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 for each county. All counties have more than one company to choose from, but all of the companies offer the same CHIP benefit package.


If your child currently has a doctor, contact your doctor's office and find out which CHIP providers your doctor is participating with from the list below so that your child may continue to see the same doctor while on CHIP insurance. You can also ask people you trust for a doctor they would recommend and then find out from that doctor the insurance providers with which they participate.

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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 provider 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 what payment options they offer.

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Is this real insurance, and what sort of service could I expect?
Absolutely. CHIP is real insurance from quality insurance providers 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.

Note: For children in the reduced premium programs (those not qualifying for Free CHIP), the families will also pay a portion of the premium.

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I am a parent and need insurance too - does CHIP cover me?
CHIP is only available to children and teens up to age 19. For other options for families and adults, please visit www.insurance.pa.gov or shop on the Federal Health Insurance Marketplace, by visiting www.healthcare.gov.

When applying online through the COMPASS website, you may also apply for yourself with your children and your application will automatically be forwarded to Medical Assistance (if you qualify) or to the Federally Facilitated Marketplace to provide you with various insurance options.

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?
During the month in which your child turns age 19, your CHIP health insurance provider will automatically refer your child to your local county assistance office (CAO) for an eligibility determination for Medical Assistance (Medicaid). Your child will remain enrolled in CHIP until the end of the month.  At that time, Medical Assistance will determine their eligibility for Medical Assistance.

Note: The CAO will contact you if additional information is needed.  It is important that you cooperate with the CAO should they request any additional information to complete the application. For additional options, please visit www.PAHealthOptions.com or, to shop on the Federal Health Insurance Marketplace, please visit 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 all of the following promptly: 

- 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 Department of Human Services. You may also receive more detailed information from the Pennsylvania Department of Human Services, including the time and date that a phone interview will be held, if needed.

It is important that you provide this information and respond promptly to prevent any break in insurance coverage.  If you have a break in insurance coverage, you may be assessed a tax penalty from the federal government.  For more information about tax penalties go to www.irs.gov

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I'm not satisfied with the insurance company I chose. Can I change companies?
Yes you may choose another CHIP company that provides insurance in your county of residence. If you wish to change companies, please contact your current CHIP provider and request the change.  They can transfer your application to the new company that you select.

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 new CHIP insurance provider which you are considering.

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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 provider 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 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 all of the following promptly:

- 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 Department of Human Services. You may also receive more detailed information from the Pennsylvania Department of Human Services, including the time and date that a phone interview will be held, if needed.

It is important that you provide this information and respond promptly to prevent any break in insurance coverage. If you have a break in insurance coverage, you may be assessed a tax penalty from the federal government. For more information about tax penalties go to www.irs.gov for details.

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I have more questions. What should I do?
Couldn't find the answer you're looking for in these questions and answers? Perhaps your answer is located 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.