This is a particular problem in States that have different applications, verification procedures, or eligibility review processes for their Age-based eligibility standards add to the occasions when children need to be transferred from one program to another. Age-based eligibility standards are particularly difficult for families in States where the programs rely on different managed care plans and providers. In these States, children in the same family might have to receive care from different providers.
Continuity of care is compromised, and providers experience unnecessary disruptions in enrollment.
Age-based eligibility standards also may make it harder for families, providers, and the public at large to understand program rules and to predict which program a child may qualify for. Age-based eligibility can make outreach less successful. These are unnecessary complications. The New York Medicaid program now covers children ages 1-5 with incomes up to 133 percent of the Federal poverty line. Children 6 and over are covered under Medicaid if their income is below 100 percent of the Federal poverty line.