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Children’s Health Insurance Program (CHIP)

Through Mississippi Health Benefits there are two health insurance options that cover children, the Children’s Health Insurance Program (CHIP) and Medicaid.

The income limits are based on Modified Adjusted Gross Income or MAGI limits. The limits are referred to as MAGI because the programs using MAGI limits are based primarily on IRS rules for counting income and determining household composition.

Who is eligible for CHIP?

CHIP provides health coverage for uninsured children up to age 19 years old. To be eligible for CHIP, a child cannot be eligible for Medicaid. At the time of application, children with health insurance are not eligible for CHIP.

Income Limits for Medicaid and CHIP Programs

Effective March 1, 2014, Internal Revenue Service (IRS) rules for Modified Adjusted Gross Income (MAGI) are used to determine a household’s income compared to the limits shown below based on household size. No deductions other than those allowed by IRS rules are used, other than a 5% disregard based on the federal poverty level (FPL) that is applied when needed to allow eligibility for Medicaid or CHIP.

Proposed CHIP State Plan Amendments

Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA) #10 was submitted to CMS on Jan. 9, 2018 to expand vision services to low-income children throughout the state by allowing the Division of Medicaid (DOM) to contract with a non-profit CHIP participating provider to offer these services on-site at certain Mississippi schools, effective January 1, 2018.

Approved CHIP State Plan Amendments

Children’s Health Insurance Plan (CHIP) SPA 15-0014 Mississippi Application for Health Benefits Revision
Children’s Health Insurance Plan (CHIP) State Plan Amendment (SPA) 15-0014 Mississippi Application for Health Benefits Revision has been approved to include in the Mississippi Application for Health Benefits the beneficiary’s choice of a preferred Coordinated Care Organization (CCO) or auto-assignment to a CCO, and to include language to satisfy Medicaid regulations governing the single, streamlined Medicaid application.

The Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA) #9 was approved April 17, 2015, and complies with 42 CFR § 457.60 and Miss. Code Ann. §§ 41-86-9 and 43-13-117. House Bill 1275, passed in the 2014 Legislative Session, authorized the Division of Medicaid to implement these changes to include administration and management of the separate CHIP health plan by Coordinated Care Organizations (CCOs).

State Plan Amendment (SPA) 13-008 Children’s Health Insurance Program (CHIP) Amendment #8 with an effective date of January 1, 2013, includes the following changes:
Section 3.1 – “Organization and Management” includes the language regarding transferring the administration of the CHIP program to the Division of Medicaid (DOM) from the Health Insurance Management Board as required by HB 316 from the 2012 legislative session.

Section DC – Dental Coverage describes the covered dental benefits for beneficiaries enrolled in CHIP.  The inclusion of these benefits does not represent a change.  CHIPRA legislation (the most recent reauthorization of the CHIP program, P.L. 111-3) required each CHIP program to include “coverage of dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.”  MS CHIP is compliant with this coverage but CMS is requiring a description of the dental coverage included in the CHIP State Plan.

Section 7.2.2 describes access to covered services including emergency services.  CMS requests MS to update the language in this section to clarify both emergent and non-emergent care is available in an ER.

This State Plan Amendment was implemented January 1, 2010 and was filed because the benchmark definition requires that any applicable benefit changes made to the State and School Employees Health Insurance Plan be consequently implemented with the CHIP.

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