To be eligible for DHCP, children: must not have comprehensive health insurance; must be under the age of 19; must reside in the State of Delaware; must be U.S. citizens or qualified non-citizens; must not be dependents of a State of Delaware employee; and must have a family income at or below 200 percent of the federal poverty level. 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.
The monthly premium for DHCP is $10, $15 or $25 and is based on income. The chart below shows the income levels and premiums based on family size:
Delaware Healthy Children Program
Monthly Premium Based on Countable Family Income
% of Federal Poverty Level
|
Family size (including parents and siblings) |
If monthly income is 100% to 133% of poverty,
DHCP premium is $10/month |
If monthly income is 133% to 166% of poverty,
DHCP premium is $15/ month |
If monthly income is 166% to 200% of poverty,
DHCP premium is $25/month |
2 |
$1,142 - 1,518 |
$1,519 - 1,894 |
$1,895 - 2,282 |
3 |
$1,432 - 1,904 |
$1,905 - 2,376 |
$2,377 - 2,862 |
4 |
$1,722 - 2,289 |
$2,290 - 2,857 |
$2,858 - 3,442 |
5 |
$2,012 - 2,675 |
$2,676 - 3,338 |
$3,339 - 4,022 |
6 |
$2,302 - 3,061 |
$3,062 - 3,820 |
$3,821 - 4,602 |
7 |
$2,592 - 3,446 |
$3,447 - 4,301 |
$4,302 - 5,182 |
8 |
$2,882 - 3,832 |
$3,833 - 4,783 |
$4,784 - 5,762 |
9 |
$3,172 - 4,218 |
$4,219 - 5,264 |
$5,265 - 6,342 |
10 |
$3,462 - 4,603 |
$4,604 - 5,745 |
$5,746 - 6,922 |
Coverage includes: doctor visits, including check-ups; prescription drugs; eye exams and glasses; dental care; routine shots; tests and x-rays; speech and hearing therapy; hospital stays; specialists; mental health counseling; and drug and alcohol abuse treatment.
For every three months a family pays in advance, they will get the fourth month free. There are no co-payments, except for visiting a hospital emergency room for a non-emergency.
The Delaware Healthy Children Program does not exclude children because of pre-existing health conditions.
To apply, a family must provide: proof of income (a full month’s pay stubs or latest tax-return if self-employed); proof of citizenship or lawful alien status; and proof of identity along with your complete application.
Families approved for DHCP coverage have a choice of three managed care plans: Delaware Physicians Care, Inc., Unison Health Plan, and Diamond State Partners. The programs are administered by the Delaware Division of Medicaid & Medical Assistance.
After income, citizenship or lawful alien status and identity are verified, the family may be approved for the program. Once approved for the program, the family must choose a managed care plan and pay the first month’s premium for coverage to begin. The family will receive a notice stating when coverage starts.
More information, as well as an online application for the DHCP, can be found on the Department of Health and Scoial Services website at www.dhss.delaware.gov/dhss/dmma/dhcp.html . To ask questions about whether you qualify or to apply over the phone, call 1-800-996-9969.
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