PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.

Parkland CHIP Perinate and Parkland CHIP Perinate Newborn Members
“CHIP Perinate” is a pregnant female CHIP Perinatal beneficiary who is identified before giving birth and is
enrolled to receive covered services from Parkland Community Health Plan pursuant to the terms of the CHIP
Perinatal Contract.
“CHIP Perinate Newborn” means a CHIP Perinate who has been born alive.
Parkland CHIP Perinate and Parkland CHIP Perinate Newborn members will need to meet the same income
guideline requirements as indicated in the sections above, however, the 90 day waiting period and cost-sharing
requirements will not apply to these members. Once the Parkland CHIP Perinate member is enrolled,
eligibility remains continuous for 12 months. Eligibility for the Parkland CHIP Perinate member will end at the
end of the month of the CHIP Perinate Newborn’s birth. Any time remaining in the first 12 months of
continuous eligibility will be transferred to the CHIP Perinate Newborn. Eligibility will be continuous for the
CHIP Perinate Newborn member for the remainder of the 12 months.
CHIP Perinate members will be linked to any current CHIP member case. Both the CHIP Perinate member and
CHIP members are required to be enrolled in the CHIP Perinate Health Plan through the CHIP Perinatal
enrollment period.
A CHIP Perinate (unborn child) who lives in a family with an income at or below 185% of the FPL will be
deemed eligible for Medicaid and will receive 12 months of continuous coverage (beginning on the date of
birth).
A CHIP Perinate will continue to receive coverage through CHIP as a “CHIP Perinate Newborn” if born to a
family with an income above 185% to 200% FPL.”
CHIP Member Enrollment and Disenrollment
Enrollment Application
Parents and guardians can apply telephonically for CHIP coverage by contacting CHIP at 1-800-647-6558.
Applicants can ask for a blank form or CHIP will print completed applications based on phone information and
mail to the requesting party for signature and return. Applicants can download and complete application forms
from the internet at www.chipmedicaid.com. Once enrolled, the CHIP eligibility remains continuous for 12
months. Eligibility determination is the responsibility of the HHSC Administrative Services Contractor.
Enrollment Process
Eligibility determination notices are sent to families determined eligible based on completed applications. The
enrollment packet mailed to families contains:
• Explanation of CHIP benefits
• Comparison table showing value-added services by health plan
• A place to indicate a child with special health care needs
• A place to indicate whether a medical support order is applicable
• How to pick a health plan, primary care provider , and the choice to pick a specialist as Primary Care
Provider
• Provider directories
• Cost-sharing information specific to the income level of the family and payment coupon book for families
with net income over 150% Federal Poverty Level
• Simple form to track cost-sharing expenses relative to caps
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