220 Healthy Kids-Silver Medical Insurance SR 03-07, 04/03 (FAM-A)

Healthy Kids-Silver (HKS) provides medical and dental insurance coverage, in cooperation with New Hampshire Healthy Kids Corporation (NHHKC), for children age 1 to 19. HKS benefits are delivered through a mandatory managed care that emphasizes preventative and primary care services.

HKS consists of two groups:

§   A subsidized premium plan for families with income less than or equal to 300% of federal poverty income guidelines, with eligibility determined by the Department; and

§   An unsubsidized premium plan for families with income in excess of 300% of federal poverty income guidelines, with potentially eligible families referred to NHHKC for follow-up.

Policy in this Manual applies only to the subsidized HKS plan.

In addition to age and income limits, HKS has the following eligibility criteria:

§   Payment of a monthly premium, unless the child is a Native American Indian or Alaskan Native;

§   The prohibition on currently having medical insurance, or having had medical insurance within the past 6 months, unless good cause exists for the termination of such medical insurance;

§   No presumptive eligibility; and

§   No retroactive medical coverage.