The Children’s Health Insurance Program (CHIP) provides quality medical and dental services to children under the age of 19 who are eligible based on non-financial and financial criteria. The methodology for determining eligibility for CHIP is Modified Adjusted Gross Income (MAGI).
The CHIP Eligibility Handbook serves to provide Managed Care Organizations and Caseworkers with a comprehensive guide that will ensure proper implementation of statutory requirements, pursuant to Title XXI of the Social Security Act, the Children’s Health Care Act, and the Patient Protection and Affordable Care Act (PPACA or more commonly referred to as ACA).
1103.11 Role of the CAO/Caseworker
The Caseworker is responsible for completing an eligibility determination for families applying for healthcare and ensuring appropriate enrollment in eligible healthcare category.
1103.12 Role of the Managed Care Organization
The Managed Care Organization (MCO) is responsible for managing benefits. The MCO will provide assistance to families with questions.
Issued March 31, 2023