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STATE CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT

STATE: Virginia Page 4-11

Effective Date: 07/01/05

11 Approval Date: _____________/06 Section 4. Eligibility Standards and Methodology. (Section 2102(b))

Check here if the state elects to use funds provided under Title XXI only to provide expanded eligibility under the state’s Medicaid plan, and continue on to Section 5.

4.1. The following standards may be used to determine eligibility of targeted low-income children for child health assistance under the plan. Please note whether any of the following standards are used and check all that apply. If applicable, describe the criteria that will be used to apply the standard. (Section 2102)(b)(1)(A)) (42CFR 457.305(a) and 457.320(a))

4.1.1. ⌧ Geographic area served by the Plan:

State wide.

4.1.2. ⌧ Age:

From birth through age 18.

4.1.3. ⌧ Income:

Effective September 1, 2002, the Commonwealth’s Medicaid program was expanded under Title XXI to provide coverage for children from age 6 through age 18 who live in families with income in excess of 100% of FPL, but less than or equal to 133% FPL. The income limit prior to this date was less than or equal to 100% FPL for children age 6 through 18. All Medicaid income disregards, deductions and methodologies used for the Poverty Level group of Medicaid eligible children in the State’s Title XIX plan apply to this expanded group. The Commonwealth claims enhanced funding for optional targeted low-income children who qualify under the Medicaid expansion. Regular FMAP is claimed for those children who do not meet the definition of optional targeted low- income child. The Family Access to Medical Insurance Security Plan, Virginia’s separate Title XXI plan, was also revised to cover children from birth through age 18 in families with gross incomes at or below 200% of the FPL, but in excess of 133% of the federal poverty level. Formerly, FAMIS covered children from birth through age 5 in families with gross income in excess of 133% of the FPL but at or below 200% of the FPL and children from age 6 through 18 in families with gross incomes in excess of 100% of the FPL but at or below 200% of the FPL.