The CHIP/Children’s Medicaid Application Process

1. The CHIP/Children’s Medicaid Application Process

2. Help is Available for Kids and Families A single mail-in application is used to determine eligibility and placement into one of 3 health insurance programs for children: • Children’s Medicaid • Children’s Health Insurance Program (CHIP) • CHIP Perinatal Program

3. QUALIFICATIONS Children’s Medicaid • Families at or below 100% of the federal poverty level • In 2010, a family of 4 can earn up to $22,050 and qualify • Children (0-18)

4. CHIP • Families at or below 200% of the federal poverty level • In 2010, a family of 4 can earn up to $44,100 and qualify • Children (0-18)

5. CHIP Perinatal • Pregnant women, including teens, who are not otherwise eligible for CHIP or Medicaid. • Household income must meet the traditional CHIP guidelines (i.e. up to 200% FPL). Note: This program providescoverage to the unborn child NOT to the pregnant woman.

6. ELIGIBILITY • Children must be either U.S. citizensorlegal permanent residents to qualify; children applying for CHIP Perinatal do not have to have citizenship documentation. • The parents’ residency status does not matter for children applying for CHIP or Children’s Medicaid.

7. ELIGIBILITY Cont’d Undocumented and immigrant parents cansafely apply for their children without fear • Neither Children’s Medicaid nor CHIP shares information with INS or IRS. • These programs also do not count as “public charge” for those applying for citizenship.

8. Section 1 – Adult Applicant or Independent Minor Info Optional!

9. Section 2 - CHIP Perinatal

10. Section 3 – Children (under 19)List ALL children living in the home, even if not all are applying or are not eligible. This indicates larger family size and reduces cost share.

11. Reminders: • Make sure ALL children under 19 and living in the home are listed on the application, even though some may NOT be applying or are ineligible. (Letter C). • If any children are legal permanent residents, don’t forget to include a copy of their Resident Card, front & back. (Letter G) • Include a copy of each child’s birth certificate.

12. Section 4 90 Day Waiting Period Has Been ELIMINATED for most children!! Children who drop private health insurance and do not qualify for an exception will have to wait 90 days. EXCEPTION: If a family currently spends more than 10% of their gross annual income on health insurance, their children are NOT subject to a 90 day wait. Example: $300/month on a salary of $30,000

13. Section 6 - Who cares for the child? • List PARENTS and STEP-PARENTS who CURRENTLY LIVE WITH the children. • DO NOT list Aunts, Uncles, Grandparents, or other relatives in this section, even if they are listed in section 1 as applying for the child. • Live-in partners Should Not be listed in this section unless they are the parent of a child listed on the application.

14. Section 7 – Household Income Only Income from parents, step-parents or children is considered! Eligibility determined by pre-tax income (gross).

15. Section 7-CONT’D Self-employment income is calculated using a separate formula using information from the Schedule C. Income includes: • Child support • Alimony • Wages (including wages from children who work) • TANF • Social Security

16. Section 7 – Proof of Household Income • One recent pay stub (last 60 days) OR • Most recent tax return (including Schedule C, if applicable) OR

17. Section 7 Cont’d • Dated/signed letter from an employer verifying income OR • Proof of self-employment Note: Twice a month is not the same as bi-weekly. Remember: You must provide proof of income. Send copies, not originals.

18. Section 8 – Household Expenses • Child Care Expenses • Child Support Payments • Alimony Payments • Disabled Adult Care Expenses Remember: You must provide proof of income. Send copies, not originals.

19. Section 9: Asset Test Asset Test limit = $10,000 Assets include: Cash on hand Checking/Savings accounts Stocks/Bonds/CD’s Vehicle First vehicle = $18,000. Second vehicle = $7,500

20. NOTE: • Certain vehicles may be exempt from the assets test if they are used for mostly business or residential purposes. • A house is not considered an asset. • 401K is not considered an asset; an IRA is an asset. • A co-signed vehicle is an asset.

21. Section 9 – Assets • Listing complete and accurate vehicle information is crucial to successful application processing. Missing information, including vehicle make, model and year are grounds for rejecting an application.

22. Section 10 – Unpaid Medical Bills Medicaid may retro-actively cover unpaid medical bills, up to 3 months. INCLUDE COPIES OF BILLS. [CHIP coverage is NOT Retro-active.]

23. SECTION 11- OptionalDesignate an authorized representative • To grant another individual access to the child’s account and to authorize them to answer questions in the event the person in Section 1 cannot be reached.

24. SECTION 12 Rights & Responsibilities • By signing the application you agree that all the information you provided is true to the best of your knowledge.

25. Section 13 – REQUIRED DOCUMENTS Gross Income • Copy of 1 paycheck stub OR • Dated and signed letter from an employer • US Citizenship or Immigration status for all Children • Copy of birth certificate • Copy of resident card (both sides)

26. Expenses • Childcare/disabled adult care expenses (if applicable) • Child support/and or alimony (if applicable)

27. Section 14 – SIGN AND DATE • A missing signature can delay the processing of an application. • Leave No Section Blank.

28. The most common missing pieces of information: • Income documentation • Citizenship Verification of child/SSN • Signature on application

29. NEXT STEPS In 45 days or less: • Family should hear from Medicaid/CHIP that application has been received • Call 1-877-KIDS-NOW to check application status • Complete and return enrollment packet ASAP! • Choose a health plan - several health plans are available in this area. • Receive insurance card

30. Getting Started! You can get the CHIP/Children’s Medicaid application by: • Contacting HISD’s Health and Medical Services at 713-556-7280 • 1-877-KIDS-NOW • Via the Web: www.chipmedicaid.org