Reported Changes

Income decreases:

If the enrollee reports a decrease in income, and requests Medicaid coverage for any household member, or a new income determination, remove any child from CHIP who is eligible for Medicaid.

If the enrollee does not request Medicaid or a new income determination, continue CHIP through the end of their enrollment period. At review, redetermine Medicaid eligibility using the MAGI-based household composition and MAGI-based income amounts.

If other changes are discovered or reported during the 12 month enrollment period, determine Medicaid eligibility only when the enrollee requests a Medicaid determination, or asks for a new income determination.

Review the change to determine if the change causes an enrollee to no longer qualify for CHIP and take appropriate actions.

Remove any child from CHIP who is Medicaid eligible.

Continue the enrollee on the CHIP program through the end of their enrollment period if the reported change does not make the child eligible for Medicaid (and it also does not make the child ineligible for CHIP.) (See Sec. 703-1 for changes that can result in CHIP eligibility ending.)

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Reported Changes

Official source

Income decreases:

If the enrollee reports a decrease in income, and requests Medicaid coverage for any household member, or a new income determination, remove any child from CHIP who is eligible for Medicaid.

If the enrollee does not request Medicaid or a new income determination, continue CHIP through the end of their enrollment period. At review, redetermine Medicaid eligibility using the MAGI-based household composition and MAGI-based income amounts.

If other changes are discovered or reported during the 12 month enrollment period, determine Medicaid eligibility only when the enrollee requests a Medicaid determination, or asks for a new income determination.

Review the change to determine if the change causes an enrollee to no longer qualify for CHIP and take appropriate actions.

Remove any child from CHIP who is Medicaid eligible.

Continue the enrollee on the CHIP program through the end of their enrollment period if the reported change does not make the child eligible for Medicaid (and it also does not make the child ineligible for CHIP.) (See Sec. 703-1 for changes that can result in CHIP eligibility ending.)