Title 16
18000 Delaware Healthy Children Program
Continuous eligibility means continued eligibility under DHCP during the 12-month period of time between the first month of eligibility and the next scheduled redetermination.
The initial month of the continuous period of eligibility is the first month in which eligibility is determined. A new period of continuous eligibility will be established beginning with the month following the last month of the previous period of continuous eligibility, when a scheduled redetermination is completed and the child is determined to be eligible.
A new 12-month period of continuous eligibility will also begin after any break in DHCP eligibility.
18800.1 Termination of Eligibility
A child who is determined eligible for DHCP remains eligible for a 12-month period of continuous eligibility unless he or she becomes ineligible for the following reasons:
a) the child becomes 19 years of age
b) the child dies
c) the child acquires comprehensive health insurance
d) the child becomes eligible for the State health benefits plan
e) the child becomes eligible for Medicaid
f) the child becomes an inmate of a public institution
g) the child is no longer a Delaware resident
h) the child no longer meets citizenship or qualified alien status
18800.2 Changes in Family Income
There is no interruption of the continuous eligibility period because of an increase in the family’s income. This includes an increase in countable income because of a change in family size.
If there is a decrease in family income or an increase in family size, eligibility will be redetermined. A decrease in income could result in the family becoming eligible for Medicaid or the child remaining eligible for DHCP with a lower premium. If the decrease in income results in a lower premium for the family, the child will receive a new 12-month period of continuous eligibility.
18800.3 Continuously Eligible Newborns
A baby born to a mother eligible for DHCP is deemed eligible at birth. The newborn’s continuous eligibility will coincide with the mother’s 12-month period of continuous eligibility.
18800.4 Redetermination of Eligibility
A redetermination of eligibility is required by the end of a 12 month period of continuous eligibility.
