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SD CHIP - Financial Eligibility

The Children's Health Insurance Program (CHIP) provides health insurance coverage to uninsured children whose family income meets financial eligibility standards. Children who already have private health insurance may also be eligible for CHIP to pay deductibles, co-payments, and other medical services not covered by their private policy.

Total monthly income, minus all allowable adjustments, establishes the "eligibility income" for CHIP. Monthly income includes the gross income, including income from self-employment, plus all other income, of parents and children under age 19 living in the home. Earnings of children are not considered as income. School grants or loans are not considered as income, but must be listed on the application.

NOTE: An "Eligibility Worksheet" is available as a guide to estimate your eligibility. The worksheet is available at http://www.state.sd.us/social/MedElig/Forms/ea203m.pdf. You will need Acrobat Reader to access the form.

Income Adjustments

Certain adjustments to income are allowed. Subtract from gross income the sum of the following:

·          Gross earnings adjustment: 20% of gross earnings or $90 for each adult who works (whichever is greater),

·          plus child care paid due to job,

·          plus child support received up to $50,

·          plus child support paid (to another household, county, or child support agency)

If eligibility income is less than the PROGRAM INCOME LIMIT in CHART #1, you may be eligible for CHIP (send in your application).

If eligibility income is more than the PROGRAM INCOME LIMIT CHART #1, and the child does not have private health insurance, refigure the eligibility income by using $0 for the gross earnings adjustment and, if the child care paid due to a job is more than $500, reduce the amount to $500. If, by using these new figures, eligibility income is less than the PROGRAM INCOME LIMIT in Chart #2, you may be eligible for CHIP (send in your application).

PROGRAM INCOME LIMIT CHART #1

(As of January, 2006 - changes yearly)

PROGRAM INCOME LIMIT CHART #2

(As of January, 2006 - changes yearly)

Family Size includes the parents and children (under age 19) living in the home.

If a child's income puts the family over the income limit, the family's other children may still be eligible. A baby living with his or her teen parents may be eligible for CHIP without looking at the grandparents' income (that is, the grandparents' income is not counted).

See Also:

CHIP - Application Procedures

Source:

http://www.state.sd.us/social/Medical/CHIP/Index.htm

Back to:

Children's Health Insurance Program (CHIP)

Office of Medical Eligibility - Overview

South Dakota Department of Social Services (DSS)

Welcome and Introduction to the South Dakota Benefits Information System

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