Section 477-19-005 - 599 CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP)005.01ELIGIBILITY REQUIREMENTS. A pregnant womanwho is not otherwise eligible for Medicaid or Children's Health Insurance Program (CHIP)may have her unborn child's eligibility reviewed under the 599 Children's Health Insurance Program (CHIP) program. Eligibility for Medicaid must first be determined before 599 Children's Health Insurance Program (CHIP) eligibility can be reviewed. Eligibility is determined for unborn children from conception through birth, if the household income is equal to or less than 197% of the Federal Poverty Level (FPL). 005.01(A)CITIZENSHIP AND NON-CITIZEN STATUS. 599 Children's Health Insurance Program (CHIP) has no requirement for citizenship or alien status, as the unborn child's status is independent of that of the pregnant woman.005.01(B)CREDITABLE HEALTH INSURANCE. There is no eligibility for the unbornchild if the pregnant woman has creditable health insurance. Health insurance which does not provide prenatal or maternity care is not considered creditable coverage. For a definition of creditable health insurance, see 477 NAC 1.005.01(C)NEBRASKA RESIDENCE. The residency of the unborn child will follow the residency of the pregnant woman.005.01(D)RELATIVE RESPONSIBILITY. Relative responsibility in the 599 Children's Health Insurance Program (CHIP) is determined using relative responsibility regulations for modified adjusted gross income (MAGI) programs. For a pregnant minor, the income of her financially responsible parents shall not be used to determine eligibility for the unborn child.005.01(E)AGE REQUIREMENT. For receipt of 599 Children's Health Insurance Program (CHIP) benefits, an individual is considered an unborn child from conception until birth.005.01(F)THIRD PARTY LIABILITY. If an ineligible pregnant woman or her spouse fails or refuses to cooperate with third party liability, the unborn child is ineligible for 599 Children's Health Insurance Program (CHIP).005.02EFFECTIVE DATE OF ELIGIBILITY. The effective date of eligibility for 599 Children's Health Insurance Program (CHIP) is no earlier than the first day of the application month. There is no retroactive eligibility for 599 Children's Health Insurance Program (CHIP).005.03CONTINUOUS ELIGIBILITY. Unborn children are continuously eligible for up to six months or through their month of birth, whichever comes first. After six months of continuous eligibility, a full eligibility review is not required. However, information reported or known to the Department must be acted upon. An unborn child must have at least a thirty day period of ineligibility before he or she would qualify for another sixmonth period of continuous eligibility. 005.03(A)ELIGIBILITY FOR THE CHILD UPON BIRTH. Following the birth of the child, eligibility will be determined for medical assistance based on any changes reported or known to the Department. If the newborn is determined eligible for medical assistance, the newborn is eligible for six months of continuous Medicaid eligibility.005.03(B)POST-PARTUM SERVICES. The pregnant woman will not be eligible for post-partum services under 599 Children's Health Insurance Program (CHIP). If post-partum care is needed for complications following labor and delivery, the woman may apply for Emergency Medical Services Assistance (EMSA).477 Neb. Admin. Code, ch. 19, § 005
Amended effective 7/29/2020