| Group |
Income Eligibility |
| Children |
200% FPL |
| Pregnant Women |
200% FPL |
| Adults |
100% FPL |
| SSI Disabled (non-elderly) |
74% FPL |
Medicaid, SCHIP, and Federal Authority2
Section 1115 Waiver - In 1995, Delaware received approval from CMS to implement the Diamond State Health Plan waiver that allowed the state to implement a mandatory Medicaid managed care program statewide and expand eligibility to low-income Delawareans with incomes up to 100 percent FPL.
Dependent Coverage
Signed by the Governor in 2006, the state passed legislation (HB 446) that requires commercial health insurance to continue coverage for unmarried adult children with no dependents under a pre-existing family policy until those children turn 24 years of age, provided that the children either live in Delaware or are full-time students. There is an additional premium charge for the continued coverage if the parents opt to cover their dependents.
Other
The Delaware Community Healthcare Access Program (CHAP) - CHAP facilitates public coverage for low-income uninsured individuals. CHAP screens individuals for Medicaid eligibility and, for those ineligible but with family income below 200 percent FPL, CHAP provides a volunteer or discounted primary care medical home, a statewide network of volunteer or discounted specialty services, discounted fee schedule lab and xray at 5 participating hospital campuses and one statewide private sector radiology service, prescription assistance, and misc. other discounted allied health services. CHAP began in 2001 and as of November 2006, 11,000 people have been served by the program.
Delaware Cancer Treatment Program - In May 2004, Delaware created and funded a $4 million (FY '05) annual program to pay for treatment for the uninsured diagnosed with cancer. The state-funded program, administered by the Delaware Division of Social Services, provides treatment for uninsured individuals up to 650 percent FPL who meet certain eligibility criteria.
Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile. |
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| 1 This overview provides a general description of state coverage levels under their Medicaid and SCHIP programs as found on state Web sites as of October 2005. This does not reflect the specific eligibility categories or requirements. In most cases the income eligibility for "parents" reflects the TANF eligibility levels for a family of two. This is not intended to be a substitute for eligibility information provided by each state. Individuals interested in applying for these programs should contact the state directly for specific eligibility requirements. In cases where eligibility information was not available on state Web sites, data were pulled from other state reports or through contacts with state officials. |
2 The profile only includes Medicaid and SCHIP waivers intended to make comprehensive expansions to the uninsured. At this time, the profiles do not include Family Planning, Pharmacy Plus waivers, or long-term care waivers. |
3 Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2005 and 2006 Current Population Survey. |
| 4 Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends. 2004 Medical Expenditure Panel Survey-Insurance Component. |
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