Eligibility & Paying for CLIP
Is my child eligible for Medicaid?
If a child was eligible for Medicaid prior to admission to CLIP, they will continue to be eligible during their treatment at CLIP. If a child was not eligible for Medicaid prior to their CLIP admission, they will be eligible now due to Medicaid’s Categorically Needy (CN) program.
How is eligibility determined?
Eligibility is determined based on income under the child’s name and the need for longer-term treatment.
CLIP treatment is very costly. The average monthly charge ranges from $14,000 to $25,000. Most youth stay in treatment for at least six months. Very few families can afford this level of treatment so the National Medicaid rule allows children to be eligible for Medicaid due to their need for longer-term inpatient psychiatric treatment. Together federal and state governments share the total cost of the child’s treatment based on his or her eligibility for Medicaid. The federal government decided that any income of the child (not the family) must help to pay towards this total cost.
What are examples of income under a child's name?
What do I have to pay for my child’s care at the CLIP Program?
Most families do not have to pay anything towards their child’s cost of CLIP care. But there are exceptions.
How do I know if we have something to pay?
There are a few different reasons why your child may be required to pay part of the cost of their CLIP care. United States’ law requires our state to review money of income that is in a child’s name. The CLIP program may also bill a parent/guardian’s private insurance. Please ask the admission counselor about this clause and if it applies to you and your family.
At admission, all parents or guardians will need to fill out an application for benefits for their child. A Department of Social and Health Services Office (CSO) worker will review the application.
The review occurs to:
1) Establish that your child is now in a long-term (more than three months) inpatient setting
2) Review any income in the child’s name, and
3) Review if there is a child income(s) and determine what the participation amount will be
What if I already use the child’s income to pay for other crucial household expenses?
We ask you to take a close look at your household budget and think about what you can cut in order to follow the federal rules. If you would lose you housing or your child's discharge will be affected because of this payment, please talk to your primary contact at the CLIP program. We may be able to work out a payments arrangement or find ways to help with the child’s participation amount.