When CE is established, it protects an applicant with a CE eligible Aid Code from receiving lesser coverage or termination of coverage during the CE period. There are situations when CE correctly “breaks” and coverage is Discontinued mid-CE. Below are the situations when CE “breaks” and CE eligible Aid Codes.
|
Mid-CE Discontinuance Reason |
Notes |
|
Past Due Premiums |
CHIP premium penalty applies to unpenalized past due premiums. This does not apply to consumers who are Pregnant or in their Postpartum period. They will continue to receive coverage until their Postpartum coverage ends. |
|
Incarceration |
Does not apply to Incarcerated Youth in an active CE period. |
|
Eligible for non-CE Program |
Examples: SSI, HCBS, LTC (does not apply to children 18 and under) |
|
No Longer Categorically Eligible |
|
|
Loss of Contact |
Ends coverage for non-pregnant adults only |
|
State Residence |
No longer a KS resident |
|
Permanently out of the Home |
|
|
Temporarily out of the Home due to Foster Care |
Ends coverage for Foster Care CH only |
|
No Eligible Child (CTM) |
Only CH is Perm out of Home or turned 19 |
|
No Eligible Child (PW) |
No CH in the home and postpartum period ended |
|
Deceased |
|
|
Negative Action |
|
|
Voluntary Withdrawal |
Applicant requested coverage end |
|
Refused Premium |
Applicant requested coverage end due to premium |
|
Program Name |
Program Aid Code in KEES |
|
Caretaker Medical |
CTM |
|
Poverty Level 19 (Title 19) |
PLN |
|
Poverty Level 21 (CHIP) |
PLT |
|
Transitional Medical |
TMD |
|
Extended Medical |
EXT |
|
Long Term Care* |
LTC |
|
Supplemental Security Income |
SSI |
|
Adoption Support Medical |
ASM |
|
Foster Care Medical |
FCM |
|
SOBRA |
SOBRA |
|
Working Healthy |
WKH |
|
Protected Medical Groups |
PMG |
*Includes HCBS programs and PRTF stays.
Note: Continuous Eligibility for LTC, SSI, ASM, FCM, WKH, PMGs, and SOBRA Medical Programs are only applicable to children up to their 19th birthday month. If an Incarcerated Youth remains within a CE period upon release, they may be reinstated on their original CE period.