Eligibility & Benefits
Eligibility & Benefits
No family makes too much money for CHIP. Most kids receive CHIP for free. Others can get the same benefits at a low cost. If your income is below the lowest amount listed, your child or teen may be enrolled in Medical Assistance. Learn more about how to qualify for CHIP, what it covers and how to apply by watching our YouTube videos.
How do I know if my child qualifies?*
Based on your family size and income, your child or teen may be eligible if he or she meets the following requirements:
- Under 19 years of age
- A U.S. Citizen, U.S. National or Qualified Alien
- A resident of Pennsylvania
- Uninsured and not eligible for Medical Assistance
An average family of four making $47,100 qualifies for free CHIP. View complete income information here.
Information for Grandparents
*Like parents, if you're a grandparent, coverage for your grandchildren is based on your income. Read more to find out if you are covered.
Information for Immigrants
* Children legally residing in Pennsylvania are eligible for CHIP regardless of your parents' immigration status. Read more to find out if you are covered.
* All new applicants whose income falls in the low-cost and full-cost CHIP ranges must also show that the child(ren) has been uninsured for six months, unless the child is under the age of two, the child has lost health insurance because a parent lost their job or the child is moving from another public insurance program. This does not apply to families who qualify for Free CHIP. Free CHIP children do not have to be uninsured for six months.
Watch our YouTube videos to see how CHIP covers childhood adventures! CHIP is there for your kids with quality, comprehensive health insurance coverage for routine doctor visits, prescriptions, dental, eye care and much more, including:
- Routine Check-ups & Well Visits
- Prescription Drugs
- Dental, Vision, Hearing Services
- Emergency Care
- Mental Health Benefits
- Durable Medical Equipment
- Substance Abuse Treatment
- Partial Hospitalization for Mental Health Services
- Rehabilitation Therapies
- Home Health Care
- Maternity Care
Includes emergency, preventive, routine exams (every six months), as well as root canals, crowns, periodontics and oral surgery for removal of partially or fully impacted wisdom teeth. Effective January 1, 2011, CHIP will cover medically necessary orthodontics up to a $5,200 lifetime maximum for dental problems that interfere with speaking, eating or breathing. Coverage for orthodontics is subject to prior authorization from the child's CHIP health plan.
If you'd like to learn more about the dental providers offered by CHIP insurance companies, please click on the links below.
- Aetna Health Inc.
- Capital BlueCross (Keystone Health Plan Central)
- Geisinger Health Plan
- Kidz Partners (Health Partners of Philadelphia, Inc.)
- Keystone Health Plan West (Highmark)
- Highmark Central Region
- Keystone Health Plan East (Independence Blue Cross)
- First Priority Health (BCNEPA)
- UPMC for Kids (UPMC Health Plan)
- United Healthcare Community Plan
CHIP is a comprehensive benefit package and the benefits -- such as dental -- cannot be purchased separately.
Includes emergency, preventive, and routine eye care, as well as the cost of exams, corrective lenses (up to two prescriptions per year), frames and medically necessary contact lenses.
Includes emergency and preventive care, as well as the cost of examinations and hearing devices.
Mental Health Services
Includes outpatient (50 visits per year) and inpatient mental health services (90 days in combination with medical admissions).
Substance Abuse Services
Includes detoxification, non-hospital residential placement, partial hospitalization and outpatient counseling.
Includes palliative (pain relief) and support services, professional services of an RN or LPN and medical care provided by a physician affiliated with the hospice agency.
FREQUENTLY ASKED QUESTIONS
Do you have questions about the CHIP program and how it works? Take a moment to review frequently asked questions.
Or view these common questions:
Tell A Friend
If you think CHIP could help someone you know, please fill out the information below and we'll send them an e-mail. Telling your friends, families and co-workers about CHIP has always been the best way to spread the word–and good health.