604 Suspension of Benefits

Effective Date: July 1, 2025

Previous Policy

Introduction

Do not close or deny individuals who are incarcerated (such as, a jail, prison or juvenile correctional facility). While incarcerated an individual will still be CHIP eligible, but their CHIP benefits will be suspended. Individuals with suspended benefits qualify only for coverage when they are within 30 days of release. Incarcerated individuals may be eligible for pre-release services. See 600.

1. Setting Suspensions and Completing Reviews
   1. For an ongoing member, suspension of benefits will begin the day following incarceration.
      1. The suspended individual’s review month will not change.
   2. The agency must conduct reviews for cases under suspension. Reviews will follow the review process outlined in 704 (Conduct an ex parte review whenever possible).  Reviews are required every 12 months for suspended individuals.
   3. For applications received while incarcerated see 701-6 .
2. Removing the suspension
   1. End the suspension the day before release.
   2. The review month will not change.