The Children’s Health Insurance Program (CHIP) is a United States federal program that provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government. It was designed to cover uninsured children in families with incomes that are too high to qualify for Medicaid but too low to afford private coverage.
What kind of protection does it provide?
CHIP coverage varies by state, but all states provide comprehensive coverage, including:
- Routine check-ups
- Immunizations
- Doctor visits
- Prescriptions
- Dental and vision care
- Inpatient and outpatient hospital care
- Laboratory and X-ray services
- Emergency services
States may offer additional benefits.
Relationship with Medicaid
CHIP is related to Medicaid in that both are federal-state partnerships designed to provide health coverage to eligible individuals. While Medicaid primarily serves low-income adults, pregnant women, elderly adults, and people with disabilities, CHIP focuses on providing coverage for uninsured children who do not qualify for Medicaid due to their family’s income level. In some states, CHIP covers pregnant women as well.
Eligibility Criteria
Eligibility criteria for CHIP vary by state but are primarily based on the child’s age, family income, residency, and citizenship or immigration status. Generally, children up to age 19 who are not covered by health insurance may be eligible if their family’s income is too high for Medicaid eligibility but does not exceed the state’s CHIP income limits.
How to Apply
Families can apply for CHIP in several ways:
- Through the Health Insurance Marketplace by filling out an application at healthcare.gov
- Directly through their state’s Medicaid or CHIP agency
- By calling the toll-free number 1-800-318-2596
When you apply for the Marketplace, you’ll find out if your children qualify for CHIP. If they do, you won’t be eligible for premium tax credits and other savings on Marketplace plans.
Accumulation with Other Benefits
CHIP can work in conjunction with other benefits, but it primarily serves as a standalone coverage program for children who don’t qualify for Medicaid and don’t have access to affordable health insurance. Benefits and coverage might vary, and in some instances, if a child is covered by another health insurance plan, they might not qualify for CHIP.
For detailed information about CHIP, including specific eligibility criteria and how to apply in your state, it’s best to contact your state’s Medicaid or CHIP office directly or visit healthcare.gov.
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