1702-1 Transitions Between State CHIP and UPP

Effective Date: January 1, 2024

No Previous Policy

When an enrollee is no longer eligible for State CHIP, review the case and determine their eligibility for Medicaid or UPP. UPP only accepts new applications during open enrollment periods.

A . Transitions between State CHIP and UPP

When the following transitions occur, the requirements in B apply:

State CHIP to UPP (within the CHIP certification period)

State CHIP to UPP (when the CHIP certification period has ended)

B . Requirements

Do not require a new application.

Waive the open enrollment requirement for UPP if there has not been a break in coverage.

All eligibility factors must be met.

Do a new income determination.

Complete a new access to insurance test.

For a CHIP child to move from State CHIP to UPP, the enrollee has 10 days from either the day the child is signed up or the date coverage begins, whichever is later, to report the insurance coverage.

If transitioning to UPP and all UPP eligibility requirements are met, end State CHIP the day before the health insurance coverage begins and open UPP effective the day the health insurance coverage begins.

When transitioning to UPP, open UPP and authorize a new 12-month certification period.