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DE Medicaid - Diamond State Health Plan

The Diamond State Health Plan, Delaware's Medicaid Managed Care Program, extends Medicaid coverage to uninsured adults who are age 19 or over, and who have gross income that is at or below 100% of the Federal Poverty Level (FPL).

This group is called the Adult Expansion Covered Group. It is also referred to as Low Income Adults in the Expanded Population, and sometimes as Low Income Uninsured Adults.

Excluded are individuals:

·      Who receive long term care services (nursing facility, acute care and home and community based waivers);

·      Who have comprehensive health insurance;

·      Who are entitled to or eligible to enroll in Medicare; or

·      Who have coverage through Military Health Insurance for Active Duty, Retired Military, and their dependents.

Adults are not eligible for Medicaid benefits until they are enrolled in a Managed Care Organization (MCO). Enrollment in a MCO is an eligibility requirement. Adults will not receive Medicaid services until they are enrolled in a MCO.

See also:

DE Medicaid Overview

DE Medicaid - Eligibility

DE Medicaid - Covered Groups

Source:

DSS Policy Manual (Sect. 16110)

Administrative Notice DMMA-02-2006, January 27, 2006

Back to:

General Assistance Overview

DE Division of Social Services - Overview

DE Benefit Information System Overview

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