Children’s Health Insurance Program (CHIP)

Health insurance is not optional — especially for children who are still growing and vulnerable to illness and injury. However, for parents with limited financial resources, private health insurance is simply a luxury they can’t afford.

For this reason, CHIP puts health coverage within reach for uninsured children in low-income families who might otherwise go without care.

CHIP + Medicaid

Both programs are an effort from the national federal government and local state governments to provide free or low-cost health coverage for our nation’s children, covering nearly 40% children overall.

While Medicaid is often the first choice for many low-income families, some earn too much to qualify for coverage yet too little to afford private insurance on their own.

For those above the Medicaid limit, CHIP comes in to bridge the gap, as it aims to cover uninsured children in families that fit into this stuck-in-the-middle category. In some states, CHIP covers parents and pregnant women.

CHIP FAQ

Are my KIDS eligible for CHIP?

These programs are state-specific, but in most states, uninsured children under the age of 19 in families with incomes up to 200% of the federal poverty level, are likely to be eligible for coverage.

While the funding is a collaborative effort from both federal and state governments, it is usually up to the states to design their policies and eligibility standards.

Currently, 10 states including District of Columbia operate CHIP through their Medicaid program; 2 states — Connecticut and Washington, operate a separate CHIP program; and 38 states use a combination approach.

What services does CHIP cover?

The benefit packages vary among states, but all tend to include

1. regular checkups,
2. eye exams and glasses,
3. dental cleanings and filings,
4. vaccinations,
5. prescription drugs,
6. access to medical specialists,
7. mental health care,
8. hospital care,
9. x-rays,
10. lab tests,
11. treatment of pre-existing needs and
12. treatment of other special health needs.

How much do I pay for CHIP?

States set CHIP premiums within federal guidelines. CHIP premiums are often determined on a sliding scale and cost-sharing is capped at 5% of total family income.

More than half of states do not charge premiums for separate CHIP coverage for families at 151% FPL.

In the those states that charge premiums for separate CHIP coverage at this income level, the average monthly premium is about $18 per child per month. ¹

How do I apply for CHIP?

To get started, make a free call to (877) KIDS NOW (543-7669) where you’ll be connected directly to a representative from your state who will help you apply.

You may probably want to use this screener tool  at HealthCare.gov to see if you and your family qualify for CHIP and Medicaid.

What if I’m denied for CHIP coverage?

If you’ve been denied for Medicaid or Children’s Health Insurance Program (CHIP) coverage by your state, you may be able to buy “subsidized private coverage” through the Marketplace instead.