Does Your Child Qualify for Delaware Medicaid?
Having medical coverage is imperative for maintaining your child’s health. But what if your employer doesn’t offer medical insurance, or that coverage just isn’t enough for your child with special health care needs?
How do you know if your family, or your child with special health care needs, qualifies for medical assistance, and if so, which program?
Learn more about which Delaware medical assistance program might best fit your child’s specialized medical needs. Your child may qualify for additional benefits even if you have private insurance. In addition to financially based Medicaid, there are other options and programs available that can supplement your child’s primary insurance coverage.
The Delaware Medicaid Options
Medicaid provides medical assistance to eligible people whose income is not enough to pay the costs of adequate medical services. There are two types of Delaware Medicaid that your child with special health care needs may qualify for.
Financial Need Based Medicaid
Qualification is determined by household income. If the household income qualifies, the entire family is eligible for Medicaid. Click HERE for income limits to apply for Medicaid.
Children’s Community Alternative Disability Program (CCADP)
Eligibility is determined by a child’s special health care needs or disability. Family income is not considered, however the child’s resources are reviewed.
To qualify for CCADP assistance, the child must first meet all three of the following medical criteria.
1. The child has at least one of three disability listings as set by SSI:
His/her physical and mental limitations, including developmental, prevent the child from performing a full range of age-appropriate daily living activities and to behaving in age-appropriate manner.
His/her impairment is comparable in severity to that which would make an adult unable to engage in substantial gainful activity such as employment.
His/her disability is expected to result in the child’s death.
2. The child must require a nursing facility level of care (intermediate or skilled care) or acute hospitalization.
3. The cost of care at home must be less than the cost of the appropriate institutional care.
Additionally, the child must be under 18 years of age, live in Delaware, and may not have more than $2,000 in their name. Only the child receives benefits under this program, not the entire family.
Check with the CCADP website or contact your nearest Delaware Division of Medicaid and Medical Assistance Long Term Care Service Unit to determine eligibility through this program or to request an application.
Helpful Links for Determining Medicaid Eligibility
These links can help you determine whether or not your family, or your child with special health care needs, might qualify for medical assistance through the Delaware Medicaid program.
- Delaware Assist Program – An online application for people in Delaware to apply for many health and social service programs. Note: You may need to download Internet Explorer or Firefox to use the online application form.
- Delaware Assist – Online quick reference guide to the Assist program.
- Income Based Medicaid Application – A printable application for Medicaid and the Delaware Healthy Children’s Program.
- Income Limits to Apply for Div. Medicaid & Medical Assistance Programs – Determine financially based qualification.
NOTE: If your family or child qualifies for Medicaid, then Medicaid may pay for many medical expenses, including durable medical equipment, mental health and substance abuse services, and more. Such expense must be medically necessary and prescribed by your child’s doctor.
NOTE: If you have other insurance, Medicaid is always the payer of last resort, paying out only after the other insurance has paid. This can mean very, little if any, out of pocket expenses. Copays are one example of expenses Medicaid may cover when you have more than one insurance.
Other Low-Cost Health Care Options
What if your child does not qualify for Delaware Medicaid, but you are in need of medical insurance for his/her medical expenses? If your child does not qualify for Medicaid, he/she may also qualify for one of these low-cost health insurance programs.
Delaware Children’s Health Insurance Program
Delaware Healthy Children’s Program (CHIP) is a health insurance program for uninsured children. It features the same high-quality coverage provided by Medicaid as well as many private insurance plans. CHIP is available for children under 19 who do not qualify for Medicaid.
Families that qualify for CHIP have access to an extensive list of services without co-pays. Click HERE for medical assistance program income limits and monthly premium rates.
The Health Insurance Marketplace
The Health Insurance Marketplace offers lower cost health insurance options. Choose Health Delaware is the state’s program created to help you better understand Delaware’s Health Insurance Marketplace, and lets you see what Delaware’s partner health insurance companies offer.
Need Help? Call Us!
Navigating through the Delaware medical assistance options can be confusing. Don’t let that stop you from receiving benefits that your child with special health care needs may qualify for.
Delaware Family Voices can help you navigate through the health care system red tape, helping you find the resources and services you need for your child. We can answer your questions about services for your child with special health care needs and disabilities. We are just a phone call away.
Join us for the monthly Medicaid / Managed Care & Mental Health phone call-ins, where you can voice your questions and concerns on Medicaid Managed Care and Mental Health Care benefits.
Note: Applications for Medicaid or the Children’s Health Insurance Program (CHIP) can be submitted at any time during the year.