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Delaware Healthy Children Program - Frequently Asked Questions


 

Q. What is the Delaware Healthy Children Program?

A. The Delaware Healthy Children Program (DHCP) provides low cost health insurance for children who are currently uninsured. It gives your children all the benefits that most private plans provide.

 

Q. How do I know if my children are eligible?

A. Uninsured children from birth to the age of 19 who live in families with countable income at or below the 212% Federal Poverty Level are eligible for DHCP coverage.

 

Q. How do I apply?

A. You can obtain an application in English or Spanish by calling DHCP at 1-800-996-9969.  You can also fill out an application on the internet using ASSIST - the State of Delaware’s online resource for individuals to apply for social service programs. For more information, you can read the DHCP flyer (PDF file), which can also be viewed as a web page .

 

Q. What if my child already has some health coverage?

A. A child who has comprehensive health insurance is not eligible for the DHCP. Comprehensive Health Insurance means a plan that provides coverage for hospitalization, doctor visits, x-rays and lab work. A child with more limited coverage may still be eligible for the DHCP.

 

Q. What is a qualified non-citizen?

A. In general, children eligible for the Delaware Healthy Children Program (DHCP) must be U.S. citizens. However, the federal government classifies some non-citizen children as “qualified aliens.” These children may be eligible. Also remember some children born outside of the U.S. may be citizens.

Examples of non-citizen children who may be eligible:

  • Lawful permanent residents who entered the U.S. before August 22, 1996
  • Parolees of more than one year and conditional entrants
  • Refugees, asylees, and those whose deportation has been withheld
  • Cuban and Haitian entrants
  • Amerasians
  • Dependents of veterans and active-duty military personnel

Many other groups of non-citizen children may be eligible. Call the DHCP at 1-800-996-9969 to ask.

 

Q. Are children of State employees eligible?

A. Children of permanent State of Delaware employees are not eligible for the Delaware Healthy Children Program (DHCP). However, children of seasonal, casual or temporary state employees can get DHCP coverage if they meet the income guidelines. Children of permanent State of Delaware employees may be eligible to receive Delaware Medicaid in some cases.

 

Q. Why aren't children of State employees eligible?

A. The Delaware Healthy Children Program (DHCP) uses federal funds from Title XXI of the Social Security Act – the State Children’s Health Insurance Program (SCHIP). By federal law, these funds cannot be used for dependents of state employees.

 

Q. What about pre-existing conditions or medical eligibility?

A. The Delaware Healthy Children Program (DHCP) does not exclude children because of pre-existing health conditions. We do not consider a child’s medical condition(s) in the determination of eligibility for the DHCP.

Delaware does offer a Medicaid program for children with severe disabilities who would otherwise qualify to be cared for in an institutional setting.  This Medicaid program is the Children’s Community Alternative Disability Program (CCADP).  If you are interested in applying for CCADP, please call the Central Intake Unit (CIU) of the Division of Medicaid & Medical Assistance (DMMA) at 1-866-940-8963 to make a referral.

 

Q. How often does the Delaware Healthy Children Program review eligibility? What is the process?

A. All children who are determined eligible for the Delaware Healthy Children Program (DHCP) receive a period of continuous eligibility.  Continuous eligibility means continued eligibility under the DHCP during the 12-month period of time between the first month of eligibility and the next scheduled review.  Monthly premiums must be paid timely during the period of continuous eligibility in order to maintain coverage of medical services under the DHCP.  The Division of Social Services (DSS) will attempt to review eligibility every 12 months based on available information.  If DSS is unable to review eligibility based on available information, the agency will send the family a review form.  The family must then complete and return the review form to DSS, along with any requested information (such as proof of updated income), by the deadline specified in the review form. 

 

Q. How much do I have to pay?

A. Premium payments are $15 or $25 per household per month, depending on your income.

There is an added bonus: for every 3 months you pay in advance, you'll get the 4th month free!  

Q. Who provides the insurance?

A. Delaware provides a choice of different managed care plans so that you can select the plan that is best suited to your child's needs.  Delaware contracts with two Managed Care plans – United Healthcare Community Plan and Highmark Health Options.

Q. Are parents covered too?

A. Sorry. The plan is currently limited to children under the age of 19. But a single monthly fee does cover every child in the household who is eligible for the plan.

Q. When will my coverage start?

A. After you are approved for the program, you must choose a managed care plan and pay the first month's premium. You will receive a notice telling you when your coverage begins.

 

Delaware Healthy Children Program - Related Links:

 



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