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When payments for children in the household are received in full, the children remain eligible for KidsCare. When one month total payment is received, the children remain eligible.
When less than one month total premium payment is received, the Division of Business and Finance (DBF) applies the amount of debt to the children.
The children remain eligible when the remaining balance due is not more than one month behind.
When payments for children in the household fall more than one month behind, the children’s eligibility will end.
A discontinuance letter is sent with the past due premium amount and an explanation that when the entire outstanding balance is paid before the effective date, coverage will continue.
At the end of the month, when the balance is paid or waived, eligibility is continued.
There is a two month lock-out period for unpaid past due premiums. Children are permitted to re-enroll in KidsCare as soon as their premiums are paid or at the end of the lock-out period, whichever comes first.
Term |
Definition |
KidsCare |
KidsCare is for uninsured children under age 19 who are not eligible for Medicaid. |
KidsCare Premium |
A premium is calculated for all customers who qualify for KidsCare. |
Discontinuance Letter |
A written letter sent to customers. This letter tells the customer that their coverage is ending. |
Lock-Out Period |
Under federal law, children who have their KidsCare eligibility discontinued for unpaid premiums are permitted to re-enroll in KidsCare as soon as their premiums are paid or at the end of the State-specified period of time not to exceed 90 days. Arizona has established a two month lock out period. |
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 |