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5 Effective Date: July 1, 2009

Approval Date:

Section 1. General Description and Purpose of the State Child Health Plans and State Child Health Plan Requirements (Section 2101)

1.1 The State will use funds provided under Title XXI primarily for

(Check appropriate box) (42 CFR 457.70):

1.1.1

Obtaining coverage that meets the requirements for a separate child health program (Section 2103); or

1.1.2.

Providing expanded benefits under the State’s Medicaid plan (Title XIX); or

1.1.3.

A Combination of both of the above.

Washington’s CHIP offers comprehensive healthcare coverage to children through age 18, who reside in households with incomes up to 300% of the federal poverty level (FPL). Healthcare coverage for children in households with incomes up to 250% of FPL is a state mandated entitlement. Coverage for children in household with incomes above 250% of FPL is offered within available state funds appropriated by Washington’s legislature. Families are required to pay a modest premium for coverage. CHIP benefits are the same as the state’s Medicaid program for children. The program uses the state’s Medicaid managed care delivery system and employs Medicaid income eligibility criteria. However, the CHIP eligibility process is different due to restrictions about existing insurance. CHIP is administered by DSHS’s Medicaid Purchasing Administration (MPA) in coordination with other DSHS administrations and other state agencies including the Department of Health (DOH), the Governor’s Office, and the Health Care Authority (HCA).