. Texas’ SCHIP coordination efforts are ongoing, but appear successful, as Texas’ SCHIP enrollment growth rate was at one time among the fastest in the nation.