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Children enrolled in KidsCare are charged a monthly premium based on the Income Group’s total income and the number of children enrolled in KidsCare.
NOTE American Indians and Alaska Natives, as well as the children and grandchildren of tribal members, are not charged a premium when they prove their tribal enrollment (or that of their parent/grandparent).
American Indians and Alaska Natives who qualify for KidsCare must provide proof of tribal enrollment to be exempt from monthly premium charges. Proof of enrollment or tribal membership includes:
Certificate of Degree of Indian Blood;
Tribal ID;
Tribal Census Record; and
Other document provided by the tribe stating that the person is an enrolled member of the tribe.
Children and grandchildren of tribal members must submit documentation that proves they are descendants of a tribal member. Proof includes:
An official letter on tribal letterhead from the tribe stating that the applicant is a child or grandchild of a tribal member; or
A document verifying the tribal member’s enrollment in the tribe, and a document verifying that the applicant is a child or grandchild of the tribal member.
When a person claiming to be an American Indian, Alaska Native, or the child/grandchild of a tribal member does not provide proof of tribal enrollment, the premium exemption does not apply, and a premium may be charged.
NOTE Eligibility is not denied because there is no proof of tribal enrollment.
When a person is approved with a premium and later provides proof of tribal enrollment, the person is exempt from paying the premium beginning the month after the proof is provided.
Proof of Tribal Enrollment should be uploaded to HEAplus when it is found in Onbase. If case notes show that proof is in an electronic format or another agency’s database and you are unsure how to access the proof, check with your supervisor before asking the customer for proof.
Listed below are the monthly premium amounts for children:
|
Household Size |
Income Less |
Income Greater |
Income Greater |
|
1 |
$0.00 - $1,957.00 |
$1,957.01- $2,283.00 |
$2,283.01- $2,935.00 |
|
2 |
$0.00 - $2,644.00 |
$2,644.01- $3,085.00 |
$3,085.01- $3,966.00 |
|
3 |
$0.00 - $3,332.00 |
$3,332.01- $3,887.00 |
$3,887.01- $4,997.00 |
|
4 |
$0.00 - $4,019.00 |
$4,019.01- $4,689.00 |
$4,689.01- $6,029.00 |
|
5 |
$0.00 - $4,707.00 |
$4,707.01- $5,491.00 |
$5,491.01- $7,060.00 |
|
6 |
$0.00 - $5,394.00 |
$5,394.01- $6,293.00 |
$6,293.01- $8,091.00 |
|
7 |
$0.00 - $6,082.00 |
$6,082.01- $7,095.00 |
$7,095.01- $9,122.00 |
|
8 |
$0.00 - $6,769.00 |
$6,769.01- $7,897.00 |
$7,897.01- $10,154.00 |
|
9 |
$0.00 - $7,457.00 |
$7,457.01- $8,699.00 |
$8,699.01- $11,185.00 |
|
10 |
$0.00 - $8,144.00 |
$8,144.01- $9,502.00 |
$9,602.01- $12,216.00 |
|
Each Additional Customer* |
Add $688.00 |
Add $803.00 |
Add $1,032.00 |
|
Premium Amount for Children |
One Child $10.00/More Than One Child $15.00 |
One Child $40.00/ More Than One Child $60.00 |
One Child $50.00/ More Than One Child $70.00 |
*“Each additional” is an approximate amount only.
A case may consist of multiple income groups. The monthly premium amount for a child is based on the income group with the highest income level and the number of eligible children in income groups. This means that instead of having a separate premium for each income group, the case will only be charged one premium that covers everyone in that case.
See Example - Premium for Cases with Multiple Income Groups
|
Term |
Definition |
|
KidsCare |
KidsCare is for uninsured children under age 19 who are not eligible for Medicaid. |
|
Program |
Legal Authorities |
|
KidsCare |
42 USC 1397bb(b) 42 CFR 457.Subpart E ARS 36-2903.01(D)(4)\ and 36-2982 AAC R9-31-303 |