The Delaware Healthy Children Program is a low-cost health insurance program for Delaware’s uninsured children. The Delaware Healthy Children Program features the same high-quality coverage you’d get with some of the best private insurance plans.
How to apply for the Delaware Healthy Children Program
| Online | In Person | |
|---|---|---|
| Apply online through ASSIST | Complete and mail this form in English or Spanish and mail it, along with required documents, to: Delaware Healthy Children Program P.O. Box 950 New Castle, DE 19720 | At your local state service center |
Need an application?
Call the Delaware Healthy Children Program at 1-800-996-9969 to request a copy of the form.
Applications are readily available in English, Spanish, Haitian Creole, Mandarin, and Arabic. If you need an application in another language, one can be provided for you.
Along with your signed and completed application, you may be asked to provide:
- Proof of citizenship and identity, or immigration status;
- Proof of family income – a full month’s paystubs, award letters, or latest tax return if self-employed.
Once our child’s application has been submitted and a determination is made, you will receive a notice in the mail informing you of the DSS determination.
DHCP FAQ
What does the Delaware Healthy Children Program cover?
The Delaware Healthy Children Program covers everything from routine checkups to eye exams to doctor and hospital services. As of July 1, 2024, Delaware no longer requires DHCP members to pay premiums. Also, Children enrolled in DHCP do not have copays for medical services or prescriptions, unless they have a non-emergency visit to a hospital emergency room.
Covered services include:
- Well-baby and well-child checkups
- Drug/alcohol abuse treatment
- Speech/hearing therapy
- Immunizations
- Physical therapy
- Eye exams
- Ambulance services
- Prescription drugs
- Hospital Care
- Physician services
- X-rays
- Lab work
- Assistive technology
- Mental health counseling
- Limited home health and nursing care
- Case management and coordination
- Hospice care
- Non-Emergency Medical Transportation (NEMT)
- Prescribed Pediatric Extended Care (PPEC)
- Comprehensive Dental services – including oral exams, x-rays, cleanings, fluoride applications, fillings, and other restorative and specialty services. Orthodontic care is also available for children who meet specific program guidelines.
How do I know if my children are eligible?
Uninsured children who live in families with countable income at or below 212% of the Federal Poverty Level are eligible for coverage if they:
- Are under the age of 19 and reside in the State of Delaware
- Uninsured or do not have comprehensive health insurance
- Are U.S. citizens or legally-residing noncitizens
- Are not dependents of a permanent State of Delaware employee
and
What if my child already has some health coverage?
Children who already have comprehensive health insurance are not eligible for the Delaware Healthy Children Program. Comprehensive health insurance means a plan that provides coverage for hospitalization, doctor visits, X-rays, and lab work. A child with more limited coverage may still be eligible for coverage through the Delaware Healthy Children Program.
What is a qualified non-citizen?
In general, children eligible for the Delaware Healthy Children Program (DHCP) must be U.S. citizens. However, the federal government classifies some non-citizen children as “qualified aliens.” These children may be eligible. Also, remember that some children born outside of the U.S. may be citizens.
Examples of non-citizen children who may be eligible:
- Lawful permanent residents who entered the U.S. before August 22, 1996
- Parolees of more than one year and conditional entrants
- Refugees, asylees, and those whose deportation has been withheld
- Cuban and Haitian entrants
- Amerasians
- Dependents of veterans and active-duty military personnel
Many other groups of non-citizen children may be eligible. Call the Delaware Healthy Children Program at 1-800-996-9969 or Customer Relations at 302-571-4900 more information.
Are the children of State of Delaware employees eligible?
Children of permanent State of Delaware employees are not eligible for the Delaware Healthy Children Program. However, children of seasonal, casual or temporary state employees can get coverage through the program if they meet the income guidelines. In some cases, children of permanent State of Delaware employees may be eligible to receive Delaware Medicaid.
The Delaware Healthy Children Program uses federal funds from Title XXI of the Social Security Act – the State Children’s Health Insurance Program (SCHIP). By federal law, these funds cannot be used for dependents of state employees.
What about pre-existing conditions or medical eligibility?
The Delaware Healthy Children Program (DHCP) does not exclude children because of pre-existing health conditions. We do not consider a child’s medical condition(s) in the determination of eligibility for the DHCP.
Delaware does offer a Medicaid program for children with severe disabilities who would otherwise qualify to be cared for in an institutional setting. This Medicaid program is the Children’s Community Alternative Disability Program (CCADP). For more information, please call Division of Medicaid and Medical Assistance Central Intake Unit at 1-866-940-8963.
How often does the Delaware Healthy Children Program review eligibility?
Who provides the insurance?
Delaware provides a choice of different managed care plans so that you can select the plan that is best suited to your child’s needs. Delaware contracts with three Managed Care plans – AmeriHealth Caritas, Delaware First Health, and Highmark Health Options.
Are dental services covered?
Dental services are covered at no cost for children visiting dentists that are enrolled with the Delaware Medical Assistance Program (DMAP). Some services may require prior authorization.
- Oral exams
- Cleanings
- X-Rays
- Fillings
- Extractions
- Root canals
- Crowns
- Oral surgery
- Orthodontic services
(Only Handicapping Malocclusion; must qualify)
What about pre-existing conditions?
DHCP does not exclude children because of pre-existing health conditions. We do not consider a child’s medical condition(s) in the determination of eligibility for the DHCP.
Delaware does offer a Medicaid program for children with severe disabilities who would otherwise qualify to be cared for in an institutional setting. This Medicaid program is the Children’s Community Alternative Disability Program (CCADP). If you are interested in applying for CCADP, please call the Central Intake Unit (CIU) of the Division of Medicaid & Medical Assistance (DMMA) at 1-866-940-8963 to make a referral.
Does the benefit include transportation to medical appointments?
Non-Emergency Medical Transportation (NEMT) is provided to and from medical and dental appointments only when a member has no other means of transportation. Please contact Delaware’s non-emergency transportation broker Modivcare at 1-866-412-3778.
Does the benefit include Prescribed Pediatric Extended Care (PPEC)?
PPEC is provided to a DHCP member even if they do not participate in the Children’s Community Alternative Disability Program (CCADP). PPEC is an alternative to institutionalization or community/home care for children with medically complex or special health care needs. Talk with your child’s Doctor to see if PPEC services would be a good fit for your child.
When will my coverage start?
After you’re approved for the program, you must choose a managed care plan. Please contact the Medicaid Health Benefits Manager at 1-800-996-9969 for assistance with enrollment in one of Delaware’s Managed Care Organizations. You will receive a notice telling you when your coverage begins.
