medicaid.gov : Children’s Health Insurance Program CHIP United States of America

Organization : Federal government
Type of Facility : Children’s Health Insurance Program (CHIP)
Country: United States of America (USA)

Website : medicaid [dot] gov

Children’s Health Insurance Program :

The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs.

Related : Health & Human Services AgencyHow to Apply California Children Services CCS : www.statusin.org/25888.html

CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Benefits:
The Children’s Health Insurance Program (CHIP) provides comprehensive benefits to children. Since states have flexibility to design their own program within Federal guidelines, benefits vary by state and by the type of CHIP program.

Medicaid Expansion Benefits:
Medicaid Expansion CHIP programs provide the standard Medicaid benefit package, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, which includes all medically necessary services like mental health and dental services.

Separate CHIP Benefits Options
States can choose to provide benchmark coverage, benchmark-equivalent coverage, or Secretary-approved coverage

Benchmark coverage based on one of the following:
** The standard Blue Cross/Blue Shield preferred provider option service benefit plan offered to Federal employees
** State employee’s coverage plan
** HMO plan that has the largest commercial, non-Medicaid enrollment within the state

Benchmark-Equivalent coverage must be actuarially equivalent and include:
** Inpatient and outpatient hospital services
** Physician’s services
** Surgical and medical services
** Laboratory and x-ray services
** Well-baby and well-child care, including immunizations

Secretary-approved coverage: Any other health coverage deemed appropriate and acceptable by the Secretary of the U.S. Department of Health and Human Services.

Eligibility:
The Children’s Health Insurance Program (CHIP) serves uninsured children up to age 19 in families with incomes too high to qualify them for Medicaid. States have broad discretion in setting their income eligibility standards, and eligibility varies across states.

Income Eligibility:
46 States and the District of Columbia cover children up to or above 200% of the Federal Poverty Level (FPL) ($44,700 for a family of four in 2011), and 24 of these states offer coverage to children in families with income at 250% of the FPL or higher. States may get the CHIP enhanced match for coverage up to 300% of the FPL ($67,050 for a family of four in 2011), which is higher than the Medicaid federal funding matching rate. See information on CHIP Financing.

States that expand coverage above 300% of the FPL get the Medicaid matching rate. States have the option to provide continuous eligibility to children who remain eligible for CHIP.

Cost Sharing :
** States can choose to impose limited enrollment fees, premiums, deductibles, coinsurance, and copayments for children and pregnant women enrolled in CHIP, generally limited to 5% of a family’s annual income. Cost sharing is prohibited for some services, like well-baby and well-child visits.

Medicaid Expansion Cost Sharing :
** States with Medicaid expansion programs must follow the Medicaid cost sharing rules.

Separate CHIP Program Cost Sharing :
** For families with incomes at or below 150% of the Federal poverty level (FPL), premiums cannot exceed the amount permitted in Medicaid.
** For families with incomes above 150% of the FPL, state cost sharing requirements can’t exceed 5% of family income.