FAQ: About Your CHIP Coverage

How do I pick a health insurance company?
As long as you know what county you live in, your choice is simple. On our Web site, you will find the list of health insurance companies offering CHIP broken out by county. All counties have more than one company to choose from, but all of the companies offer the same CHIP benefit package.

We can't tell you which company to choose, but we can help you make a decision if you are having trouble deciding. If your child currently has a doctor, contact your doctor's office and find out if he/she participates with the CHIP companies listed below so that you can continue to go to that doctor after you choose the CHIP insurance company. You can also ask people you trust for a doctor they recommend.

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Will my insurance card say my child is on CHIP?
No. The insurance cards you receive look like any other card from the insurance company you choose and do not have the CHIP logo on them.

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Can I pay my monthly CHIP premium online from my checking account?
For payment questions, you will need to call your CHIP provider and to find out your options.

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Is this real insurance, and what sort of service could I expect?
Absolutely. CHIP is real insurance from real insurance companies that have offered health insurance products for decades. You can expect quality service, as well as a comprehensive benefit package.

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Who pays for this?
CHIP is funded by three sources: the federal government, the state's general fund and by a tax collected on cigarettes sold in Pennsylvania.

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I am a parent and need insurance too - does CHIP cover me?
At this time, CHIP is available only to those up to children up to age 19. For options, please visit www.PAHealthOptions.com or, to shop on the Federal Health Insurance Marketplace, please vist www.healthcare.gov. Also, there are many free or low-cost health services available in Pennsylvania if you meet certain income requirements. More information on these services can be found here.

 
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What happens after my child turns 19?
A month before your child turns age 19, your CHIP health insurance company will automatically refer your child to your local county assistance office (CAO) for an eligibility determination for Medical Assistance (Medicaid). Please be sure to cooperate with the CAO should they request any additional information. For options, please visit www.PAHealthOptions.com or, to shop on the Federal Health Insurance Marketplace, please vist www.healthcare.gov. Also, there are many free or low-cost health services available in Pennsylvania if you meet certain income requirements. More information on these services can be found here.

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I just got a notice that our CHIP insurance is going to be cancelled - what do I do?
If you believe that your CHIP benefits are being cancelled or changed in error, we encourage you to call your CHIP health plan first so that they can discuss their decision with you. You will find their toll-free number on the letter that you have received. After you talk to them, if you still do not agree with their decision, or if you choose not to call them to discuss the decision, you may submit a written request to them for an impartial review within 30 days from the date of the letter. You can send your written request to the address listed on your letter. Please submit:
- a written, dated request stating why you disagree with their decision
- a copy of the entire letter you received
- any additional documentation to support your case
- a phone number where you can be reached during the day

They may contact you for more information. If they cannot resolve your issue, they will forward your written request and any additional information to the Pennsylvania Insurance Department. You may also receive more detailed information from the Pennsylvania Insurance Department, including the time and date that a phone interview will be held, if needed.

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I'm not happy with the insurance company I chose. Can I change companies?
If there are other CHIP insurance company contractors in your county, you may choose another CHIP company. If you wish to change companies, please contact your current CHIP company and request the change.

Also, if you wish to stay with your current Primary Care Physician, please call your physician to be sure that he/she participates with the other CHIP company.

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Help - I lost my insurance card! Can I get a new one?
If you lost your insurance card - don't panic! Simply contact your CHIP insurance company and request a new card.

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I was denied for CHIP and I disagree with the reasons why. Can I appeal the decision?
Yes. If you do not agree with this decision, we encourage you to call tyour CHIP health plan first so that they can discuss their decision with you. You will find their toll-free number on the letter that you have received. After you talk to them, if you still do not agree with their decision, or if you choose not to call them to discuss the decision, you may submit a written request to them for an impartial review within 30 days from the date of the letter. You can send your written request to the address listed on your letter. Please submit:
- a written, dated request stating why you disagree with their decision
- a copy of the entire letter you received
- any additional documentation to support your case
- a phone number where you can be reached during the day

They may contact you for more information. If they cannot resolve your issue, they will forward your written request and any additional information to the Pennsylvania Insurance Department. You may also receive more detailed information from the Pennsylvania Insurance Department, including the time and date that a phone interview will be held, if needed.

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I have more questions. What should I do?
Couldn't find the answer you're looking for? Maybe it's under another category in our FAQ section. Check it out.

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FREQUENTLY ASKED QUESTIONS

For questions about coverage and benefits, contact a CHIP health insurance company.

To find health insurance companies that offer CHIP in your area search by county.