Child Medicaid

Child Medicaid is a medical assistance program for children who do not qualify for Newborn or Newborn Plus Medicaid, but who are still under the age of 18 or expect to graduate from high school before age 19. Adult caretakers do not have to be related to the children to apply on their behalf.  The income standard, after allowable deductions, is based on a percentage of the financial assistance grant level, as determined by the Utah State Legislature. The Federal Poverty Level is available on the Internet at http://aspe.hhs.gov/poverty

Income Eligibility Standards in Monthly Amounts (as of April 2005)            

Household Size  *Monthly Income         Household Size     *Monthly Income

1     . . . . . . . . . . .    $ 382                             6     . . . . . . . . $   857
2     . . . . . . . . . . . .  $ 468                             7     . . . . . . . . $   897
3    . . . . . . . . . . . .   $ 583                             8     . . . . . . . . $   938
4     . . . . . . . . . . . .  $ 682                             9     . . . . . . . . $   982 
5     . . . . . . . . . . . .  $ 777                           10     . . . . . . . . $ 1,023 

*Deductions

Deduct $90.00 from the countable earned income of each working family member, child care expenses.  Under limited circumstances, a deduction of $30.00 plus 1/3 of working income may be allowed when the client has received this same deduction under a type of Family cash assistance in one of the last four months.  Income too high? See NOTE at bottom of page.

*SpendDown

Medicaid applicants whose income exceeds the monthly income standard may be considered for the Medically Needy program, sometimes referred to as the Spenddown Program.  This program allows a person who is otherwise eligible either to pay "excess" monthly income to the state or to accept responsibility for a portion of their monthly medical bills.

Asset Limits

1 person   - $2,000.00
2 Persons - $3,000.00
For each additional person, add $25.00.  Too many assets?  See NOTE at bottom of page.

Retroactive Coverage

Most Medicaid programs allow an applicant to request coverage for medical services for up to three months prior to the month in which the person filed a Medicaid application.  A person who received medical, dental or mental health services and subsequently qualifies for Medicaid may return to each provider with a Medicaid Identification Card for the month in which service was provided. A provider who has already rendered services may subsequently choose to accept Medicaid as payment in full or refuse to seek Medicaid payment because the patient had not been determined eligible for Medicaid at the time of service.  If the provider accepts Medicaid, Medicaid may pay for the service.  If the provider refuses Medicaid, the patient is responsible for the charges.

NOTE: The CHIP (Child Health Insurance Program) is a program for children who don't have medical insurance.  It has a higher income limit than Medicaid.  It also has no asset limit.  Call toll-free 1-888-222-2542.

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