In addition to eligibility requirements applicable to MAGI CHIP in other rules in chapter 410 division 200, this rule describes specific eligibility requirements for the MAGI CHIP program.

1. (1) Individuals may not be eligible for MAGI CHIP with an effective date prior to October 1, 2013.

2. (2) To be eligible for MAGI CHIP, an individual must:

   1. (a) Be under 19 years of age; and
   2. (b) Meet the budgeting requirements of OAR 410-200-0315.

3. (3) To be eligible for MAGI CHIP, an individual may not:

   1. (a) Be eligible for MAGI Child, MAGI Pregnant Woman, MAGI Parent or Caretaker Relative, or Substitute Care programs;
   2. (b) Be receiving or deemed to be receiving SSI benefits; and

   3. (c) Be covered by minimum essential coverage. For the purposes of this rule, a child is not considered to have minimum essential coverage if it is not accessible for one or more of the following reasons:

      1. (A) The travel time or distance to available providers within the minimum essential coverage network exceeds:

         1. (i) In urban areas: 30 miles, 30 minutes, or the community standard, whichever is greater; or
         2. (ii) In rural areas: 60 miles, 60 minutes, or the community standard, whichever is greater;
      2. (B) Accessing the minimum essential coverage would place a member of the household at risk of harm.
4. (4) For the Authority to enroll a child in MAGI CHIP based on a determination made by an Express Lane Agency (ELA), the child’s parent or guardian shall give consent in writing, by telephone, orally, or through electronic signature.

Statutory/Other Authority

ORS 411.402, 411.404 & 413.042

Statutes/Other Implemented

ORS 411.400, 411.402, 411.404, 411.406, 413.032, 413.038, 414.025, 414.231 & 414.706

History

DMAP 23-2020, amend filed 05/07/2020, effective 05/08/2020
DMAP 3-2015, f. & cert. ef. 1-30-15
DMAP 67-2014(Temp), f. 11-14-14, cert. ef. 11-15-14 thru 5-13-15
DMAP 20-2014, f. & cert. ef. 3-28-14
DMAP 4-2014(Temp), f. & cert. ef. 1-15-14 thru 3-30-14
DMAP 54-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14