Overview of CHIP
There are a lot of reasons why kids or teens might not have health insurance —maybe their parents lost a job, don't have health insurance at work, or maybe other options just cost too much.
Whatever the reason, if your child or teen is uninsured and ineligible for Medicaid, the Children's Health Insurance Program — or CHIP — may be able to help. Having high-quality, low-cost health insurance helps put your mind at ease and puts your children in a better position to thrive and grow into healthy adults.
Children who have health insurance generally have better health throughout their childhood and into their teens. They are more likely to:
- Receive needed shots that prevent disease
- Get treatment for recurring illnesses such as ear infections and asthma
- Access preventive care that keeps them healthy
- Get sick less frequently
- Receive the treatment they need when they are sick
- Maintain better attendance and performance at school
Coverage through CHIP provides your kids with all of these valuable advantages.
CHIP is brought to you by leading health insurance companies. You'll have a choice of major insurance companies with networks of physicians, specialists, and care facilities near you. Your kids may even be able to keep visiting the same doctors they see today.
Benefits
CHIP is there for your kids with quality, comprehensive health insurance coverage for routine doctor visits, prescriptions, dental care, eye care, and much more, including:
- Immunizations
- Hearing services
- Emergency care
- Mental health services
- Hospitalization
- Durable medical equipment
- Substance abuse treatment
- Partial hospitalization for mental health services
- Rehabilitation therapies
- Home health care
- Maternity care
- Hospice and palliative services
- Medically necessary orthodontia
- Autism Spectrum Disorder and related services
Eligibility
Many kids receive CHIP for free, others can get the same benefits at a low cost.
Your child or teen may be eligible if they meet the following requirements:
- Under 19 years of age
- A U.S. citizen, U.S. national, or qualified immigrant
- A resident of Pennsylvania
- Uninsured and not eligible for Medicaid
Parents may think their kids can't get CHIP because they make too much money, but this is not true! CHIP covers uninsured kids and teens up to age 19 who are not eligible for Medicaid.
For most families, CHIP is free. What you pay depends on the number of members of your household, as well as total household income. Families with incomes above the free CHIP limits will pay low monthly premiums and co-pays for some services. View income and eligibility information.
There are no exclusions for pre-existing conditions in CHIP or Medicaid. However, if your child has a serious medical condition or disability, they may be considered for Medicaid.
Annual Enrollment
Once enrolled, children are guaranteed 12 months of CHIP coverage unless they no longer meet the basic eligibility requirements. Families must renew their coverage every year so that your child's CHIP coverage continues. CHIP insurance companies send renewal notices 60 days before your benefits are going to end, and families must fill out and send the renewal information back to their CHIP insurance company in order for benefits to continue.
Application Process
Applying for CHIP is easy.
You can apply for CHIP online, by phone, or by mail. You will need to have the following information ready:
- Income amounts for your entire household before taxes: This includes income from employment and all other forms of income (for example: social security, pension, workers' compensation, unemployment, child support, etc.)
- Social Security Numbers and birthdates for all applicants
- Day care expenses for your household (if any)
- Work transportation expenses for your household (if any)
- Private health insurance information (if you have or had private health insurance in the last 90 days)
Note: Your application is for healthcare for children, so depending on household income and other factors, your child will be placed in the appropriate healthcare program. That may be Medicaid, CHIP, or a referral to Pennie, Pennsylvania's health insurance marketplace.
Apply for CHIP
Once you’ve gathered the necessary information, you can apply for CHIP online, by phone, or by mail.
Frequently Asked Questions about CHIP
Absolutely. CHIP is real insurance from quality insurance providers that have offered health insurance products for decades. You can expect quality service, as well as a comprehensive benefit package.
No. The insurance cards you receive look like any other card from the insurance provider you choose and do not have the CHIP logo on them.
The CHIP application requires that you provide information including income for everyone who lives with you and everyone who is expected to be included on your tax return, even if they do not live with you. CHIP has rules that determine who is included and those that are not included when determining eligibility.
As the legal guardian of a child, you can apply for healthcare on their behalf. When you apply for CHIP, your income will only be counted if you have legally adopted your grandchild/niece/nephew.
During the month in which your child turns 19, your local county assistance office (CAO) will review whether they are eligible for Medicaid. Your child will remain enrolled in CHIP until the end of the month in which they turn 19.
Note: The CAO will contact you if additional information is needed. It is important that you respond to the CAO so that your child's Medicaid eligibility can be decided in a timely manner and so that they do not risk a gap or loss of health insurance coverage.