Continuous Eligibility for Medicaid and CHIP Coverage

States have the option to provide children with 12 months of continuous coverage through Medicaid and CHIP, even if the family experiences a change in income during the year. Continuous eligibility is a valuable tool that helps States ensure that children stay enrolled in the health coverage for which they are eligible and have consistent access to needed health care services.

Why Implement Continuous Eligibility?

Children who have health insurance continuously throughout the year are more likely to be in better health. Guaranteeing ongoing coverage ensures that children can receive appropriate preventive and primary care as well as treatment for any health issues that arise. Stable coverage also enables doctors to develop relationships with children and their parents and to track their health and development. Additionally, eliminating the cycling on and off of coverage during the year reduces State time and money wasted on unnecessary paperwork and preventable care needs.

States Providing Continuous Eligibility

The following States provide 12-month continuous eligibility for Medicaid and/or CHIP; the exceptions are specified.

yes

= yes

State	CHIP	Medicaid	Exceptions
Alabama	Yes	Yes
Alaska	Yes	No
Arizona	Yes	No	12 months continuous coverage is guaranteed only for the first year of coverage.
California	Yes	Yes
Colorado	Yes	No
Delaware	Yes	No
Florida	Yes	No
Idaho	Yes	Yes
Illinois	Yes	Yes
Iowa	Yes	Yes
Kansas	Yes	Yes
Louisiana	Yes	Yes
Maine	Yes	Yes
Michigan	Yes	Yes
Mississippi	Yes	Yes
Montana	Yes	Yes
Nevada	Yes	No
New Jersey	Yes	Yes
New Mexico	Yes	Yes
New York	Yes	Yes
North Carolina	Yes	Yes
North Dakota	Yes	Yes
Ohio	Yes	Yes
Oregon	Yes	Yes
Pennsylvania	Yes	No	Exceptions to continuous coverage include, but are not limited to a child moving out of the house, non-payment of premiums, conditional enrollment pending verification of citizenship, and misinformation provided at the application or renewal that would have resulted in ineligibility.
South Carolina	Yes	Yes
Tennessee	Yes	No	State conducts audits of random applications to verify the information. If the audit shows the child/children are not eligible, eligibility will be terminated, even if it is within the 12-month period.
Texas	Yes	No	Eligible children whose families have incomes at or below 185% FPL receive 12-month continuous eligibility. Eligible children whose families have incomes above 185% FPL are required to verify income eligibility at month six.
Utah	Yes	No
Virginia	Yes	Yes	Exceptions to continuous coverage include an increase in gross monthly income to above 200% FPL.
Washington	Yes	Yes
West Virginia	Yes	Yes
Wyoming	Yes	Yes

Additional Resources

CCF 12-month Continuous Eligibility Program Design Snapshot (PDF 848.36 KB)