Md. Code Regs. 10.09.62.04

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.62.04 - Application

A. The Department or its designee shall determine eligibility for a targeted low-income child and a birthing parent.

B. The Department or its designee shall give oral, written, or electronic information about the separate CHIP Program and CHIP Health Services Initiative such as:

(1) Requirements for eligibility;

(2) Available services;

(3) An individual's rights and responsibilities;

(4) Information in plain English, supported by translation services; and

(5) Information accessible to disabled individuals requesting an application.

C. An individual requesting health coverage from an insurance affordability program shall be given an opportunity to apply.

D. The Department or its designee shall make the application available to the individual without delay by telephone, by mail, in person, or by internet or other available electronic means, and in a manner accessible to disabled individuals requesting an application.

E. A resident temporarily absent from the State but intending to return may apply for health coverage from an insurance affordability program by telephone, by mail, in person, or by internet or other available electronic means to the Department or its designee in any jurisdiction. The individual shall:

(1) Demonstrate continued residency in the State; and

(2) Meet all nonfinancial and financial requirements to be determined eligible.

F. Application Filing and Signature Requirements.

(1) An individual who wishes to apply for health coverage under an insurance affordability program shall submit a written, telephonic, or electronic application signed under penalty of perjury to the Department or its designee in any jurisdiction. An applicant is responsible for completing the application but may be assisted in the completion by an individual of the applicant's choice.

(2) For the purpose of establishing eligibility of a child applicant who is neither pregnant nor postpartum, a parent or stepparent living with the child shall complete and sign the written, telephonic, or electronic application. If the child does not live with a parent, an authorized representative who is 21 years old or older shall complete and sign the application.

G. The date of application shall be the date on which a written, telephonic, or electronic signed application is received by the Department or its designee. The application may be mailed or submitted electronically to the Department or its designee.

H. An individual who has filed a written, telephonic, or electronic application may voluntarily withdraw that application, but the application remains the property of the Department or its designee and the withdrawal does not affect the periods under consideration specified under §I of this regulation.

I. Period Under Consideration.

(1) The Department or its designee shall establish a current period under consideration based on the date of application established under §G of this regulation.

(2) For a targeted low-income child, the period under consideration is from conception to birth, and for retroactive eligibility, the 1, 2, or 3 months immediately preceding the month of application for the separate CHIP Program if those months are prior to the birth.

(3) For the birthing parent, the period under consideration is the postpartum period and contingent on the application of the targeted low-income child on or before the last day of the fourth month after the pregnancy ends.

J. Processing applications time limitations shall operate in accordance with the requirements of COMAR 10.09.24.04.

K. Required Information. All information needed to determine eligibility for the separate CHIP Program and CHIP Health Services Initiative shall be reported. When there is evidence of inconsistency between information attested by the applicant and data reported by the State and federal databases, the applicant shall be required to offer an explanation and appropriate verification to reconcile the inconsistency.

Md. Code Regs. 10.09.62.04

Regulations .04 adopted effective 50:22 Md. R. 974, eff. 11/13/2023