CHIP gives insurance to kids whose families make too much for Medicaid but not enough to pay for private coverage. Just like regular insurance plans, CHIP comes with certain costs like co-pays. But these fees depend on where you live.
The program gives kids access to providers and hospitals that specialize in child healthcare. Benefits include visits to the doctor, dental, labs, vision care and more. Depending on where you live, you may get additional benefits too. For example, Texas has a helpline that you can call 24 hours a day.
Information About CHIP Insurance
While CHIP is different from state to state, states are all required to provide certain coverage, including:
- Emergency help.
- Immunization shots.
- Visits to the doctor.
- Pharmacy services.
- Hospital care.
- Dental and vision.
Some services provided by CHIP will be free, like annual physicals. The costs for other services are based on the state. The same rule applies to premiums, as these are decided by the state. In any case, the federal government established that families can’t be charged over 5 percent of their yearly income. Premium charges are fixed, regardless of the number of kids in a family.
Parents are not able to get CHIP coverage. Only kids and teens qualify. Also, note that CHIP does not look at pre-existing conditions when deciding if a child can get benefits.
Find Information About CHIP Requirements
The main CHIP qualifications focus on the age of the children. Kids have to be 18 or younger. The second main requirement is that the family cannot qualify for Medicaid because they make too much money. The third requirement is that CHIP applicants have to legally reside in the U.S. and be residents of the state. Following the ACA in 2010, however, there was one more requirement that you could meet to get benefits. If you were the child of a public employee and you meet income requirements, you could submit a CHIP Medicaid application as well.
Every state sets its CHIP income guidelines. Washington D.C. and 46 states give families coverage if they earn up to 200 percent of the federal poverty level. The other states give families coverage if they earn up to 250 percent of the poverty limit.
Another eligibility group that can receive CHIP insurance now is pregnant women. However, this is only limited to certain states, such as Colorado, Missouri, New Jersey, Rhode Island and Virginia. The services covered by CHIP for pregnant women include prenatal care, delivery, and postpartum healthcare. Women who apply must meet income requirements to be eligible.
Learn How to Apply for CHIP
Each state handles its own CHIP enrollment procedure. There isn’t a defined enrollment period, which means that you can apply for CHIP at any time of year. Additionally, you can apply for CHIP in multiple ways in most states, including online, by mail and in person at a local office.
Many states allow you to apply for CHIP and Medicaid at the same time, with the same application form.
You can apply for CHIP through your state. This is possible by accessing the application form, filling it out and sending it to a local office. You can apply through the federal government, too. This is possible by using one of these methods below:
- You may call the CHIP number, 1-800-318-2596.
- You may go through the Health Insurance Marketplace to apply. The Marketplace will take a little longer to process the application because it must send your details to the right state department first, which you will work with to complete the application process.
If you want to apply conveniently, you may fill out a CHIP online application. Most states provide this option for easy access. You may also call your state’s CHIP phone number to apply by phone, if the option is provided. Nevertheless, you may also download an application form, fill it out and submit it at a local office.
Typically, you will find out about your CHIP application after 45 days. Keep in mind that you will need to provide certain documentation before your application is considered, such as documents to prove the identity of your household members and how much they earn.
If accepted into the CHIP program, you will pick a doctor as the next step after enrollment. You will have a whole network of providers to choose from. You will have a network of hospitals and clinics to choose from as well.
Find Out About CHIP Waiting Lists
The Children’s Health Insurance Program may have a waiting list for your child to receive benefits. But this depends on your state. In 2014, there was a law passed stating that these waiting lists cannot exceed a certain period of time, 90 days. In any case, there are exemptions to these waiting lists, which your child may meet. This means that there are waiting list preferences, and these are decided by the states.
One of the typical exemptions is a child who is no longer covered by Medicaid because their parents met the lifetime limit. Another common exemption is kids who were once covered by a COBRA health insurance plan. COBRA is basically the health plan that people can purchase when their employer coverage is ended. An example of when this may happen is a lay-off.
So if your child has been affected in one of the above ways, there is a chance that he or she may qualify for a waiting list exemption. If not, be sure to check with your state to see what the waiting list situation is. Different states have different waiting lists and will have different rules as they relate to preferences, as mentioned above.