Title 16
15000 AFDC-TANF Related Programs
The woman must be uninsured. The woman is not eligible if she has:
a) Medicaid or is eligible under any of the Mandatory Categorically Needy coverage groups. The mandatory groups include Section 1931, Transitional or Prospective, IV-E Foster Care, IV-E Adoption Assistance, Low Income Pregnant Woman or Child, SSI, or Deemed SSI.
b) Medicare
c) Comprehensive health insurance
d) Military Health Insurance for Active Duty, Retired Military, and their dependents
15505.1 Definition of Comprehensive Health Insurance
Comprehensive health insurance is a benefit package comparable in scope to the "basic" benefit package required by the State of Delaware's Small Employer Health Insurance Act at Title 18, Chapter 72 of the Delaware Code. To be considered comprehensive health insurance, the benefits package must cover hospital and physician services, laboratory and radiology and must include coverage for the treatment of breast and cervical cancer.
A woman is not considered to have comprehensive health insurance when she is not actually covered for treatment of breast or cervical cancer. For example, a woman who has comprehensive health insurance but is in a period of exclusion (such as preexisting condition exclusion) for treatment of breast and cervical cancer. Also, if a woman exhausts her lifetime limits under the insurance (including treatment for breast or cervical cancer), she is not considered to have coverage.
A woman who has comprehensive health insurance that has limits on benefits (such as limits on the number of outpatient visits per year) or high deductibles, is not eligible under this group.
