Delaware Healthy Children Program (DHCP) Application Information
The Delaware Healthy Children Program or DHCP provides low-cost insurance to eligible children. It aims to help uninsured children get medical benefits like the ones provided by most private insurance companies.
The DHCP is meant for children under age 19 who are in families with an income of no more than 200% of the Federal Poverty Level (FPL). The program gives medical assistance to those who are qualified such as doctors' services, hospital services, laboratory, prescription drugs, substance abuse services, mental health, dental services, and x-ray.
The Delaware Healthy Children Program deals with everything from doctor services to regular medical examinations to hospital services and eye checkups. Children who are covered by the DHCP receive various services for a low premium every month without any co-payments (except non-emergency visits to emergency rooms). Some of these medical services include:
- Hospital care
- Eye examinations
- Well-baby and well-child examinations
- Alcohol and drug abuse treatment
- Physical therapy
- Hearing and speech therapy
- Prescription drugs
- Ambulance services
- Physician services
- Mental health counseling
- Assistive technology
- Hospice care
- Case management and coordination
- Limited home health and nursing care
To be able to receive coverage under the Delaware Healthy Children Program, you must pay a monthly premium. Premiums are paid per household per month, no matter how many children are qualified in the family. The amount to be paid depends on your family's income:
- If the income of your family is less than 100% of the FPL up to 133%, the monthly premium is $10.
- If your family's income is between 133% and 166% of the FPL, the premium is $15.
- If your countable family income is between 166% and 200% of the FPL, the premium is $25 per month.
All qualified children in the DHCP have a minimum of 12 months of continuous health insurance coverage if payments are made every month (payment is due every 20th of the month for the coverage of the following month). Before the eligibility coverage ends, you will be given an application in the mail; you have to submit the accomplished application along with a copy of your income verification for one month - redetermination of eligibility by the end of the 12-month period is a must.
If you want to pay the premium in advance, you can do so and there's an additional bonus, depending on how many advance payments you make:
- Pay three months advance and you will receive one premium free month.
- Pay six months in advance and you will receive two premium free months.
- Pay nine months in advance and you will receive three premium free months.
These advance premium payments may possibly go on past the schedule of the eligibility redetermination. If ever the child becomes ineligible for the program, the family will receive a refund of the advance payments.
If you are unable to pay the premium for two months, the coverage will be cancelled. You will receive a cancellation notice that will advise you to report any changes in your situation (for example, your income has reduced) that may affect your eligibility. If this happens, you may re-enroll anytime and there is no penalty; a new 12-month period will start.
There will be no disruption in the continuous period of eligibility if the income of your family has increased. On the other hand, if there is a decrease in the countable income or the size of your family has increased, there will be a redetermination of eligibility. This may result in your family becoming eligible to receive benefits from Medicaid or the child remaining qualified for the Delaware Healthy Children Program but with a lower monthly premium. If a lower premium is assigned to your household due to the decrease of income, the period of continuous eligibility will again start.
The following are the eligibility requirements of the Delaware Healthy Children Program:
- Must be below 19 years old
- Must be a citizen of the United States or a qualified non-citizen
- Must be a resident of the State of Delaware
- Is not covered by any comprehensive health insurance
- Is not a dependent of a permanent state employee in Delaware
- Must meet income requirements
If your child is already covered by a comprehensive health insurance plan, he/she is not eligible for the program. If you voluntarily stop the coverage, your child is still not qualified in the DHCP for six months, unless there is a good cause for the loss of insurance coverage.
An eligible child for the Delaware Healthy Children Program will continue to receive benefits for a 12-month period of continuous eligibility; however, there are instances in which he/she may become ineligible for certain reasons. A child no longer qualifies to receive benefits from the DHCP if he/she:
- Becomes 19 years old
- Becomes qualified for Medicaid
- Obtains a comprehensive insurance coverage
- Happens to become qualified for the State health benefits plan
- No longer resides in Delaware
- Becomes an inmate
- Does not meet the legal alien status or citizenship anymore
Healthy Children Program Application Instructions
To apply for the Delaware Healthy Children Program, you may call DHCP at 1-800-996-9969 to request an application form or if you need any assistance in your application. You may also get the form by downloading it here. After filling it out, you may send it to the address below, along with the proof of your household income, proof of citizenship or legal alien status, and proof of pregnancy (if applicable):
Delaware Healthy Children Program
PO Box 950
New Castle, DE 19720-9914
Once you have been approved for DHCP, you need to pick a Managed Care Plan (MCP) and then pay the premium for the first month. You will be informed of the date when the insurance coverage starts.
Under the program, you may choose among the Managed Care Plans that have an agreement with Delaware. There are currently three MCPs: the Diamond State Partners, the Unison Health Plan, and the Delaware Physicians Care, Inc.