|
  NR = not reported   NA = not applicable      -- = the state was not required to complete this section of the state plan             template and did not volunteer the information. |
| Identifiers | Amendment Information and Footnotes (1-2) | |||||||
|---|---|---|---|---|---|---|---|---|
| State | Program | Phase or Component | Amend.# | Other Changes Made by Amendment | Item Footnoted (1) | Footnote Text (1) | Item Footnoted (2) | Footnote Text (2) |
| AK | AK Denali KidCare | NA | ||||||
| AL | AL SCHIP | Phase 1 | ||||||
| AL | AL SCHIP | Phase 1 | NA | |||||
| AL | AL SCHIP | All Kids (Phase 2) | ||||||
| AL | AL SCHIP | All Kids (Phase 2) | 1 | M10 | No copayments required for preventive care or well-baby visits. | |||
| AL | AL SCHIP | All Kids (Phase 2) | 2 | |||||
| AL | AL SCHIP | Plus (Phase 3) | ||||||
| AL | AL SCHIP | Plus (Phase 3) | 2 | |||||
| AR | AR SCHIP | Phase I - ARKids A | ||||||
| AR | AR SCHIP | Phase I - ARKids A | NA | |||||
| AR | AR SCHIP | Phase II - ARKids B | ||||||
| AR | AR SCHIP | Phase II - ARKids B | 1 | |||||
| AS | AS SCHIP | NA | B2 | No individual eligibility determinations are made. Rather, the percentage of the population who are presumed to be eligible for the program is estimated each year. The presumed eligible population is the number of people whose incomes are below 100% of the poverty level, minus the number of illegal aliens. This is the same poverty level used by the Medicaid program. | ||||
| AZ | KidsCare | NA | B2 | The income threshold rises over time: 11/1/98, 150%; 7/1/99, 175%; 7/1/2000 - 9/30/07, 200%. | M1 | Only for non-emergency use of the emergency room. | ||
| AZ | KidsCare | 1 | Amendment one to KidsCare changes the reasons a child would not be guranteed 12-month eligibility including: (1) the child's legal guardian fails to cooperate to meet program requirements, (2) child's whereabouts are unknown, (3) failure to pay premiums, (4) child is a patient in an institution for mental illness, (5) voluntary withdrawal. | |||||
| AZ | KidsCare | 2 | Amendment two to KidsCare eliminates the requirement of applicants to choose a contractor or service provider before the application is approved; physician's assistants may bill independently for behavioral health visits; references to the use of Title XXI funding for direct services provided by community health care clinics and hospitals were deleted; behavioral health services are limited to 30 days of inpatient services per year and 30 outpatient visits per year. | M5 | For families with incomes between 150-175% FPL, the maximum per child is $10 per month. | M7 | For families with incomes between 150-175% FPL, the maximum premium per family is $15 per month. | |
| AZ | KidsCare | 3 | Amendment three to KidsCare states that childen who have reached the lifetime limit on private insurance are considered uninsured and not subject to the six month waiting period. | |||||
| AZ | KidsCare | 4 | Amendment four to KidsCare allows parental declaration of income for the program. | |||||
| CA | Healthy Families | Medi-Cal Expansion | ||||||
| CA | Healthy Families | Medi-Cal Expansion | NA | |||||
| CA | Healthy Families | Medi-Cal Expansion | 1 | |||||
| CA | Healthy Families | Medi-Cal Expansion | 2 | Amendment two to Healthy Families, Medi-Cal increases the enrollment broker fees from $25 to $50 per successful applicant and exempts Indian children from copayments when they use Indian Health Service funded clinics. | ||||
| CA | Healthy Families | Health Insurance Plan (MRMIB) | ||||||
| CA | Healthy Families | Health Insurance Plan (MRMIB) | NA | M11 | No copay for prenatal care, well-baby or well-child vists, or immunizations. | M2 | Premiums are set on a sliding scale, determined in part on the delivery plan chosen by the enrollee. | |
| CA | Healthy Families | Health Insurance Plan (MRMIB) | 2 | Amendment two to Healthy Families, MRMIB increases the enrollment broker fees from $25 to $50 per successful applicant and exempts Indian children from copayments when they use Indian Health Service funded clinics. | ||||
| CA | Healthy Families | Health Insurance Plan (MRMIB) | 3 | Amendment three to Healthy Families, MRMIB expands eligibility by applying Medi-Cal income deductions when determining eligibility for the Healthy Families Program. | ||||
| CA | Healthy Families | Health Insurance Plan (MRMIB) | 4 | Amendment four to Healthy Families, MRMIB allows a Family Contribution Sponsor to pay a specific child's Healthy Families Program premiums for the first year of enrollment. | ||||
| CA | Healthy Families | Health Insurance Plan (MRMIB) | 5 | Amendment five to Healthy Families, MRMIB exempts Native American and Alaska Native children from cost sharing requirements. This is a federal requirement for SCHIP. | ||||
| CA | Healthy Families | Access for Infants and Mothers (AIM) | ||||||
| CA | Healthy Families | Access for Infants and Mothers (AIM) | NA | |||||
| CA | Healthy Families | Access for Infants and Mothers (AIM) | 2 | Amendment two to Healthy Families, AIM increases the enrollment broker fees from $25 to $50 per successful applicant and exempts Indian children from copayments when they use Indian Health Service funded clinics. | ||||
| CA | Healthy Families | Access for Infants and Mothers (AIM) | 3 | |||||
| CA | Healthy Families | Access for Infants and Mothers (AIM) | 4 | Amendment four to Healthy Families, AIM impacts the AIM allows a Family Contribution Sponsor to pay a specific child's Healthy Families Program premiums for the first year of enrollment. | ||||
| CA | Healthy Families | Access for Infants and Mothers (AIM) | 5 | Amendment five to Healthy Families, AIM exempts Native American and Alaska Native children from cost sharing requirements. This is a federal SCHIP requirement. | ||||
| CA | Healthy Families | Child Health and Disability Prevention Program | ||||||
| CA | Healthy Families | Child Health and Disability Prevention Program | NA | B1 | Or less than 21 and eligible for Medi-Cal. | |||
| CA | Healthy Families | Child Health and Disability Prevention Program | 2 | Amendment two to Healthy Families, Child Health and Disability Prevention Program increases the enrollment broker fees from $25 to $50 per successful applicant and exempts Indian children from copayments when they use Indian Health Service funded clinics. | ||||
| CA | Healthy Families | Child Health and Disability Prevention Program | 3 | Amendment three to Healthy Families, Child Health and Disability Prevention Program changes the provider claiming period for services received prior to enrollment from 30 to 90 days. | ||||
| CA | Healthy Families | California Children`s Services | ||||||
| CA | Healthy Families | California Children`s Services | NA | B2 | Gross family income <$40,000/yr. or projected medical costs > 20% of family income. | |||
| CA | Healthy Families | California Children`s Services | 2 | Amendment two to Healthy Families, California Children's Health Services increases the enrollment broker fees from $25 to $50 per successful applicant and exempts Indian children from copayments when they use Indian Health Service funded clinics. | ||||
| CA | Healthy Families | County Mental Health Program | ||||||
| CA | Healthy Families | County Mental Health Program | NA | |||||
| CA | Healthy Families | County Mental Health Program | 2 | Amendment two to Healthy Families, County Mental Health Program increases the enrollment broker fees from $25 to $50 per successful applicant and exempts Indian children from copayments when they use Indian Health Service funded clinics. | ||||
| CO | CHP+ | NA | J23 | For HMO enrollees only. Service not included under the CHP+ provider Network Coverage. | J38 | Skilled nursing and organ transplants are covered for HMO enrollees only. Services are not included under the CHP+ Provider Network Coverage. | ||
| CO | CHP+ | 1 | Amendment one to CHP+ adds case management services for HMO enrollees, discontinues transportation services for those enrolled in the CHP+ provider network. | |||||
| CO | CHP+ | 2 | ||||||
| CT | HUSKY Program | Part A | ||||||
| CT | HUSKY Program | Part A | NA | iif | As of 1/1/98, the program was expanded to cover children ages 16-18 (born prior to 9/30/83). | F4 | Enrollment broker will conduct some outreach activities, along with a statewide children's health advocacy group. | |
| CT | HUSKY Program | Part A | 0 | |||||
| CT | HUSKY Program | Part A | 1 | |||||
| CT | HUSKY Program | Part B | ||||||
| CT | HUSKY Program | Part B | NA | B2 | <=235% FPL, after 65% income disregard. Families with incomes above 300 percent FPL can purchase coverage without state subsidy. | F4 | Enrollment broker will conduct some outreach activities, along with a statewide children's health advocacy group. | |
| CT | HUSKY Program | Part B | 1 | Amendment one to the HUSKY Program, Part Ballows federal employees and children of some municipal employees to be eligible for HUSKY B. | ||||
| CT | HUSKY Program | HUSKY Plus Plan for Children with Special Physical Health Needs | NA | B2 | <=235% FPL, after 65% income disregard. Families with incomes above 300 percent FPL can purchase coverage without state subsidy. | F4 | Enrollment broker will conduct some outreach activities, along with a statewide children's health advocacy group. | |
| CT | HUSKY Program | HUSKY Plus Plan for Children with Special Physical Health Needs | 1 | Amendment one to the HUSKY Program, HUSKY Plus Plan for Children with Special Physical Health Needs implements full mental health parity by eliminating limitations on inpatient and outpatient treatment of DSM IV mental health conditions or substance abuse problems. | ||||
| CT | HUSKY Program | HUSKY Plus Behavioral Health Plan | NA | B2 | <=235% FPL, after 65% income disregard. Families with incomes above 300 percent FPL can purchase coverage without state subsidy. | F4 | Enrollment broker will conduct some outreach activities, along with a statewide children's health advocacy group. | |
| CT | HUSKY Program | HUSKY Plus Behavioral Health Plan | 1 | Amendment one to the HUSKY Program, HUSKY Plus Behavioral Health Program implements full mental health parity by eliminating limitations for inpatient and outpatient treatment of DSM IV mental health conditions or substance abuse problems. | ||||
| DC | DC Healthy Kids | NA | ||||||
| DE | Delaware Healthy Children`s Program | NA | M3 | 101-133% FPL = $10/month/family
134-166% FPL = $15/month/family
167-200% FPL = $25/month/family | ||||
| DE | Delaware Healthy Children`s Program | 1 | Amendment one to Delaware Healthy Children's Program states that all wages paid by the Census Bureau for temporary employment related to Census 2000 activities are excluded for the period April 1, 2000 through December 31, 2000. | |||||
| FL | FL KidCare | Medicaid expansion | ||||||
| FL | FL KidCare | Medicaid expansion | NA | |||||
| FL | FL KidCare | Medicaid expansion | 1 | |||||
| FL | FL KidCare | Healthy Kids | ||||||
| FL | FL KidCare | Healthy Kids | NA | J22 | Counties have the option of providing this benefit. | |||
| FL | FL KidCare | Healthy Kids | 1 | |||||
| FL | FL KidCare | Healthy Kids | 3 | Amendment three to FL KidCare, Healthy Kids states that Florida developed a dental services pilot project in Palm Beach and Dade County. Providers have already signed contracts to provide limited dental benefits to Healthy Kids enrollees beginning in the fall of 1999. The pilot is to run for a minimum of 18 months, and will culminate with an in-depth project evaluation. Based on the findings of the evaluation, the program may expand to other areas of the state. Also, Flordia uses a third party administrator to pre-screes applications for Medicaid eligibility. The administrator also processess KidCare applications for children not eligible for Medicaid. | J22 | Dental services pilot created in Palm Beach and Dade County. Other areas of the state may eventually join the pilot. At a minimum, children receive x-rays and two cleanings per year. | ||
| FL | FL KidCare | Healthy Kids | 4 | |||||
| FL | FL KidCare | Medi-Kids | 1 | |||||
| FL | FL KidCare | Medi-Kids | 4 | Amendment four to FL KidCare Medi-Kids implements mandatory assignment for children whose families do not chose a managed care provider within 10 days of receiving a choice-counseling letter. | ||||
| FL | FL KidCare | CMS | 1 | |||||
| FL | FL KidCare | CMS | 4 | |||||
| GA | Peach Care for Kids | NA | M2 | Required for children over 6. | ||||
| GA | Peach Care for Kids | 0 | ||||||
| GA | Peach Care for Kids | 1 | Amendment one to Peach Care for Kids states that if coverage is terminated due to nonpayment of premium, coverage may be reinstated at any time within the 12 month eligibility period, with the payment of premium for month of reinstatement. Coverage will resume the first of the next month. | |||||
| GU | Guam SCHIP | NA | B2 | Guam will use the same eligibility as the Medicaid program. | ||||
| HI | HI SCHIP | Phase I | NA | |||||
| HI | HI SCHIP | Phase I | 1 | |||||
| IA | Hawk-I | Medicaid Expansion | NA | |||||
| IA | Hawk-I | Medicaid Expansion | 4 | |||||
| IA | Hawk-I | Separate State Program | 1 | |||||
| IA | Hawk-I | Separate State Program | 2 | Amendment two to Hawk-I, Separate State Programallows for a 20-percent deduction to earned income in determining eligibility for the HAWK-I program, and includes an additional managed health care plan, Unity Choice from Wellmark Health Plan of Iowa. | ||||
| IA | Hawk-I | Separate State Program | 3 | Amendment three to Hawk-I, Separate State Program adds a third managed care plan, John Deere Health Plan to selected counties in Iowa. The plan also removes cost sharing for American Indians/Alaska Native children and allows a deduction for depreciation of capital assets when considering self-employment income. | ||||
| IA | Hawk-I | Separate State Program | 4 | B12 | 20% of earned income will be exempt when determining family income. Also, income from self-employment will be the gross income minus the cost of doing business. This includes the depreciation of capital assets as identified for income tax purposes. | |||
| ID | ID SCHIP | NA | ||||||
| ID | ID SCHIP | 1 | ||||||
| ID | ID SCHIP | 2 | Amendment two to ID SCHIP states that in order to increase coordination efforts, the state created an executive oversight committee responsible for overall project direction and quality improvement activities for SCHIP. The state also simplified the application and improved outreach approaches. The state eliminated the requirement for proof of citizenship from non-applicants and annualized income for enrollment in order to assist seasonal or temporary workers. | |||||
| IL | Kidcare | Phase 1 | NA | F6 | Applicants may not fax applications since an original signature is required. | |||
| IL | Kidcare | Phase 2 | 1 | B12 | Income exemptions under Phase 2 are the same as the exemptions under Medicaid. | F2 | The department may release an RFP to contract with multiple entitites to identify and implement creative outreach strategies to locate and enroll hard-to-reach populations. | |
| IN | Hoosier Healthwise | Phase 1 | NA | |||||
| IN | Hoosier Healthwise | Phase 1 | 0 | |||||
| IN | Hoosier Healthwise | Phase 2 | 2 | |||||
| KS | HealthWave | NA | ||||||
| KS | HealthWave | 1 | Amendment one to Heathwave changes the state's Title XXI State plan to allow an infant born to a mother, who is under age 19 and enrolled in HealthWave, to retroactively enroll in HealthWave starting with the month of birth as a means of ensuring continuity of care for the newborn. However, the infant must be screened for Medicaid eligibility and enrolled in Medicaid, if appropriate, no later than 90 days from the date the Agency was notified of the infant’s birth. The mother of the infant will already be screened for Medicaid eligibility as a pregnant woman, with a family size that includes the unborn child. This amendment also specifies that the clearinghouse contractor is responsible for enrollment of HealthWave eligibles into participating health plans. | |||||
| KY | KCHIP | Medicaid Expansion | ||||||
| KY | KCHIP | Medicaid Expansion | NA | |||||
| KY | KCHIP | Medicaid Expansion | 1 | |||||
| KY | KCHIP | Insurance Product | ||||||
| KY | KCHIP | Insurance Product | NA | |||||
| KY | KCHIP | Insurance Product | 1 | |||||
| KY | KCHIP | Insurance Product | 2 | Amendment two to KCHIP, Insurance Product changes the service delivery mechanism from accountable pediatric organizations to a Medicaid-look alike. Health care services include all current Medicaid services except non-emergency transportation and EPSDT special services. | ||||
| LA | LaCHIP | NA | ||||||
| LA | LaCHIP | 1 | ||||||
| MA | MassHealth | Standard | NA | B5 | Pregnant teens (<=18 years) covered to 200% FPL. | F8 | State makes "mini-grants" to community-based organizations to conduct outreach. | |
| MA | MassHealth | Family Assistance Direct Coverage | NA | F8 | State makes "mini-grants" to community-based organizations to conduct outreach. | B13A | The program is not open to students whose parents live outside the state and to those who come to Massachusetts for medical care in a setting other than a nursing facility and who maintain a residence outside of Massachusetts. Individuals in penal institutions are not eligible for MassHealth. | |
| MA | MassHealth | Family Assistance Premium Assistance | NA | F8 | State makes "mini-grants" to community-based organizations to conduct outreach. | B13A | Not open to students whose parents live outside the state and to those who come to Massachusetts for medical care in a setting other than a nursing facility and who maintain a residence outside of Massachusetts. Individuals in penal institutions are not eligible for MassHealth. | |
| MA | MassHealth | Common Health | NA | F8 | State makes "mini-grants" to community-based organizations to conduct outreach. | B13A | Not open to students whose parents live outside the state and to those who come to Massachusetts for medical care in a setting other than a nursing facility and who maintain a residence outside of Massachusetts. Individuals in penal institutions are not eligible for MassHealth. | |
| MD | Maryland Children`s Health Program | Phase I | NA | |||||
| MD | Maryland Children`s Health Program | Phase I | 1 | Amendment one to Maryland Children's Health Program, Phase I adds coverage of the Maryland Kids Count program, a Section 1115 demonstration, to the SCHIP population. The population added to SCHIP includes children who are born after September 30, 1983 who are in families below 185% FPL but who do not qualify for SOBRA eligibility for Medicaid. Thus, children ages one through five in families with income above 133% of FPL and children ages six and above who were born after September 30, 1983 who are in families with income over 100% of FPL will be newly added to MD's SCHIP. | ||||
| MD | Maryland Children`s Health Program | Phase II | 2 | |||||
| MD | Maryland Children`s Health Program | Phase II- ESI | 2 | M1 | The employer will withhold the employee's share of the insurance premium and the state will issue a check to the family once a month, prior to the payroll deduction to cover the state subsidy. | |||
| ME | ME CHIP Medicaid Expansion | NA | ||||||
| ME | Cubcare | NA | ||||||
| ME | Cubcare | 1 | Amendment one to Cubcare states that American Indian and Alaska Native children are not required to enroll in mandatory managed care. | |||||
| MI | MI SCHIP | MI CHILD | NA | |||||
| MI | MI SCHIP | MI CHILD | 1 | Amendment one to MI SCHIP, MI CHILD requires final eligibility determinations to be done by state staff. Established a 12-month lock-in to health plans with changes allowed in the first 30 days of enrollment and for the cause thereafter. | ||||
| MI | MI SCHIP | MI CHILD | 2 | Amendment two to MI SCHIP, MI CHILD allows self-declaration of income and modifies the redetermination process. | ||||
| MI | MI SCHIP | Medicaid Expansion | 1 | |||||
| MI | MI SCHIP | Medicaid Expansion | 2 | Amendment two to MI SCHIP, Medicaid Expansion establishes self-declaration of income and simplifies the redermination process. | ||||
| MN | Minnesota Medical Assistance Program | NA | ||||||
| MO | MC+ for Kids | NA | B2 | Gross income; 200% net income after 100% income disregard. | B12 | Equal to 100% FPL. | ||
| MO | MC+ for Kids | 1 | M10 | Copayments apply to children with family incomes greater than 185% FPL. | M11 | No copayments required for well-baby visits. | ||
| MP | CNMI SCHIP | NA | B2 | CNMI will use the same eligibility as the Medicaid program. | ||||
| MS | MS SCHIP | Phase I | ||||||
| MS | MS SCHIP | Phase I | NA | |||||
| MS | MS SCHIP | Phase II | ||||||
| MS | MS SCHIP | Phase II | 1 | |||||
| MS | MS SCHIP | Phase II | 2 | |||||
| MS | MS SCHIP | Phase II | 3 | |||||
| MS | MS SCHIP | Employer-sponsored coverage | 1 | Amendment one to MS CHIP, Employer-sponsored coverage states that Mississippi will provide secondary coverage for children enrolled in employer-sponsored plans by providing no-cost well-child visits and immunizations if not covered by the employer-sponsored plan. | ||||
| MT | MT SCHIP | NA | M7 | MT has an annual enrollment fee of $12-15 per family. There is no monthly premium. | ||||
| MT | MT SCHIP | 1 | Amendment one to MT SCHIP states that birth control contraceptives are no longer a covered benefit. The state changed the required time to process SCHIP applications from within 5 working days to within 10 working days. The maximum annual copayment was increased from $200 to $215. | B2 | All wages paid by the Census Bureau for temporary employment related to Census 2000 activities are excluded. SCHIP excludes $120 per month for each earned-income earner and up to $200 per month for each person for whom dependent care is paid. | |||
| NC | NC SCHIP | NA | B18 | 6 months after the program is in effect, the waiting period is 60 days. | B2 | Enrollees with incomes up to 225%FPL may buy into the program at full premium cost. | ||
| NC | NC SCHIP | 1 | Amendment one to NC SCHIP changes the definition of "uninsured" to mean the applicant is and was not covered under any private plan for 60 days immediately preceding the application. | |||||
| NC | NC SCHIP | 2 | Amendment two to NC SCHIP allows school-based health centers to deliver clinic services. | |||||
| NC | NC SCHIP | 3 | Amendment three to NC SCHIP expands dental services to include flouride applications twice during a 12-month period, sealants, simple extractions, therapeutic pulpotomies, and prefabricated stainless steel crowns. | |||||
| NC | NC SCHIP | 4 | Amendment four to NC SCHIP exempts special needs children from the 2-month waiting period of uninsurance required for program eligibility if health insurance benefits are terminated due to a long-term disability or substantial reduction in or limitation of lifetime medical benefits or benefit category. | |||||
| NC | NC SCHIP | 5 | Amendment five to NC SCHIP permits the state to establish a freeze on new enrollments in order to stay within the federal and state budget parameters. The state anticipates closing new enrollments for an unspecified amount of time beginning January 1, 2001. Families will continue to file applications to the program and the eligibility information system will establish a computerized waiting list. When the Division of Medical Assistance determines that it is financially possible to allow for new enrollees, applications will be activated according to the order on the waiting list. | |||||
| ND | Healthy Steps | Phase I | ||||||
| ND | Healthy Steps | Phase I | NA | |||||
| ND | Healthy Steps | Phase II | ||||||
| ND | Healthy Steps | Phase II | 1 | M8 | A $50 deductible will be applied to families for the first day of each inpatient hospital admission in a general hospital or psychiatric or substance abuse inpatient facility. | |||
| NE | Kid`s Connection | NA | ||||||
| NE | Kid`s Connection | 1 | ||||||
| NH | Healthy Kids | Gold | NA | |||||
| NH | Healthy Kids | Gold | 1 | Amendment one to Healthy Kids Gold modifies the benefits package. Prescription contraceptive drugs are limited to FDA approved oral contraceptives and Depoprovera. Emergency dental treatment is covered at 100%, and coverage of fillings is expanded to to 100%, up to a maximum of $500 per child per year. | ||||
| NH | Healthy Kids | Silver | NA | M4 | $20/month for families between 185-250% FPL. | M11 | Does not apply to well-child visits, preventive health visits or dental check-ups. | |
| NJ | KidCare | Plan A | NA | |||||
| NJ | KidCare | Plan B | NA | |||||
| NJ | KidCare | Plan B | 1 | |||||
| NJ | KidCare | Plan B | 3 | Amendment three to KidCare, Plan B states that children are exempt from the six month period of uninsurance prior to application if the child was covered under an individual health benefits plan or COBRA plan prior to application for NJ KidCare. Exceptions are also granted if the child had not been voluntarily disenrolled from an employer-sponsored group insurance plan during the six-month period prior to application for NJ KidCare, or the child loses insurance as a result of a job change, when the insured does not have access to affordable coverage in the new job. | ||||
| NJ | KidCare | Plan B | 4 | |||||
| NJ | KidCare | Plan C | NA | M11 | Exceptions for well-child visits. | |||
| NJ | KidCare | Plan C | 1 | |||||
| NJ | KidCare | Plan C | 3 | Amendment three to KidCare, Plan C states that children are exempt from the six month period of uninsurance prior to application if the child was covered under an individual health benefits plan or COBRA plan prior to application for NJ KidCare. Exceptions are also granted if the child had not been voluntarily disenrolled from an employer-sponsored group insurance plan during the six-month period prior to application for NJ KidCare, or the child loses insurance as a result of a job change, when the insured does not have access to affordable coverage in the new job. | ||||
| NJ | KidCare | Plan C | 4 | |||||
| NJ | KidCare | Plan D | 2 | M11 | Exceptions for well-child visits. | |||
| NJ | KidCare | Plan D | 3 | Amendment three to KidCare, Plan D states that children are exempt from the six month period of uninsurance prior to application if the prior coverage was lost because the employee changed jobs and does not have access to affordable coverage in the new job. | ||||
| NJ | KidCare | Plan D | 4 | |||||
| NJ | KidCare | 1115 Demonstration | NA | |||||
| NM | NM SCHIP | NA | F10 | Applicants for TANF and Food Stamps are screened for SCHIP eligibility. | B17 | Exceptions to the 12-month ineligibility rule are made for involuntary loss of insurance, including the dropping of coverage by the employer; a catastrophic illness in a family possessing limited coverage; underinsured with special needs; and a change in marital status or any other change in circumstances which may inadvertently affect coverage. | ||
| NM | NM SCHIP | 2 | Amendment two to NM SCHIP exempts Native American children from making copayments. This is a federal SCHIP requirement. | |||||
| NM | NM SCHIP | 1115 Demonstration | NA | |||||
| NV | Nevada Check-Up | NA | M7 | $50/quarter for families above 175% FPL
$25/quarter for families 151-175% FPL
$10/quarter for families below 151% FPL | B21 | The eligibility of all enrollees in the program is redetermined at the same time each year, regardless of the date of enrollment. | ||
| NV | Nevada Check-Up | 1 | ||||||
| NY | NY SCHIP | CHPLUS | ||||||
| NY | NY SCHIP | CHPLUS | ||||||
| NY | NY SCHIP | CHPLUS | NA | F9 | Phased in beginning in fall 1998, then statewide in late 1999. | M5 | Premiums are on a sliding scale. | |
| NY | NY SCHIP | CHPLUS | 2 | |||||
| NY | NY SCHIP | Medicaid Expansion | 2 | |||||
| OH | OH Child Health Plan | NA | ||||||
| OH | OH Child Health Plan | 1 | Amendment one to OH Child Health Plan changes the redetermination period from 6 months to one year. | |||||
| OK | SoonerCare | NA | F11 | A simplified application has been developed for those applying for AFDC-related benefits. | ||||
| OK | SoonerCare | 1 | ||||||
| OR | OR SCHIP | NA | ||||||
| OR | OR SCHIP | 2 | Amendment two to OR SCHIP revises several of the program's performance measures. Specifically, the State revised the measure that lists focus groups and structured interviews as a means of determining quality and appropriateness of care, and instead is relying on consumer satisfaction surveys for consumer feedback and meetings with agency personnel. The State revised the section on clinical measures and utilization to specify that "utilization" rather than "trends" will be monitored in the SCHIP population. The section listing the performance goals for Oregon SCHIP enrollees was revised to delete early childhood caries and treating children's ear infections, since these will be included in the Oregon Health Plan (OHP) measures (combined Medicaid and SCHIP) and will not be collected other than for the SCHIP population. The External Quality Review Organization no longer samples specific SCHIP measurements. | |||||
| OR | OR SCHIP | 3 | Amendment three to OR SCHIP increases the number of children permitted to be covered under the State's enrollment cap from 16,800 (as stated in the original State plan) to approximately 19,800 children. | |||||
| PA | PA SCHIP | NA | M1 | Cost sharing for prescription drugs. | ||||
| PA | PA SCHIP | 1 | Amendment one to PA SCHIP eliminates cost sharing for prescription drugs. The amendment also eliminates the 2.5% in-kind contribution previously imposed on grantees. | |||||
| PA | PA SCHIP | 2 | Amendment two to PA SCHIP changes the eligibility standards methodology to allow a work-expense deduction and day-care expense deduction to be subtracted from gross earnings to determine net available income. | |||||
| PA | PA SCHIP | 3 | ||||||
| PA | PA SCHIP | 4 | ||||||
| PR | PR SCHIP | NA | ||||||
| RI | RIte Care | NA | M10 | Enrollees have a choice between a premium or copayment option. | M4 | Premiums are required on a sliding scale. | ||
| RI | RIte Care | 1 | Amendment one to RIte Care eliminates the interview process. | B12 | Earnings of dependent children are disregarded unless children are employed full time. | |||
| RI | RIte Care | 1115 Demonstration | NA | |||||
| SC | Partners for Healthy Children | NA | ||||||
| SD | SD SCHIP | NA | ||||||
| SD | SD SCHIP | 1 | ||||||
| SD | SD SCHIP | 2 | Amendment two to SD SCHIP eliminated cost sharing for 18-year olds. There is no cost sharing required in South Dakota's SCHIP program. | |||||
| SD | SD SCHIP | CHIP NM | 3 | |||||
| TN | Tennessee`s CHIP | Phase I | NA | |||||
| TX | Texas Healthy Steps | Phase I | ||||||
| TX | Texas Healthy Steps | Phase I | NA | |||||
| TX | Texas Healthy Steps | Phase II | ||||||
| TX | Texas Healthy Steps | Phase II | 1 | |||||
| UT | UT SCHIP | NA | M10 | No copayment for well-baby/well-child care and immunizations. | M11 | $5 if family income is below 150% FPL. | ||
| VA | VA SCHIP | Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan | NA | J21 | Only to save the life of the mother. | |||
| VA | VA SCHIP | Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan | 1 | Amendment one to VA SCHIP changes the name of the program from Children's Medical Security Insurance Plan to Family Access to Medical Insurance Security Plan (FAMIS). | ||||
| VA | VA SCHIP | Family Access to Medical Insurance Security Plan (FAMIS) - ESI | 1 | |||||
| VI | Virgin Island`s SCHIP | NA | B2 | The Virgin Islands will use the same eligibility as the Medicaid program. | ||||
| VI | Virgin Island`s SCHIP | 1 | The Virgin Islands originally proposed to use SCHIP funds to extend Title XXI coverage to Medicaid children after the Territory ran out of federally capped Medicaid dollars. The SCHIP funds were used to pay inpatient pediatric medical bills for children in the Territory's two hospitals. Amendment one allows the Title SCHIP funds to pay pediatric bills incurred by any approved medical provider. | |||||
| VT | VT SCHIP | NA | M11 | No copayments for well-baby or well child visits or for diagnostic and preventive dental visits; and the copayments begin 7/1/99. | M7 | Premiums will increase to $20 per month per family when administratively possible. | ||
| VT | VT SCHIP | 1 | ||||||
| VT | VT SCHIP | 2 | ||||||
| VT | VT SCHIP | 3 | ||||||
| WA | WA SCHIP | NA | M10 | No copayment required for well-baby and well-child services. | ||||
| WA | WA SCHIP | 1 | Amendment one to WA SCHIP expands the assignment of children into manged care health plans, eliminates the requirement for families to select a health plan as part of the application process, and eliminates the requirement for families to sign a written agreement to pay premiums as a condition of eligibility. The amendment also excludes temporary employment related income from Census 2000 activities. | |||||
| WI | BadgerCare | Medicaid expansion | ||||||
| WI | BadgerCare | Medicaid expansion | NA | F6 | A new mail in application will be developed. | F4 | The enrollment contractor trains advocacy groups and community based agencies for outreach efforts. | |
| WI | BadgerCare | Medicaid expansion | 1 | B1 | Medicaid eligibility is expanded for children 6-18. Custodial parents and other family members are covered when it is cost effective to do so. | A4 | If the cost of employer-sponsored coverage for the family is less than the cost of enrolling only the children in BadgerCare, the state will purchase ESI family coverage using Title XXI funds. | |
| WI | BadgerCare | Employer-sponsored Coverage | 1 | |||||
| WI | BadgerCare | NA | ||||||
| WV | WV SCHIP | Phase I | NA | |||||
| WV | WV SCHIP | Phase I | 2 | Amendment two to WV SCHIP, Phase I effectively eliminates the Medicaid expansion program and incorporates the enrollees into the state designed program, or Phase II of West Virginia's SCHIP. | ||||
| WV | WV SCHIP | Phase II | 1 | |||||
| WV | WV SCHIP | Phase II | 2 | Amendment two to WV SCHIP, Phase II effectively eliminates Phase I, the Medicaid expansion program, and incorporates enrollees into Phase II, the state designed program. | ||||
| WV | WV SCHIP | Phase II | 3 | Amendment three to WV SCHIP, Phase II changes the name of the program from Phase II to Phase III. | M10 | Copayments are required for families over 150% FPL. | J7 | Perscription benefit services are covered with mandatory generic substitution, which includes oral contraceptives. |
| WY | WY SCHIP | CHIP One | NA | H7 | Same coverage as provided under WY Medicaid Plan. | |||