Health insurance is not optional — especially for children who are still growing and vulnerable to a wide range of injuries and illnesses.
In 2013, the U.S. Census Bureau reported that 5.3% of children under age 19 were without health insurance.1
Not surprisingly, children from lower income families (7.5%) were more likely to be uninsured.
For many single mothers strapped for cash, health insurance is simply a luxury they just can’t afford.
And for this reason, children from single-parent families — the group arguably the most in need of health insurance — are among the highest uninsured demographic in the U.S.
CHIP & Medicaid
Both programs are an effort from the national federal government and local state governments to provide free or low-cost health coverage to more than one in three children.
In June 2013, over 28 million children were enrolled in Medicaid and another 5.7 million were enrolled in CHIP.2
Medicaid is the first choice for many low-income families, as this program deals specifically with insuring children from very low-income families — those with income up to 138% of the poverty level.
However, some families may earn ‘too much’ to qualify for Medicaid benefits but whose income is ‘too little’ to afford getting 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.3 In some states, CHIP covers parents and pregnant women.
Are my KIDS eligible for CHIP?
These programs are state-specific, but in most states, uninsured children under the age of 19, whose families earn up to about $47,700 annually for a single mother of two, are likely to be eligible for coverage.4
Under the Affordable Care Act, more than half of the states (29, including D.C.) cover children in families with incomes at or above 250% FPL and 19, including D.C., cover children in families with incomes at or above 300% FPL.
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, 7 states including District of Columbia operate CHIP through their Medicaid program; 15 states operate a separate CHIP program; and 28 states use a combination approach.
What CHIP Covers?
The benefit packages vary among states, but all tend to include
- regular checkups,
- eye exams and glasses,
- dental cleanings and filings,
- prescription drugs,
- access to medical specialists,
- mental health care,
- hospital care,
- lab tests,
- treatment of pre-existing needs and
- treatment of other special health needs.
How do I Apply?
To get started, make a free call to 1-877 KIDS NOW (1-877-543-7669) 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 Medicaid or 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.
- U.S. Census Bureau, Health Insurance Coverage in the United States: 2015 [↩]
- Medicaid Enrollment: June 2013 Snapshot and CHIP Enrollment: June 2013 Snapshot [↩]
- Enrolling More Kids in Medicaid and CHIP [↩]
- The average CHIP income eligibility level for children is 241% of the Federal Poverty Level – Medicaid.gov [↩]