1. Health

CHIP - The Children’s Health Insurance Program

CHIP Benefits and Eligibility

By

Updated August 05, 2013

CHIP - The Children’s Health Insurance Program

Learn about the CHIP program in your state.

Getty Images

What is CHIP?

The Children’s Health Insurance Program (CHIP), created by Congress in 1997, is a partnership between the federal government and the states to extend health coverage to uninsured children and pregnant women in families who cannot afford to purchase private health insurance but have incomes too high to qualify for Medicaid.

Your state has the option to either expand its Medicaid program to include people who are eligible for CHIP or create a separate state program.

A Dr. Mike CHIP fact: In 2008 more than 7.3 million children received services from the Children’s Health Insurance program.

On February 4, 2009, President Obama signed into law the Children's Health Insurance Program Reauthorization Act (CHIPRA), which renews and expands CHIP from 7 million children to 11 million children. The new law also pays for CHIP through 2013.

Who Is Eligible for CHIP?

If you cannot afford to buy private health insurance and your family earns too much to qualify for Medicaid, you may be eligible for CHIP.

Each of the states and the District of Columbia has different eligibility rules. However, in most states, uninsured children who are 18 and younger whose families earn up to $44,100 a year (for a family of four) may be eligible.

The annual income figure varies depending on the size of your family. For example, for a family of two the income limit is $29,140 a year and for a family of six the income limit is $59,060 a year.

CHIP and Health Reform

If your children are currently enrolled in the CHIP program in your state, it is unlikely that you will notice any changes in your children’s benefits or where they receive care due to the passage of the Patient Protection and Affordable Care Act (health reform) in March 2010.

The health reform law requires your state to maintain the current eligibility in CHIP until 2019. The bill also extends funding for CHIP through 2015.

How Much Will CHIP Cost Me?

Depending on your income and the state you live in, you may have to pay a small monthly premium to receive coverage. Some states also have an enrollment fee or copayments for healthcare services. For example, the state of Colorado charges $35 to enroll two or more children and has a copayment of $2 to $5 for a doctor’s visit and to fill a prescription.

The fees required by the states are often very low and may be related to your income. For example, in New York State, you may be eligible to enroll your children in CHIP with a higher income and pay a monthly premium of $9. And, in Illinois, a family of four with an annual income between $44,000 and $66,156 would have to pay a monthly premium of $40 for each child.

What Are the CHIP Benefits?

Although your state can create its own set of benefits for CHIP, each state is required to cover the following services:

  • routine check-ups
  • immunizations
  • dental care
  • inpatient and outpatient hospital care
  • Emergency room visits
  • laboratory and x-ray services

As previously mentioned, your state can require that you share in the cost of CHIP through monthly premiums and copayments for services. However, preventive care must be provided at no cost to you.

Where Can I Find Information About My State’s CHIP?

One of the best resources for information about CHIP is the government-sponsored website InsureKidsNow.

This site provides information about CHIP and Medicaid and, using an interactive map, gives you access to CHIP in all 50 states and the District of Columbia. The site also has a hotline and you can watch a video that features families who have benefited from CHIP.

Why Is CHIP Important?

In his remarks when he signed the Children’s Health Insurance Program Reauthorization Act, President Obama said the following:

“No child in America should be receiving her primary care in the emergency room in the middle of the night. No child should be falling behind at school because he can’t hear the teacher or see the blackboard. I refuse to accept that millions of our kids fail to reach their full potential because we fail to meet their basic needs. In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation – health care for our children is one of those obligations.”

And, “Since it was created more than ten years ago, the Children’s Health Insurance Program has been a lifeline for millions of kids whose parents work full time, and don’t qualify for Medicaid, but through no fault of their own don’t have – and can’t afford – private insurance. For millions of kids who fall into that gap, CHIP has provided care when they’re sick and preventative services to help them stay well."

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.