Family Healthcare (FAMIS) Manual – Table of Contents

0920.020.00 MC+ ELIGIBILITY FOR CHIP CHILDREN (MC+)

IM-99 October 2, 2007,  IM-130 November 4, 2005,  IM-83 August 2, 2005

To qualify for MC+ under the Children’s Health Insurance Program (income above the non-CHIP Group maximums) a child must be uninsured and family income must be below 300% of the Federal Poverty Level (FPL).

CHIP children are divided into three eligibility groups:

  • CHIP NO COST GROUP: Net income above non-CHIP maximum. Gross income up to and including 150% FPL.
  • CHIP REDUCED PREMIUM GROUP: Gross income over 150%, and at or below 225% FPL.
  • CHIP FULL PREMIUM GROUP: Gross income over 225% and below 300% FPL.

In addition to the eligibility requirements for all MC+ children, all CHIP children must be currently uninsured and pass a gross income test.

All Premium Group children (gross income over 150% FPL and under 300% FPL) must also meet the following criteria:

  • uninsured for 6 months
  • no access to affordable health insurance
  • payment of premium
  • gross income test
  • net worth of $250,000 or less