State Affairs and Government

CHAPTER 42-12.3
Health Care for Children and Pregnant Women

SECTION 42-12.3-9

§ 42-12.3-9. Insurance coverage – Third party insurance.

(a) No payment will be made nor service provided in the RIte Start or RIte Track program with respect to any health care that is covered or would be covered, by any employee welfare benefit plan under which a woman or child is either covered or eligible to be covered either as an employee or dependent, whether or not coverage under such plan is elected.

(b) A premium may be charged for participation in the RIte Track or RIte Start programs for eligible individuals whose family incomes are in excess of two hundred fifty percent (250%) of the federal poverty level and who have voluntarily terminated health care insurance within one year of the date of application for benefits under this chapter.

(c) Every family who is eligible to participate in the RIte Track program, who has an additional child who because of age is not eligible for RIte Track, or whose child becomes ineligible for RIte Track because of his or her age, may be offered by the managed care provider with whom the family is enrolled, the opportunity to enroll such ineligible child or children in the same managed care program on a self-pay basis at the same cost, charge or premium as is being charged to the state under the provisions of this chapter for other covered children within the managed care program. The family may also purchase a package of enhanced services at the same cost or charge to the department.

History of Section.
(P.L. 1993, ch. 398, § 1.)