| Children's Medicaid2 |
Separate Children's CHIP2 |
Pregnant Women3 |
Parents4 |
| 175% |
N/A |
175% |
77% |
| Children |
Pregnant Women |
| No |
No |
| Waiting Period |
Length |
| None |
N/A |
| Program Type7 |
Joint Application |
Face-to-Face Interview |
Asset Test8 |
Paper Documentation of Income Not Requested9 |
| M-CHIP |
N/A |
No |
No |
N/A |
| Presumptive Eligibility |
Express Lane Eligibility10 | SSA Data Match to Verify Citizenship11 |
| No |
No |
Yes |
| Application Form Submitted Electronically |
Electronic Signature | Ability to Start/Stop Application |
Online Application has Enhanced Functionality |
| N/A |
N/A |
N/A |
N/A |
| Frequency of Renewal (in months) |
12-month Continuous Eligibility |
Face-to-Face Interview |
Paper Documentation of Income Not Requested9 |
| 12 |
Yes |
No |
N/A |
| Joint Renewal Form | Administrative Renewal13 |
Telephone Renewal | Online Renewal | Express Lane10 |
| N/A |
Yes |
No |
No |
No |
| Simplified Family Application15 |
Face-to-Face Interview | Asset Test8 | SSA Data Match to Verify Citizenship11 |
Paper Documentation of Income Not Requested9 |
| No |
No |
$2,000 |
Yes |
Yes |
| Frequency of Renewal (in months) |
Face-to-Face Interview |
Paper Documentation of Income Not Requested9 |
| 12 |
No |
No |
| Presumptive Eligibility |
Asset Test16 |
| No |
No |
| Premium/Enrollment Fee Required |
Begin at (of the FPL) |
Copayments Required |
Begin at (of the FPL) |
| No |
N/A |
No |
N/A |
Source: M. Heberlein, et al., "Holding Steady, Looking Ahead," Kaiser Commission on Medicaid and the Uninsured, (January
2011); updated by the Center for Children and Families. Data as of January 1, 2011.
Notes:
1: Income eligibility levels noted are expressed as a percentage of the
Federal Poverty Level (FPL), without regard to income disregards or
deductions.
2: Income eligibility levels for children's Medicaid includes
CHIP-funded
Medicaid expansions; separate CHIP programs are shown under children's
CHIP. Arizona instituted an enrollment freeze in its CHIP program,
KidsCare, on December 21, 2009. The program remains closed to new
applicants.
3: Pregnant women's income eligibility levels are shown for regular Medicaid, CHIP, and through the unborn child option.
4: Parents' income eligibility levels are shown for parents without earned
incomes (i.e., does not reflect earnings disregards used to determine
income eligibility for working parents) applying for comprehensive
Medicaid coverage based on a family size of three.
5: The "ICHIA" option in CHIPRA allows states to use federal funds to
cover lawfully residing immigrant children and pregnant women in
Medicaid/CHIP without imposing a five-year waiting period. This
indicates whether the state has received approval of a State Plan
Amendment to
adopt this option.
6: Information applies to both Medicaid and CHIP, if applicable, unless otherwise noted.
7: States can use their Title XXI (CHIP) funds to expand Medicaid
(M-CHIP), cover children through a separate program (S-CHIP), or
combine the two approaches (COMBO). Arkansas, Minnesota, Oklahoma,
Rhode Island, and Wisconsin have separate CHIP programs for their
coverage of pregnant women using the unborn child option. Connecticut,
Florida, Illinois, Maine, Minnesota, New Hampshire, New Jersey, New
York, North Carolina, Ohio, Oregon, Pennsylvania, Tennessee, and
Wisconsin allow families with incomes above the levels shown buy into
Medicaid/CHIP.
8: Asset limits noted are for a family of three.
9: In states that do not require families to provide documentation of
income at application, states generally verify this information through
data matches with other government agencies, such as the Social
Security Administration and state departments of labor. Often, families
in states with administrative verification have to provide
documentation of income if self-employed, if income is questionable, or
if the state is unable to administratively verify the information. Some
states request paper documentation of income at application, but if the
family does not submit the documentation with the application, the
state will attempt to administratively verify the information before
following up with the family. States that verify income
administratively, but continue to ask for income documentation on their
applications are not counted as streamlining their procedures. This is
different than how it has been defined in the past.
10: The new Express Lane Eligibility option allows states to use data
and eligibility findings from other public benefit programs when
determining children’s eligibility for Medicaid and CHIP at enrollment
or renewal. States are designated as using Express Lane Eligibility if
they have implemented an initiative and have an approved State Plan
Amendment from CMS.
11: This CHIPRA option became newly available in 2010 and allows states
to conduct data matches with the Social Security Administration to
verify citizenship.
12: Unless specified otherwise, the Medicaid online application and
electronic submission, electronic signature, and documentation rules
apply to both children and parents. Waiver or state-funded coverage
for parents may have different policies.
13: In Arizona, the 12-month continuous eligibility policy in CHIP is a
guaranteed enrollment period that only applies to the first 12 months
of coverage.
14: A state is classified as providing administrative renewal if it
sends a pre-populated form with all eligibility information available
or a renewal letter to the family in advance of the renewal date. The
family is required to either sign and return the form, signaling that
they wish to continue coverage, or do nothing. States that send a
pre-populated form, but require families to submit paper documentation
to continue coverage do not qualify has having implemented
administrative renewals.
15: Data represents policies for parents covered through 1931 Medicaid
coverage; some states have differing policies for parents and other
non-disabled adults covered through waiver or state-funded coverage
programs.
16: States are classified as providing a simplified family application
if parents can apply for coverage without having to complete a separate
application or additional forms. In some states a longer form must be
used to apply for family coverage while a shorter, simpler form is
available for children's coverage; these states are not classified as
offering a simplified family application.
17: With the exception of Arkansas, all states with an asset test for
pregnancy coverage rely on a standard limit regardless of family size.